Frontline workers suffer stress, grief and burnout as homelessness numbers grow

Jessica Greenhalgh, Research Assistant at the University of Stirling and lead author of the review, said: “Our findings show the psychological impact on homelessness workers of repeated exposure to client death. These workers are in a different position to emergency workers, as the people they support are usually known to them, from repeated interactions. It is imperative that structured, evidence-based support is provided to these staff, to avoid the risk of stress, burnout and staff leaving their jobs – especially at a time when homelessness is such a mounting public and political concern.”

While The Salvation Army’s harm reduction approach has placed a significant focus on reducing harm to staff, the church and charity has welcomed this research as a way of affirming that approach and developing it further in support of officers and employees working across services in the UK and Ireland.

Giving voice to grief and stress

Lee Ball, The Salvation Army’s Director of Addictions, said: “This report is hard to read, but it is right that these experiences are spoken about. It shines a light on something many frontline workers know only too well. When you spend months or years alongside people, supporting them through some of the most difficult periods of their lives, you don’t leave those relationships at the office door.

“When someone dies, it hurts. That’s the simple truth. What this review does so well is give voice to the grief, stress and emotional weight that can come with frontline work. These are difficult conversations, but they are honest ones, and they matter.

“We’ve always believed that harm reduction is as much about looking after our workforce as it is about looking after the people we support. It’s encouraging to see many of the ideas in this review reflected in the way we already think and work, but we should never stop asking how we can do better.

“Our staff are our most valuable asset. If we want compassionate, relationship-based support for people experiencing homelessness, poor mental health, substance use and sometimes trauma, we must be just as committed to caring for the people who provide it.”

Drive to end rough sleeping

Prime Minister Andy Burnham used his first speech in office to announce a drive to ending rough sleeping, with an additional £340 million in funding.

As of June 2025, the number of households assessed as homeless and owed settled accommodation from their local authority were at the highest levels recorded in at least the last six years in England, Scotland, and Wales, according to the Office for National Statistics. The number of households in temporary accommodation is also at a record high in England, Scotland, and Wales; there were around 117,400 households in England, 16,300 households in Scotland, and 6,400 households in Wales living in temporary accommodation at the end of March 2024.

The paper is published in the Journal of Social Distress and Homelessness.

This review was funded as part of the work conducted by the Salvation Army Centre for Addiction Services and Research.