2026/01/01 by Michela Tinelli, J. John Harris, Nicole Steils +7 · 1 voice
Health Professions · Social Sciences · #Homelessness and Social Issues #Elder Abuse and Neglect #Healthcare innovation and challenges
paper · doi:10.1155/hsc/6029421
openalex publication_date 2026/01/01 · openalex created_date 2026/04/17 · openalex updated_date 2026/07/22
This paper explores the economic implications of different support scenarios for individuals who self‐neglect whilst experiencing multiple exclusion homelessness (MEH) or hoarding behaviour (HB). It draws on analysis of six Safeguarding Adults Reviews (SARs) of self‐neglect‐related deaths from across English localities. Focused on the last one or 2 years of an individual’s life, the SARs provide a detailed examination of resource utilisation across various sectors. The study employs economic modelling to compare the costs associated with ‘unmet needs’, the scenario that ended in death, and the potential costs and benefits derived from meeting these needs more effectively. Sensitivity analyses test the robustness of the model, exploring various budgetary adjustments. For MEH cases, the analysis suggests that shifting from uncoordinated use of urgent and emergency services to planned multidisciplinary support for individuals could free up public resources, enabling reinvestment and better outcomes. The study indicates potential cost savings, emphasising the importance of timely and coordinated interventions to improve the well‐being of individuals experiencing MEH. In HB cases, addressing gaps in responses to self‐neglect among older individuals requires increased resource investment mainly for housing and adult social care but also demonstrates a release of resources for health and a significant reduction in costs for criminal justice and fire and rescue services. The study highlights the role of local voluntary sector groups in providing support and guidance. The study evidences the importance of a multidisciplinary approach, early interventions, and ongoing collaboration among diverse professionals to ensure a holistic response to the complex needs of vulnerable populations. It emphasises the need for continuous collection of quality data, to enable service evaluation and facilitate efficient resource allocation for integrated care systems, and ultimately to contribute to better outcomes for individuals experiencing self‐neglect.