Experiences of health, care access, and recovery in people experiencing homelessness: a multi-perspective qualitative study

Given the adverse health outcomes and barriers to healthcare associated with homelessness, this study aimed to explore its impact on health, identify barriers to healthcare access, and examine perceived needs and effective interventions from the perspectives of people experiencing homelessness, individuals with lived experience of homelessness, and professionals working in health and social services. A qualitative study was conducted in Zaragoza, Spain, using semi-structured interviews with 27 participants, including people experiencing homelessness ( n = 11), individuals with lived experience of homelessness ( n = 7), and professionals ( n = 9). Participants were recruited through purposive sampling. Data were analysed using thematic analysis. Participants described homelessness as having a substantial impact on physical, mental, and social well-being. Mental health emerged as a major concern, with depression, anxiety, emotional distress, suicidal ideation, and loneliness frequently reported. Physical health problems included chronic diseases, respiratory conditions, pain, injuries, poor nutrition, sleep deprivation, and substance use disorders. Barriers to healthcare access included administrative requirements, lack of documentation, digital exclusion, long waiting times, stigma, discrimination, and limited availability of specialized mental health services. Participants identified multidisciplinary care, continuous psychological support, community-based interventions, and stable housing combined with personalized psychosocial support as key components of effective care. Homelessness requires integrated, trauma-informed, and person-centred public health responses. Reducing barriers to healthcare, strengthening mental health services, and expanding multidisciplinary interventions may reduce health inequalities and improve health outcomes and social inclusion among people experiencing homelessness.