Needs Assessment research reveals: Homeless People in Central and Southeast Europe Face Serious Barriers to Housing and Healthcare
In spring 2025, we conducted a survey in five Central and Southeast European countries as part of the SOLACE-CEE project. Our goal was to map the real-life situation of people experiencing homelessness and housing exclusion. Through questionnaires and in-depth interviews, we examined living conditions, barriers to healthcare and social services, health literacy, and use of IT tools among people experiencing homelessness. The data we collected will help support the development of effective services for homeless people in the CEE region.
Our research revealed that people experiencing homelessness face a combination of challenges that often interact with each other. “A total of 265 respondents – individuals and household heads – participated in our data collection, and our local teams conducted dozens of in-depth interviews not only with people experiencing housing exclusion but also with healthcare and social service providers in each country. This allowed us to gather both quantitative data and a broader understanding of the context, highlighting the complex needs of the target group,” stated the research team at the Metropolitan Research Institute (MRI).
Key findings:
Housing
45% of respondents live in shelters, 23% in temporary structures, and only 15% in standard housing. One in ten households is completely without a roof over their heads. The sample included 279 minors (43%). Up to 70% of families with children are single-parent households.
Income and Employment
The groups we aim to include are very vulnerable in terms of income and employability: 35% of women have only primary or no education at all (compared to 5% of men). Only 15% of respondents have formal employment, while 20% have no income. More than half (53%) rely on social benefits.
Physical Health
Potential clients face multiple morbidities. 61% reported at least one health problem, 34% are unable to work due to their health, and 46% were hospitalized in the past two years. Preventive check-ups are almost non-existent, with 40% not attending medical examinations.
Mental Health
80% of respondents have experienced traumatic events. Every second client experienced abuse in childhood, adulthood, or both. One in three lost a close person due to mental health issues, and more than half lived with someone struggling with substance use.
Discrimination
25% of respondents were denied healthcare, and 40% experienced disrespectful behavior while using health services. Many clients lack anyone to turn to for support, particularly men with long-term homelessness experiences.
Our research provides a clear picture of the challenges faced by people experiencing homelessness in Central and Southeast Europe. It highlights gaps not only in housing and healthcare but also in the coordination and integration of services.
“The results clearly show that clients’ needs are complex, and our approach must also be comprehensive. Standalone services without coordination may not adequately respond to all needs,” said Alena Vachnová, Chair of the Board of Nadácia DEDO, the lead partner of the project. “SOLACE-CEE integrates healthcare and social services, enabling the creation of coordinated services directly specialized for the living conditions of people experiencing homelessness and housing exclusion.”
Insights from Professionals
Qualitative interviews with professionals also emphasized the need for stable and flexible funding, better collaboration and coordination between social and healthcare services, strengthening staff capacities, and implementing trauma-informed, integrated care approaches including Housing First models. Administrative and regulatory gaps and complex bureaucracy were identified as additional barriers.
Building Effective and Integrated Services
The summary of survey and interview results provides a foundation for developing effective, coordinated, trauma-informed, and integrated services that genuinely respond to the needs of people experiencing homelessness in the CEE region.
