The importance of integrated child-centred policies in education, social services and housing has been highlighted by new research into the profound harm homelessness causes to children.
The study, funded by the Nuffield Foundation, uncovered widespread mental health problems among a sample of 194 children aged between two and 16 living in hostels in Birmingham.
Researchers Stuart Cumella and Panos Vostanis, of Birmingham University, found that one-third of the children showed signs of anxiety, depression or other problems sufficiently severe to require referral for treatment. Just 3 per cent were in contact with the mental health services.
Although 75 per cent of the sample had been attending mainstream schools, the figure dropped to 29 per cent after they became homeless. Attendance at nursery schools fell from 13 per cent to 4 per cent. Fear of violence at school, lack of money for travel or uniform and delays in free school meal provision were among the reasons given.
By far the most common cause of homelessness was a parent's need to escape violence, either from partners or neighbours. More than half the children living in temporary accommodation had witnessed or were aware of violence inflicted by a parent's former partner.
One eight-year-old girl told researchers: "My dad punched my mum. She fell over and knocked her head on the coffee table. She was crying out and bleeding. I hit daddy and asked him to stop. He held her by the ankles out of the window. I was sad and upset."
According to Dr Vostanis, homelessness was not the sole cause of the children's mental health problems. "What came across very clearly is that there are multi-problem families. There are long histories of abuse of the mothers and their children. We compared them with deprived families who were housed in the same area and found big differences in their psychiatric problems. The other families were more stable.
"Whatever the causes, the rates are so high that we know they are at risk and that they do not have access to services."
In Birmingham alone, more than 200 children a week are included in 11, 879 homeless households that seek help from the city council every year. The authority, which has never used bed-and-breakfast accommodation, but instead provides specially adapted flats with staff on site 24 hours a day, is developing policies to meet the needs of children in homeless families.
The education department is exploring ways of including a special allowance in the local management of schools formula for schools facing extra demands because of large numbers of homeless pupils. It also wants to improve communication between schools to provide greater continuity for pupils who change address frequently.
"It is an issue that deserves a lot more attention than it gets. Children are victims of homelessness, whether they are very young or teenagers . . . the best efforts of all the agencies are not the sum of their parts," Professor Tim Brighouse, Birmingham's chief education officer, said. "The most vulnerable of our children are at risk of being the most invisible. Unless we get housing, social services, health and education together we are not providing all the services we can provide to kids who are most at risk."
He added: "There are a number of schools which are on a kind of trail based on children who are moving from temporary accommodation to temporary accommodation and changing schools in the process.
"These schools are on the receiving end of a turbulent population and we want to bring them together to share curriculum issues and information about these families. That presents a huge challenge, because the families are often fleeing debt or violence and do not want everyone to know where they are. "
While the impact of homelessness on the children's development had not been quantified by the study, Professor Brighouse said the problems were extensive: "We are in no doubt, from anecdotal evidence, that it is having an effect on reading development and general school development and, most importantly, on their self-confidence.
"The most precious thing you can give a child is a worthwhile relationship with an adult over a period of time. If the child is always changing school, the likelihood of getting that experience is diminished."
Copies of the report are available from the department of psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2QZ.