Sleeping with your feet sticking out

In short

This text is about autistic people experiencing homelessness. International studies show that autistic people are more common among people without a home than in the general population. Autism is not the cause: the problem is the lack of affordable housing and adapted support. The text argues for programmes that combine housing and support, such as the Housing First model.

In the photograph there is a tent pitched on the pavement. Inside, someone is sleeping. Their feet stick out, because the tent is short, because there is nowhere else, because the street was not made for anyone to lie down in.

In Portuguese, «sleeping with your feet sticking out» means waking up grumpy, annoyed, in a bad mood. It is a light, almost comical expression we use to excuse a bad day. This image gives it back its literal meaning and takes away the humour. There are people who sleep, every night, with their feet sticking out. And they have every reason to wake up angry, not at life, but at the way society has organised itself around them.

This text is about those people. In particular, about autistic people who live on the street, in shelters or on someone's sofa. And it is also about all of us: about a country that has not yet decided whether a home is a right or a reward.

The ones who don't show up in the figures

Homelessness is one of the most extreme manifestations of social inequality, poverty and a country's structural failures. It is defined by the lack of secure housing and is not limited to sleeping rough, the condition of being «roofless». It also includes those living in temporary accommodation, in shelters or staying with friends as a favour, the condition of being «houseless».

In mainland Portugal, the survey of the National Strategy for the Integration of Homeless People (ENIPSSA) counted 14,476 people in this situation on 31 December 2024, 1,348 more than the previous year. Of these, 9,403 were roofless. In 2022 there were 10,773. The number grows year after year.

None of these statistics tells us how many of these people are autistic. But international research offers worrying clues. In a landmark study in London, around 12% of long-term homeless people supported by a street outreach team met the criteria for ASD, whereas in the general adult population the prevalence is around 1%. Another British study found figures close to 19% using a screening instrument, and studies in Dublin point in the same direction. Autistic people appear to be clearly over-represented in homeless populations and in the services that support them.

The mechanisms behind this association remain unclear. Many of these people have never been diagnosed. They reach adulthood without a name for their difficulties, without access to assessment and without the support a diagnosis could open up. Inequalities in access to diagnosis are themselves part of the problem.

Autism doesn't put anyone on the street

The path that leads an autistic person into homelessness is long and rarely has a single cause. It brings together adverse childhood experiences, demographic factors such as gender, age and low socioeconomic status, and personal issues such as trauma, substance use and mental health problems. Added to these are difficulties in relationships, lack of support from services and the conditions that so often accompany ASD, such as anxiety and depression.

But it should be said clearly: autistic traits do not, in themselves, cause homelessness. They shape the way each person relates to the housing, employment and social support systems. A confusing form, a phone helpline, a job interview full of unspoken assumptions, a shelter with dozens of beds, noise and constant light: all of this can be insurmountable for an autistic person. One of the British studies heard precisely that: shared spaces and large groups keep many autistic people away from the very services that exist to help them.

Homelessness therefore arises when structural conditions fail to meet the needs of neurodivergent people. Unaffordable housing, services designed for a single type of person and inequalities in diagnosis do the rest. Autism, being heterogeneous and poorly understood, exposes people to discrimination and isolation, and that isolation increases the risk of losing one's home. The problem is not in the way these people think. It is in the way we have built the front doors.

Working and still not making ends meet

For a long time, the usual answer to poverty was employment: find a job and the rest will sort itself out. For autistic people, the first part of this equation remains difficult. Recruitment processes value easy conversation, eye contact and the ability to «sell» oneself, skills that say little about how someone will actually do the job. Many qualified autistic people fall at the interview stage. Others manage to get in but don't stay, because workplaces fail to make the simple adjustments they would need: predictability, clear instructions, less noise, managers who understand.

The result is familiar to anyone who works with autistic adults: unemployment, underemployment, short and precarious contracts, interrupted careers. It is no coincidence that, among the causes most often cited by homeless people themselves in the 2023 ENIPSSA survey, unemployment or job insecurity comes first.

But the second part of the equation no longer works either. Today there are people who work and still cannot afford a home. In Portugal, about one in ten employed people is at risk of poverty. Among households that rent, nearly three in ten spend more than 40% of their income on rent. Having a job is no longer a guarantee of having somewhere to live. For those who already start at a disadvantage in the labour market, as so many autistic people do, this margin is even narrower.

A home of one's own

Portugal has ratified the United Nations Convention on the Rights of Persons with Disabilities, which enshrines each person's right to choose where and with whom they live. In practice, the options remain few: stay with one's parents for as long as they can manage, move into a residential service or, when none of that exists, be left adrift.

The Independent Living Support Model (MAVI) was an important step. It guarantees personal assistance to people with disabilities for everyday activities, through the Independent Living Support Centres, and in 2026 Parliament approved its expansion. But MAVI is above all a personal support measure, with limited places and uneven territorial coverage. It is not, nor does it claim to be, a national programme of independent housing for people with disabilities.

That is precisely what is missing: a programme that brings together housing and support. Affordable, stable housing with manageable rent, combined with flexible support that can be scaled up or down according to each person's needs. For many autistic adults, the issue is not needing an institution. It is needing a quiet, predictable home of their own, and someone to help deal with letters from the tax office, manage money or sort out a breakdown without going into crisis.

The Housing First approach, which Portugal already uses in several projects for homeless people, shows that starting with the home works. What is missing is to extend this logic, preventively, to people with disabilities, before they end up on the street. And one question is also rarely asked: what happens to an autistic adult when their parents grow old or die? Many families have no answer, and neither does the State.

Building houses is not enough

Portugal, Europe and many other countries are going through a serious, structural housing crisis. It is tempting to reduce it to a supply problem: there aren't enough homes, so build more. Construction is necessary, but it is not enough. A new house that nobody can afford solves nothing. A house that is affordable on paper, but with an application process that requires navigating platforms, deadlines and interviews, remains closed to those who cannot cope with that bureaucracy.

The housing debate must include those who are always at the back of the queue: people with disabilities, neurodivergent people, those on low and unstable incomes, those without family to act as guarantor or safety net. For these people, the right to housing depends on several things at once:

• enough public and cost-controlled housing, with quotas or priority for people with disabilities;

• simple, clear and accessible application processes, with alternatives to purely digital or telephone services;

• support in keeping one's home, so that losing a job or a mental health crisis does not end in an eviction order;

• emergency responses that respect the sensory needs of autistic people, instead of large communal shelters;

• social services professionals and street outreach teams trained in ASD, able to recognise signs of undiagnosed autism and refer people for assessment.

The right to housing is in the Constitution. What is missing is treating it as a right for everyone, and not only for those who can compete in an ever harsher market.

Waking up with your feet sticking out

The person in the photograph will wake up in a few hours. Their feet will be cold, they will have to take down the tent before someone tells them to move on, they will look for somewhere to wash. Perhaps they are autistic and have never known it. Perhaps they once had a job, a home, a family that can no longer help. Perhaps they simply fell through the cracks of systems that were never designed with them in mind.

If they wake up angry, they will be right. Anger is the right response to a country where people work and have no home, where being different still comes at a high price, where the independent life of people with disabilities depends on the luck of there being a place available. Perhaps we should all wake up a little like that, grumpy, uneasy, with our feet sticking out. At least until no one has to sleep on the street for us to notice them.