Walking through Exeter city centre at night, it is hard to avoid seeing the people slumped in subways, crouched in street corners, and camped in car parks.
The cathedral city has one of the worst rates of rough sleeping anywhere in the country.
In November, the problem in Devon was heavily publicised when 21-year-old Michelle Conroy was killed by a falling tree in central Exeter as she sheltered in a tent during a spell of extreme weather.
Then, days later, Michael Gething, 42, was found dead on the streets of Totnes from suspected hypothermia – thought to be the fifth homeless person to perish in the county in the past year.
Dave Browning, who has been homeless for more than eight years and was the boyfriend of Ms Conway, described the city as "one of the worst places for homelessness".
The 26-year-old added: "Even though people are aware of the problem, it's only getting worse."
Exeter has the sixth-highest population of rough sleepers for any UK city. The latest annual street audit conducted by the city council over a 20-hour period in December estimated that 30 people were sleeping on the streets. That figure has more than doubled in the last two years, and quadrupled since 2008.
More than 180 were found across Devon and Cornwall and a total of 337 in the wider South West, according to last year's audit, compared to just 32 counted across the whole of the North East.
A recent report by homeless charity Crisis estimated the number of rough sleepers across Britain has soared by 23% to 2,183 in the past year.
"Every day you're thinking about getting enough food to eat and staying well," said Steve Saunders, who has lived on Exeter's streets for more than ten years. The 39-year-old added: "You learn to find wasted food in bins and to beg for money."
Addictions to alcohol and drugs are common, with an estimated four out of five on the streets taking illegal substances.
Fellow rough sleeper Matt pointed to a "vicious cycle" of drug addiction and wanting to recover. The 38-year-old said: "I left home at 16 without a good education. Once you're on the streets it's easy to get hooked on drugs, which stops you seeking help."
Although studies find it hard to pin down the cause of rough sleeping, recurring themes include unemployment, relationship breakdowns, substance misuse and mental health issues.
Mark, 45, who has lived in insecure housing for 17 years, said: "Life on the streets is hard. Spending a lot of time sleeping rough can send you into a downward spiral. The drink keeps you warm and numbs the mind, but it makes you depressed."
Mortality rates among the homeless are high. Rough sleepers have a life expectancy of 42 compared with a national average of 77. They are also 35 times more likely to take their own life.
"It does get miserable," admitted 40-year-old Sean, who began living in woods outside the city earlier this year. "I've never had suicidal thoughts, but sometimes I do question why I should bother living."
Last year there was a 40% rise in static homelessness across England and a 23% rise in rough sleeping.
Former rough sleeper John is one of Exeter's success stories. The 46-year-old had become entangled in a poverty trap. "Without an address I couldn't get a bank account, and without a bank account I couldn't get a job," he explained. But after becoming a Big Issue magazine vendor, he managed last year to secure a rented flat near the quay.
"I've made it to the other side," he said. "Now I'm determined to get another job."
Several organisations provide frontline survival care and offer a range of resettlement services for the homeless. The Street Homeless Outreach Team has been operating in Exeter for ten years. It aims to quickly make contact with rough sleepers and minimise the time they sleep rough.
Often those who accept help are referred to a dedicated doctors' surgery, and where appropriate they are offered a range of accommodation including hostels. The team begin outreach at 6am two days a week, with an ultimate target of reducing the rough sleeping population to zero.
Another long-established homeless charity, St Petrock's, provides a range of emergency support and prevention services. It has helped more than 10,000 people since starting in 1994, and up to 60 people use its services each day.
Primarily, the charity runs a survival service for the homeless. People who are cold and hungry can receive hot food and drinks and have a shower. Last year, 60% of clients were new cases, including notable increases in women and those under 26.
Since the recession, rising numbers of rough sleepers in Exeter have been coupled with funding cuts to local councils, which has impacted on the level of services provided. Two years ago the city council's funding was cut by 45% to £3.4 million, removing the support for the homeless.
Chris Hancock, housing needs manager at the city council, said: "What is visible on the streets is not necessarily the true picture. Rough sleepers tend to hide away and not sleep in visible places. The number of rough sleepers in Exeter is far higher than we would like. The economic climate is difficult and some people come into the city from elsewhere thinking it's a better option."
A government initiative called No Second Night Out, which has directly helped more than 1,500 people to find a way out of rough sleeping, arrived in Devon and Cornwall earlier this year. Its rapid response teams aim to identify rough sleepers and ensure that none of them spend more than one night on the streets.
Not everyone is willing to accept help though. Big Issue seller Phil, 32, said: "I know it's cold on the streets, but I'd rather be out than in a hostel. I won't move forward in there.
"Unless you've got mental health issues or are elderly or pregnant, it's difficult to get proper support. We're just a burden to the city authorities."
For many rough sleepers their way of life becomes ingrained, as Steve succinctly conveys. "There's something keeping me here, but I don't know what."
Anyone who wants to report a rough sleeper should call Devon and Cornwall Rough Sleeping Partnership on 0800 151 3441.
