Pet ownership and homelessness: a scoping review

ABSTRACT

Between 5 and 25% of people experiencing homelessness have pets. Pet ownership can have a range of impacts in the lives of people experiencing homelessness, which may mitigate or further complicate the many adversities they face. However, there is a need to better understand the benefits and challenges associated with pet ownership to determine how this group can be best supported. Accordingly, a scoping review was conducted using PubMed, PsycINFO, and Google Scholar to address the question: What are the effects of pet ownership on people experiencing homelessness? All of the 18 reviewed studies used either qualitative or cross-sectional research designs. Three domains have been principally examined in relation to pet ownership and homelessness: (1) psychological health and purpose; (2) social support and connection; and (3) access to housing, employment, and service use. Physical health, violence, and crime were less frequently studied. Although the findings offer further support that there are both benefits and liabilities to pet ownership for people experiencing homelessness, there is a critical need for more rigorous research, including longitudinal and intervention studies. Recommendations for developing more pet-friendly services and using a strengths-based approach that considers animal companionship when working with people experiencing housing instability are also discussed.     

A part of something: The importance of transitional living programs within a Housing First framework for youth experiencing homelessness

Young people experiencing homelessness face severe threats to their health and well-being and while we know quite a bit about these risks, much less is understood about the usefulness of the services currently being provided to mitigate them. Transitional living programs (TLPs) are one of three core strategies executed by the federal government of the United States to address youth homelessness. The purpose of this phenomenological, qualitative study was to understand the impact over time of the housing and support services provided by a TLP directly from the perspectives of formerly homeless youth. Data was collected through in-depth, semi-structured interviews with 32 young people who exited a TLP located in Chicago, Illinois between 1 and 11 years ago. Participants believed TLPs to be an essential part of our solution to address youth homelessness, identifying themes of family, individual connections, community and preparedness that they believe uniquely qualify TLPs as a developmentally-appropriate program model for youth in times of housing crisis.     

Applying the Housing First approach to single-site permanent supportive housing

This study explored how the U.S. Departments of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program applies Housing First principles in the context of ten single-site programs. Focus group discussions with 64 HUD-VASH staff and community partners explored how the programs were influenced by Housing First principles and specific strategies to implement these principles in a single-site setting. Focus group respondents described resourceful ways that the principles of Housing First were implemented in their programs specifically related to (1) housing choice and structure, (2) separation of housing and services, (3) service philosophy, and (4) service array. Several of the Housing First domains cite the importance of integrated housing and the provision of services off-site; it was of particular interest to learn how single-site programs address these issues logistically. Lessons learned from this study include the importance of leveraging the independent yet overlapping tasks of case management and property management to ensure functional – if not geographic – separation of housing and services; maintaining staff on-site to address Veterans’ needs; working with community service organizations to complement the array of service available to residents; and housing single-site programs in mixed-use buildings.     

Reliability and validity of the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT) in real-world implementation

This study examined the reliability and validity of the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT), a widely-used assessment of the health and social vulnerabilities and housing needs of individuals experiencing homelessness. Homeless Management Information System data were obtained for 1495 individuals who were administered the VI-SPDAT between 2014 and 2016. Subsamples were selected for reliability and validity assessments. Results suggest there are challenges to the reliability and validity of the VI-SPDAT in practical use. VI-SPDAT total scores did not significantly predict risk of return to homeless services, while type of housing was a significant predictor. Vulnerability assessment instruments have important implications for communities working to end homelessness by facilitating prioritization of scarce housing resources. Findings suggest that further testing and development of the VI-SPDAT is necessary.     

Employment among unaccompanied women experiencing homelessness

ABSTRACT

Women represent one of the fastest growing segments of the homeless population and employment is often central exiting homelessness. However, little research considers employment experiences among unaccompanied women, a particularly vulnerable sub-population. This study explored how unaccompanied women experiencing homelessness (n?=?20) perceived and negotiated employment in a mid-sized community. Thematic analysis revealed four themes: limited work experience, limited aspirations, the holding pattern, and individual barriers. Findings endorse the need for Housing-First interventions to prioritize stable housing and employment-friendly shelters.     

The need for safe spaces: Exploring the experiences of homeless LGBTQ youth in shelters

Studies indicate LGBTQ youth are at higher risk of homelessness (2–13 times) than their heterosexual cisgender counterparts and that they represent a substantial portion of youth utilizing housing and shelter services. Some authors have provided anecdotal (rather than empirical) examples of LGBTQ youth experiencing abuse or mistreatment in shelters; most studies focusing on LGBTQ homeless youth have been conducted in large cities and have rarely collected data from both youth and providers. Using an exploratory, grounded theory approach, this study utilized data from interviews with LGBTQ youth with a history of homelessness as well as service providers working with this population in a mid-sized Northeastern city. Findings suggest youth experience multiple challenges, barriers, and mistreatment in the shelters; further, data suggests several ideas about how to transform shelters to better meet the needs of LGBTQ youth.     

The role of eviction in veterans’ homelessness recidivism*

Eviction is one of the leading causes of homelessness in the U.S.A. Though permanent supportive housing (PSH) helps participants maintain housing, some still leave due to eviction. This study aimed to determine whether eviction is an important predictor of recidivism and time to return to homelessness for participants exiting PSH. The characteristics and post-exit service use of 2802 Veteran PSH participants were analyzed based on exit reason. A Cox proportional hazards survival analysis modeled risk factors for returning to homelessness within 360 days of exit. Compared with other exiters, evicted Veterans remained in the program for less time, were less likely to be receiving service-connected compensation, and used more services – particularly mental health and substance use services – following their exit, and those who returned to homelessness did so more quickly. Identifying participants who might benefit from more intensive services, project-based housing, or income supports may prevent evictions and subsequent returns to homelessness.     

Exploring the Hidden Nature of Gambling Problems among People Who Are Homeless

Abstract

Although people with gambling problems are now recognised to be among those groups of people at increased risk of homelessness, little research has explored their experiences. This qualitative interpretive study explored the experiences of people who were homeless and had gambling problems, and the housing and gambling service providers assisting them. In-depth interviews were conducted with 17 service users and 18 service providers. A key finding was that gambling problems among those experiencing homelessness are often hidden; few people presented to housing services admitting to gambling problems. Shame, stigma, and identity issues were described as the main reasons service users did not disclose their gambling activities. The research highlighted that the relationship between service providers and service users was infused with power imbalances and shaped by social discourses and policies that demand self-responsibility and hinder information sharing between service providers and service users.     

Improving Outcomes for Unemployed and Homeless Young People: Findings of the YP4 Clinical Controlled Trial of Joined Up Case Management

Abstract

The YP⁴ study was a clinical controlled trial (CCT) of joined up services for young people experiencing both homelessness and unemployment in Victoria, Australia. The joined up service delivery (J group, n = 222) participants were offered intensive client-centred case management, involving direct provision of a range of services as well as the brokering of additional services. The standard services (S group, n = 174) participants remained eligible for standard services. Access to the Australian Government income support agency's (Centrelink) administrative data provided a retention rate close to 90% over the three annual data collection points of the study (baseline, 12 months and 24 months). Both groups improved their circumstances over the two years of the trial. The results showed no statistically significant treatment effects. The effect for employment earnings was approaching significance (p = .06) with J group increasing their employment earnings to a greater extent than S group. The findings and their implications for the implementation of joined up case management, future policy and practice, and future homelessness research is discussed.     

Planning for the Residential Needs of Lesbian,Gay, Bisexual,and Transgender Older Adults

Lesbian, gay, bisexual, and transgender (LGBT) older adults experience housing-related barriers. Previous research has described residential challenges experienced by this population, but few studies have examined implementation of housing solutions. This exploratory study conducted 7 semistructured phone interviews with program directors and/or development managers from initiatives offering residential services to LGBT older adults. Qualitative analysis identified themes that characterize the implementation of housing solutions. Study results suggest that future residential solutions for LGBT older adults should consider housing in relation to other aging-related barriers and frame solutions that promote collaboration among community actors (e.g., residential and service providers).     

Tracking residential outcomes of supported independent living programs for persons with serious mental illness

This study seeks to document patterns and reasons of leaving housing, and identify factors associated with different types of exits for a cohort of 452 residents with serious mental illness entering supported independent living (SIL) in Philadelphia, PA. The study cohort was tracked through an integrated administrative database comprised information on basic demographic and clinical characteristics, length of stay, homeless shelter use, and publicly funded behavioral health services use. A convenience sample of 46 SIL leavers and their support staff provided data on scenarios of leaving. The findings of this study suggest that departure from SIL is not a unitary phenomenon, but involving plausibly favorable as well as unfavorable circumstances. Multivariate analysis based on administrative tracking data suggests demographic and clinical factors, housing setting, and service use factors to have effects on leaving SIL and distinct types of exit examined in this study. Data procured from the convenience sample highlight the potential roles that program rules and resident–staff relationships play in affecting housing tenure. Implications of the findings for the development of permanent supportive housing for persons with serious mental illness are discussed.     

Impact of a supported housing prioritization system using vulnerability and high service utilization

For people experiencing chronic homelessness, supportive housing with intensive social, health, and behavioral health services reduces the likelihood of re-entering homelessness and the public costs of associated acute medical care, shelter use, and incarceration. Due to a limited supply of supportive housing, it must be allocated to those most in need. This paper examines findings from a unique, region-wide method for prioritizing individuals for supportive housing based on utilization of high-cost public services and vulnerability if left on the street. A sample of 196 individuals were prioritized for housing based on this method, while a comparison group of 102 were housed not using the method. Results showed that those housed under the prioritization method achieved greater reductions in utilization of high-cost public services, but were also less likely to have positive dispositions when exiting the housing programs, suggesting the need for a greater intensity of supports and/or multiple “doses” of supportive housing before stability can be expected. The method described in the paper can provide a starting point for developing regional, comprehensive systems of coordinated, prioritized entry into supportive housing, such as those now required by US Department of Housing and Urban Development.     

Barriers and facilitators to shelter utilization among homeless young adults

Rates of shelter use among homeless youth are low compared to use of other supportive services, yet research on barriers to shelter use has been conducted in limited regions, specifically in West Coast or Midwest cities. Additionally, while studies have generally focused on barriers to shelter use, studies on what might facilitate shelter use are lacking. This study explores barriers and facilitators to shelter use among homeless young adults from a large city in the Southwest region. Focus groups were conducted with a diverse sample of 49 homeless young adults ages 18–24. Drawing on models of health service use, findings were categorized into two domains – attitudinal and access. Themes related to attitudinal barriers include stigma/shame and self-reliance/pride. Attitudinal facilitators include the desire to extricate themselves from street life and turn their lives in a new direction. Access-related themes include barriers such as a lack of shelters and services available to meet the needs of youth, adverse shelter conditions, staff attitudes that are not acceptable to youth, restrictive shelter rules, restrictive definitions of homelessness, and a desire to differentiate themselves from older homeless individuals. Certain characteristics or circumstances (e.g., being pregnant), having supportive others, and shelters’ ability to connect them to other services emerged as access facilitators to shelter use. Implications for policymakers, service providers, and future research are discussed.     

The benefits of information communication technology use by the homeless: a narrative synthesis review

Recent studies have suggested that technologies are becoming an increasingly ubiquitous element in the lives of individuals experiencing homelessness. With both Canadian and US researchers reporting staggering levels of homelessness on both sides of the border, an understanding and synthesis of the current literature exploring how technologies are being utilized by homeless individuals and how it may impact their well-being is of relevance to policy makers and social service organizations. The study explored and synthesized literature to examine the ways in which individuals experiencing homelessness utilize information and communication technologies (ICTs), and how the use of ICTs influences the health and social outcomes of individuals experiencing homelessness. The study examined 16 peer reviewed articles using a narrative synthesis systematic review, following three elements of the narrative synthesis approach: preliminary synthesis of findings; exploration of relationships between studies; and assessment of the robustness of the synthesis. In relation to what ICTs are used for by homeless individuals, three major themes emerged: social connectedness, identity management, and instrumental purposes. Furthermore, there was some tentative evidence about a positive relationship between ICT use among individuals experiencing homelessness and health outcomes. The paper discussed limitations, future areas of research, as well as some policy directions.     

Challenges in evaluating programs serving homeless families

Homeless families, usually headed by single mothers, are the fastest growing segment of the homeless population. Although families with children make up a large percentage of those experiencing homelessness, there have been few studies on the effectiveness of services for homeless families offered by shelters transitional housing programs, and other agencies. This article summarizes the research that has been conducted on families that are homeless and the limitations of this research for program evaluation. Challenges to program evaluation are identified: the lack of published studies in the area; the fact that program evaluation is rarely built into programs or funded; the methodological issues in tracking families; the difficulty in assessing the impact on families; implementation issues; the range of barriers to housing stability faced by homeless families; and changes in society at large that influence the results of evaluation. Six recommendations are made for meeting these challenges: evaluation from a coherent theory of change; setting reasonable and differential expectations for clients; strengthening linkages with other agencies that serve the same client population; increasing the emphasis on follow-up; utilizing prevention efforts to reduce the number of families that become homeless; and working for expanded low-income housing and expanded subsidies.     

Emerging adult homelessness in geographic perspective: A view from the Rust Belt

This study provides a place-centered analysis of homelessness among emerging adults (age 18–24) by examining this issue in the context of the U.S. Rust Belt. In-depth interviews were conducted with a diverse sample of 30 homeless young adults in the small post-industrial city of Buffalo, New York. Our qualitative analysis focused on how place intersects with other factors to shape participants' experiences of homelessness and their views of the city and local social services. Participants described a sense of limited opportunity in Buffalo as well as the frustration that the service spectrum was too small, yet confusing to navigate. These findings point to directions for expanding employment prospects and housing and service options for homeless young adults in small cities.     

Lessons learned from children who have experienced homelessness: what services need to know

Children who accompany their parents or guardians during a period of homelessness make up 37% (more than one in three) of all people accessing the Supported Accommodation Assistance Program (SAAP) services. This paper describes an Australian qualitative study that explored the experiences of children who accompanied their families during periods of homelessness. It focuses particularly on what children and young people say they want from the services that they come in contact with; particularly specialised homelessness services such as housing support services and refuges. Key themes that emerged from the research include: the need for services to engage with children as individuals in their own right, to listen to and acknowledge their stories, to have services that meet their individual needs, to act and respond when children feel unsafe and for workers who can provide support to children to talk to parents about what is going on. Children and young people wanted workers to know that they felt their parents were doing their best to keep them safe. They focused on what their parents could do and did do rather than what they were not able to provide. They called on the human service system to do the same.     

Advancing Program Theory for Licensed Assisted Living Services in Independent Housing

Assisted living programs (ALPs) embed licensed assisted living services within independent housing. To advance nascent research on this type of housing plus services, this study aimed to develop empirically grounded program theory on the processes through which ALPs benefit residents within independent housing. Eighteen in-depth interviews were conducted with current and prospective consumers of an ALP in northern New Jersey, including residents and family caregivers. The setting for the ALP was a federally subsidized independent housing building, which had introduced the ALP approximately 1 year prior to the study. Themes emerging from an iterative coding process indicated the most valued aspects of the ALP’s service delivery, including the comprehensiveness of the service options, the flexible timing for their delivery, and the relational aspects of care. Participants further described the ways in which the structure of the ALP facilitated prevention, such as preventing the occurrence and escalation of adverse health events. The study concludes by presenting a program model that integrates these findings, which suggests that ALPs deliver care in ways that make long-term services and supports more accommodating and acceptable to consumers. This, in turn, can enhance their preventive value to facilitate aging in place among independent housing residents in clinical need of such supports.