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.     

Suicidality among homeless people: Testing the mediating effects of self-efficacy and depression

ABSTRACT

This cross-sectional study examined the mediating effect of PTSD on suicide ideation and suicide attempt through two mediators, self-efficacy and depression, among homeless adults. We recruited a non-random, purposive sample of 156 homeless adults from seven homeless people shelters in Kansas. SEM results suggest that self-efficacy and depression were significant mediators between PTSD and suicide ideation, but not between PTSD and suicide attempt. This study’s findings can be used to identify risk factors associated with suicidal behaviors that can be used to design service programs aimed at preventing suicidal ideation and attempt among people who are homeless.     

“I’m not homeless,I’m houseless”: identifying as homeless and associations with service utilization among Los Angeles homeless young people

Little is known about homeless young people’s identification of being homeless and how that identity may or may not be associated with service utilization. This study of 444 homeless young people attending Los Angeles area drop-in centers explores the associations of demographic characteristics, homelessness characteristics, negative lifetime experiences, mental health symptoms, technology use, and past month service utilization with identifying as homeless. Fifty-two percent of the sample identified as being homeless. Being Black, a current traveler, and history of injection drug use were all significantly associated with a decreased likelihood in identifying as homeless. However, having fair/poor health, accessing shelter services, and reporting one’s own substance use as a reason for homelessness were all significantly associated with identifying as homeless. There are important service implications for reaching young people who are in need of services but may not identify with the target population label of homeless.     

Changes in the health status of newly housed chronically homeless: the Alaska Housing First program evaluation

The Housing First (HF) model is an evidence-based supportive housing initiative that provides permanent housing for the homeless without preconditions such as sobriety or treatment compliance. This three-year longitudinal study investigated the effects of Alaska's inaugural Housing First projects in Anchorage and Fairbanks on local service usage, costs and tenant quality of life (QoL). A total of 94 tenants participated at baseline in the QoL study and 68 continued to follow-up. Cost data was collected from local municipalities, Alaska Department of Corrections, and local hospitals, health care clinics, behavioral health providers, and detox facilities. Emergency services use by tenants decreased from the year before moving into Housing First to the year after. Changes in health care costs were more variable depending on site and type of service.     

Changing the method of working with homeless people: a photovoice project in Italy

In Italy, many organizations are experimenting with the Housing First (HF) model to promote a change in how they work with homeless people. This change creates some difficulties, especially in promoting freedom of choice in people involved in the HF programs. This study explored the definition of “home” in homeless people’s points of view. The study participants were 5 homeless men involved in a HF program called “The Road Home” implemented in the city of Padua. Data were collected using Photovoice, a photographic method based on participatory action research. During the project, the participants took photographs to illustrate their definitions of “home” and then engaged in a critical dialogue about the images represented in the photographs. The results of the study showed that occupants identified the home as being related to family, friendship, cohabitation, and hope for the future. The Photovoice project provided an opportunity to promote discussions that revealed the true needs of the people involved, and in the meantime, it brought a change to the program and to the community, in addition to promoting the HF model in the community.     

Running on empty: Monitoring the lives and circumstances of formerly homeless families with children

Homelessness is a manifestation of acute poverty accompanied by long-term unemployment, deficient human capital, problems with substance abuse, inadequate welfare benefits, and other vulnerabilities. Homeless people have problems that require sustained intervention strategies that will permit them the opportunity to enter the labor market, maintain permanent housing, remain healthy and functional, and take care of their families. To this end, more and more transitional housing programs have been opened—programs that provide shelter stays of longer duration than emergency shelters as well as an array of support services designed to help people move along the path toward economic independence. Do people do better after living in transitional housing? To address this question, this research monitored homeless families who “graduated” from a large transitional housing program in Baltimore. Following two cohorts of families for more than one year at several points in time, this research finds that families exhibited a series of positive changes in the lives of both adults as well as children. Families did not become economically self-sufficient as indicated by complete independence from income maintenance programs. This study suggests that the availability of income maintenance programs, particularly rental housing subsidies may be a critical factor in permitting homeless people to stabilize their life situations.     

A new look at the health and homeless experience of a cohort of five-year olds

Homelessness is increasing and health workers and others need to be ever vigilant about the risk that this has on children's health. What is that risk and what are children's experiences of homelessness? A retrospective case note study was carried out to compare the health of a group of five-year olds who had experienced homelessness and compare them with matched ‘non-homeless’ controls. A home interview questionnaire was used to give a profile of the children's housing experience and the health issues faced during their time in temporary accommodation. Fifty-three cases when compared with 41 controls showed a statistically greater prevalence of child protection issues and an increased number of health needs identified at the school nurse health appraisal. The housing profile identified that the case children moved homes many times (37 per cent more than five times), were homeless much longer than the officially registered period (67 per cent more than 12 months) and 61 per cent were made homeless through domestic violence. The study reinforces the need for us to acknowledge important environmental stress and to continue to advocate for this group of disadvantaged children.     

Identity in transition: how formerly homeless individuals negotiate identity as they move into housing

It is unclear what happens when stigmatized individuals undergo status transitions into non-stigmatized groups. This paper explores changes in housing status, identity, and social relationships over time and their impact on formerly homeless individuals. Drawing on longitudinal qualitative interview data collected over six months from seven individuals transitioning out of homelessness and into government supported housing, this paper examines identity changes during such a status shift. Analysis shows that individuals distanced themselves from both homeless and formerly homeless people, and connected with others through groups not affiliated with homelessness or shelter life. When exiting a stigmatized status, like homelessness, social distancing may be particularly important as it helps redefine the self as apart from that previously held stigmatized status. Implications for research and policy are discussed.     

Service providers to the homeless mentally Ill: Their thoughts,perceptions, and recommendations for the homeless

A qualitative research study was conducted to obtain an understanding of the people who provide services to persons who are homeless and mentally ill. Service providers were asked about the kinds of services they provide, what they consider beneficial to this population, the kinds of services they would like to provide, and what is needed to alleviate the homeless problem. Services found in the study included, those that meet basic needs, psychiatric/medical services, social services, and activities. Service providers indicated the major service priority is housing and the necessity of: (a) a safe environment, (b) additional psychiatric/social services, (c) day programs, and (d) health care. It is recommended that service providers advocate for the necessary improvements in services including, collaborative workshops and training sessions to the public and to each other.     

The periphery of care: Emergency services for homeless people in rural areas

Until recently, homelessness in rural areas has received little recognition because of overwhelming assumptions about the urban-centredness of homeless people and their needs. This paper seeks to build on recent research that has begun to uncover some of the problems and characteristics of rural homelessness, by suggesting two significant dynamics which together can shape the experience of different groups of homeless people in rural environments. First, rural places reflect particular local qualities which contextualise both the circumstances of homelessness and the provision of services in response to those circumstances. Secondly, the contemporary governance of homelessness unfolds rather unevenly in different rural areas, producing distinct local service environments with varying degrees of ‘insider’ and ‘outsider’ status in relation to joined-up responses to the needs of homeless people. These dynamics are articulated through three case studies: a remote friary in a deep rural area of southern England; a small hostel run by a vibrant non-statutory organisation in a small town in the west of England, and two advice centres in a coastal resort in the north-east of England. Through these case studies we highlight the importance of both local reactions to the homeless other, and local relations between central government funding, local authority initiatives and charitable organisations, in the production and consumption of spaces of care in settings set in, or serving, rural environments.     

Sense of community through supportive housing among formerly homeless individuals with serious mental illness

Much research documents the correlation between homelessness and mental illness. Often, existing research focuses on deficits that live at the intersection of these phenomena. The present study utilizes a sense of community (SOC) framework to interrogate the ways in which formerly homeless individuals with serious mental illness perceive and experience community in supportive housing. Through focus groups with 18 consumers, this study contextualizes dimensions of SOC (membership, emotional connection, needs fulfillment, and influence) for the aforementioned population. Analysis of focus group data produced 16 themes and subthemes that support and extend our understanding of SOC for a population often conceptualized as isolated and alone. Implications for policy and practice emphasize: (1) the importance of supportive housing communities and the call for policymakers to increase funding for such programing; and, (2) that practitioners facilitate housing members’ voices to effectuate change in supportive housing and increase SOC.     

Predictors of employment among sheltered homeless women

The effect of homelessness on the psychological and physical health of women is damaging and long lasting. Understanding of the personal factors that enable homeless women to secure employment and re-enter mainstream society is of utmost importance. A sample of homeless women residing in a US Midwestern nonprofit treatment and transitional living shelter for homeless women and their children were surveyed regarding the extent to which life satisfaction, social self-efficacy, and hopeful thinking predicted women's expected capabilities to obtain employment above and beyond social support provisions, while controlling for participants' age, ethnicity, and education level. Findings failed to reveal that social psychological (i.e., life satisfaction and social self-efficacy) and intrapersonal (i.e., hope) variables predicted homeless women's job procurement self-efficacy above and beyond perceived social support. The social support provision of social integration and younger age significantly predicted women's self-efficacy to secure employment. Implications of results for social justice initiatives and interventions are discussed.     

Using WhatsApp for a homeless count

The study analyses how the use of instant messaging (WhatsApp) alongside other ICT tools is adequate to complement the count of homeless people in an area. In particular, it describes the methodology used in order to organize the first official count of homeless people in Girona (Catalonia, Spain). Given that this is the first count of individuals experiencing homelessness in the city, it is difficult to say that it is an improvement, but it could be suggested that the app might make the future counts more efficient. Both professional and volunteers and homeless people used WhatsApp to send information. A total of 283 homeless people were detected. Results show that the usage of this application optimized the results of the count. 36.1% of the data were obtained online. Homeless people, who were reluctant to contact directly with the professional team, used WhatsApp to communicate with them, adding up to 19.4% of the data obtained. Results show how communication between homeless people and health and mental health services can be potentially improved with this type of application.     

Prevalence of clinical autistic traits within a homeless population: barriers to accessing homeless services

ABSTRACT

Recent research suggests a high prevalence rate of Autism Spectrum Conditions (ASC) amongst the homeless population. Although, it is well-documented that autistic people experienced many barriers to accessing health services, little is known about their challenges in accessing homeless services. Thus, the present study aimed to measure prevalence of high levels of autistic traits, and to identify barriers that prevent autistic people accessing homeless services. Participants recruited from homeless services (n?=?65) completed the Autism Quotient-10 (AQ-10) alongside a questionnaire regarding perceived accessibility of homeless services. Results revealed that 18.5% of participants scored Above the Clinical Threshold of the AQ-10 (ACT-AQ). Moreover, the ACT-AQ group reported that encountering big groups in shared accommodation represent a significant barrier to engaging with homeless services. Further research is needed to identify the full degree of ASC representation and the factors that might prevent autistic homeless people accessing homeless services, and thus overcoming homelessness.     

Informal shelter providers: Low income households sheltering the homeless

Despite the important role they play in preventing homelessness, those who shelter people who can not afford housing of their own have been neglected by researchers. This study examines the characteristics of these low income informal shelter providers. While informal shelter providers were similar to a comparison group of low income households that did not shelter others, there were also significant differences between the two groups. Informal shelter providers were more much more likely to live in single family dwellings, they were more likely to be long-term residents of the community, they were more likely to have experienced homelessness themselves, and they devoted a disproportionate share of their incomes to housing.     

Public housing agency preferences for the homeless as a policy lever: Examining county-level housing subsidy receipt and maltreatment rates

This study examines the relationship between county Public Housing Agency (PHA) practices that prioritize families experiencing homelessness and county-level child maltreatment rates. Using data from a survey of PHAs and the National Child Abuse and Neglect Data System (NCANDS) with a sample of 534 counties, we find that policies which give preference to homeless households for housing assistance are associated with reduced victimization and substantiation rates, while policies that reduce barriers to assistance eligibility are associated with reporting rates. Our findings suggest that beyond prioritizing homeless families for housing assistance as a means of ending homelessness, providing families with more expedient access to a valuable public subsidy may have important positive externalities, such as reduced CPS involvement. Additional partnerships between child welfare agencies and housing providers, particularly those that provide housing subsidies, may be worthy of additional investment and evaluation.     

Agency in advanced liberal services: grounding sociological knowledge in homeless people's accounts

This paper aims to understand how people who are homeless respond to advanced liberal social services that endeavour to promote their autonomy and responsible actions. We prioritize the experiences and positions of people who are homeless, and what agentic action means to them. Sociological literature is selective about what accounts are deemed agentic. Agency is associated with accounts that resist or subvert dominant neoliberal framings of homelessness as failure of individuals. When people experiencing homelessness or poverty themselves foreground autonomy or responsibility, sociologists treat them as cultural dopes who have internalized neoliberal discourse. Our analysis is driven by an ethnographic study in an Australian homelessness shelter. We demonstrate how people who are homeless neither outright reject nor completely embrace advanced liberal practices to influence their actions and promote autonomy. People engaged in relational reasoning. Paternalist and advanced liberal social services were both lauded and rejected for their capacities and limitations to realize a good life. We contribute to the discussion for sociology to value people's accounts and experiences, rather than broader social process explaining their accounts. From the perspectives of people who are homeless, we show that just because something appears neoliberal does not mean it should be automatically rejected.     

A population-based inquiry of homeless episode characteristics and early educational well-being

Child homelessness and educational well-being is an area of national research that requires more precise investigation to address mixed findings. The aim of this study was to extend the investigation of the relations between homelessness and educational well-being by determining if timing and frequency of homeless episodes are differentially associated with children's academic and classroom engagement outcomes. This investigation used a comprehensive research model to study the effects of these homeless episode characteristics within a large urban student cohort. Additionally, this study accounted for co-occurring early risk factors. Findings indicated that having a first homeless episode in early childhood was associated with non-proficiency in mathematics and academic engagement problems. Also more frequent homeless episodes were related to truancy in third grade. These results stress the importance of early intervention for homeless children and underscore the need to further understand the variation in young children's homeless experiences.