“Please Ask Me How I Am”: Experiences of Family Homelessness in the Context of Single Mothers' Lives

An increasing number of studies in recent years have examined the issue of family homelessness. The majority of this research has taken a quantitative approach, focusing primarily upon the demographics and characteristics of homeless mothers and children and the conditions of shelter facilities. The goal of this study was to examine the experience of family homelessness from an alternative perspective through interviews with formerly homeless mothers about their lives before and after leaving the shelter system. In-depth interviews with 24 formerly homeless single mothers in New York City were conducted and subsequently analyzed employing a qualitative-narrative approach. Major themes that emerged from the women's life stories are elucidated: poverty, neglect, abuse, troubled interpersonal relationships, and mental health concerns. Surprisingly, a majority of women spoke of their experience in the shelter system in positive terms. This and other findings are discussed in the context of the women's life experiences and support services provided by the New York City shelter system. Social policy issues and recommendations for future research and program development are presented.     

No Place Like Home: A Study of Two Homeless Shelters

Homelessness is one of the most pressing social problems today. Society has responded to the problem with the creation of homeless shelters. yet, the nature of the operation of the shelter is not defined. This study explored the operations of two single adult homeless shelters to understand how they operate in addressing the problem of homelessness. The study identified two different types of services, one called "house" and the other ((home." House services provided basic food, shelter, and linkage to social services, which fulfilled the basic definition of the problem of homelessness as defined by the Institute of Medicine. Home services provided the basic services of house but also went one step beyond by providing these services within the context of a supportive environment, thus creating informal social supports. The study discusses the implications of each of these modalities in addressing the problems associated with people who are homeless as well as the differences in policies and structures which contribute to one shelter providing house and the other home services.     

Homelessness and Children's Use of Mental Health Services: A Population-Based Study

This study examined whether children who become homeless differ from other low-income children in their mental health service use before and after their first homeless episode, and to what extent homelessness is associated with an increased likelihood of mental health service use. Differences between children with and without new onset of sheltered homelessness in the use of mental health services emerged following homelessness and widened over time. Sheltered homelessness and foster care placement history were associated with increased odds of receiving inpatient and ambulatory mental health services. Findings underscore the importance of collaborations between homeless assistance, foster care, and mental healthcare in efforts to mitigate family homelessness and collateral needs among homeless children.     

No place like home: A study of two homeless shelters

Homelessness is one of the most pressing social problems today. Society has responded to the problem with the creation of homeless shelters. Yet, the nature of the operation of the shelter is not defined. This study explored the operations of two single adult homeless shelters to understand how they operate in addressing the problem of homelessness. The study identified two different types of services, one called house and the other home. House services provided basic food, shelter, and linkage to social services, which fulfilled the basic definition of the problem of homelessness as defined by the Institute of Medicine. Home services provided the basic services of house but also went one step beyond by providing these services within the context of a supportive environment, thus creating informal social supports. The study discusses the implications of each of these modalities in addressing the problems associated with people who are homeless as well as the differences in policies and structures which contribute to one shelter providing house and the other home services.     

Social support among homeless and housed mothers: an integrative review

Homelessness has been associated with levels of stress beyond the normal strain of living in poverty. For mothers who are homeless, support from their social networks may provide a buffer from some of the stresses associated with being homeless. To better understand the relationship between social support and female-headed homeless families, an integrative review was conducted of 12 research articles that compare social support among low-income housed mothers and homeless mothers, using guidelines set forth by Ganong. The included studies revealed four significant attributes of social support among housed and homeless mothers: size of the social support network; composition of the social support network; contacts with members of the social support network; and perceived support from members of the social support network. Nurses who work with homeless families are in a position to help develop ways for these families to cultivate and maintain their social support networks while homeless. Nurses can be available to offer support, including the necessary mental health services or referrals.     

Intersection of homelessness and mental health: A mixed methods study of young adults who accessed psychiatric emergency services

Young adults who experience homelessness have high rates of mental disorders, yet low rates of outpatient mental health service use. This mixed methods study examined the intersection of homelessness and mental health in a sample of 54 young adults (ages 18–25) who were hospitalized on a short-term, inpatient psychiatric unit. Nearly half (n = 26) reported being homeless in the prior year and more than a quarter were homeless at the time of admission (n = 15). Qualitative analyses identified key factors that contributed to both mental health problems and homelessness including disrupted support networks, fragile family relationships, foster care involvement, substance use and traumatic events. Homelessness was both a facilitator and a barrier to successfully accessing mental health services to manage mental health symptoms. Findings highlight the interconnection of homelessness and mental health and their common relationship with additional underlying risk factors. Providers across service settings need to recognize the overlap of client populations and provide integrated, trauma informed care to address housing instability, mental health, and substance use together.     

Stability in the Social Support Networks of Homeless Families in Shelter: Findings From a Study of Families in a Faith-Based Shelter Program

The following article outlines a longitudinal study tracking changes of the social support networks of 28 homeless families in shelter. Weekly changes in support networks of homeless mothers were tracked including 482 dyadic ties between mothers and supportive persons. Findings suggested that informal social support and persons who provided emotional support were significantly more stable forms of support in the mothers' lives throughout their shelter stay. Time was found to be a significant predictor of financial well-being and housing stability at shelter exit, but characteristics of the supportive ties were not. Implications for family social work and research practice are presented.     

“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.     

Homelessness and mental illness: who resorts to state hospitals?

Mental illness among the homeless is a topic which has received much attention in the last few years. Most studies in this field have examined the incidence and prevalence of mental illness among the residents of temporary shelters, missions and SRO hotels. Using data from a broader policy study of community mental health, this study addresses the issue of mental illness and homelessness from a different direction. By examining the incidence and subjective meaning of homelessness among patients in state hospitals, this study attempts to understand the relationship between homelessness, illness and the admission process. It was found that a significant portion (18 percent) of hospitalized mental patients attributed their admission to problems in housing. This group uses the hospital as a resource in their lives, admitting themselves to the hospital to replace inadequate social networks. For such patients, a mental hospital admission reflects a rational decision, based on his/her understanding of the limited options for care in an age of deinstitutionalization.     

Moving Beyond Housing: Service Implications for Veterans Entering Permanent Supportive Housing

As a result of efforts to end homelessness among U.S. veterans, more former service members are entering permanent supportive housing (PSH). While PSH has been successfully used to house homeless veterans, more research is needed about services beyond housing placement and retention. This study uses the Gelberg–Andersen behavioral model for vulnerable populations to determine associations between predisposing, enabling, and need characteristics and recent service use (i.e., services to satisfy basic needs, occupational development, financial, healthcare, mental health) among unaccompanied homeless veterans (N?=?126) entering PSH in Los Angeles. Among the significant findings, as indicated using univariable logistic regression models, were veterans who had incarceration histories were more likely to utilize basic needs services, compared to those without incarceration histories. Veterans who received an honorable discharge were more likely to utilize occupational development services, compared to veterans with other discharge statuses. Veterans who had a case manager were more likely to utilize mental health services than those without a case manager, while those who received social security were less likely to utilize mental health services compared to veterans who did not receive social security. Veterans who met criteria for a psychological disability and veterans who met criteria for probable PTSD were more likely to use basic needs services and mental health services than veterans who fell below these thresholds. Clinical implications for social workers including “equal access to services,” “enhancing economic stability,” “providing safe and affordable housing with trauma-informed services,” and “training service social workers to deliver well-informed linkages and services” are discussed.     

A life course approach to understanding homelessness of shelter residents

ABSTRACT

Using in-depth interviews of 40 residents from a homeless shelter in El Paso, Texas in the United States, this study examines the etiology, processes, and patterns of homelessness by assessing those confronting homeless spells at different time points and for varying reasons. Our study is guided by the research questions: How did residents of homeless shelters experience transitions and turning points of homelessness? What were the coping resources that homeless people drew on to overcome life adversities? Overall, we found that risk accumulation as a result of different traumatic events, such as death of a family member, marital or relationship breakdown, victimization, unemployment, substance addiction, poor mental health, or discrimination confronted in varied contexts, could serve as precursors or consequences that exacerbated the housing crisis over the course of a life. We recommend that efforts geared toward remediating, alleviating, or preventing homelessness be life course driven. It is only through compassion and empathy rather than criminalizing and stigmatizing that we can help stop the triggers and spread of the downward spiral of homelessness.     

Homelessness and hunger

We employ data from the National Survey of Homeless Assistance Providers and Clients to examine the character and correlates of hunger among homeless people. Our analysis, couched in an adaptation framework, finds more support for the differentiation hypothesis than for the leveling hypothesis: Complex patterns of food insecurity exist at the individual level, and they vary with the resources available (e.g., higher monthly income, regular shelter use) and obstacles faced (e.g., alcohol, drug, and physical and mental health problems). The chronically homeless, who suffer from multiple deficits, appear particularly food-insecure, a finding that favors the desperation hypothesis over its street-wisdom alternative. We conclude that hunger is not uniformly experienced by members of the homeless population. Rather, some individuals are better situated than others to cope with the stressful nature of homelessness when addressing their sustenance needs.     

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.     

Homelessness,housing instability,intimate partner violence,mental health,and functioning: A multi-year cohort study of IPV survivors and their children

Abstract

Homelessness and housing instability frequently accompany intimate partner violence and can negatively impact health and functioning. When children are exposed to homelessness or housing instability their ability to develop and function is compromised. The purpose of this study is to examine the differential impact of homelessness and unstable housing on health and functioning of women and their children over a 2-year period. Two hundred and seventy-seven mothers reporting intimate partner violence (stalking, physical, or sexual violence by an intimate partner) were asked about housing stability, abuse, risk for murder, mental health, employment/wages, and their child's functioning over a 2-year period. Outcomes of mothers reporting homelessness and unstable housing were compared to mothers reporting stable housing. Over one-third (36%) of the mothers reported at least one episode of unstable housing over the 2-year period and 11% reported homelessness. Measures of maternal mental health and child functioning were worse for both unstably housed and homeless women, compared to stably housed women, with a higher risk for sexual abuse and risk for murder for homeless women. New models of rapid rehousing are needed that address not only the housing problems of women who have experienced intimate partner violence but also the mental health and safety issues that the women and their children face.     

Depression among the homeless

Very little is known about one of the most common mental health problems facing the homeless: high levels of depressive symptomatology. This paper explains variation in the prevalence of depressive symptoms (CES-D) for a random sample of 150 shelter- and street-based homeless persons in the Birmingham metropolitan area. Fifty-nine percent of the sample show the signs of "probable clinical caseness"; yet there is significant variation in the level of symptomatology. A modified version of the social resources model explains 31 percent of the variation in CES-D scores. Although psychological resources play an important role in the distress outcome, as predicted, social supports are found to have limited impact on depression. Life circumstances have significant direct effects on depression. Persons with previous histories of mental illness and with extensive life event histories are more susceptible to distress. Younger persons, the chronically homeless, the street-based homeless, the sick, and the less educated are also more likely to experience depression. This study suggests the importance of understanding homelessness both as a psychological condition and as a complex set of life circumstances and physical deprivations.     

Recovering from Homelessness: Determining the “Quality of Sobriety” in a Transitional Housing Program

Recent years have seen fundamental shifts in the objectives and delivery of assistance to the homeless. An early emphasis on emergency shelter and monetary housing assistance has been replaced by a focus on programs designed to blend shelter with an array of social services. In most instances, however, programs combining shelter and social services are designed as transitional; that is, they are intended to help homeless individuals and families move from a position of dependence to one where they can live independently. The emphasis in transitional housing programs is on making homeless people housing ready. This paper concerns the process of assessing housing readiness as observed during eighteen months of fieldwork in a federally supported transitional housing program for formerly homeless single adults. The detailed case study that follows supports three important findings. First, there was virtual unanimity among staff and residents that substance abuse was the cause of their homelessness and the key to its solution. Second, success within the program was defined and operationalized along very specific but well understood normative dimensions that have little to do with the material circumstances in which residents find themselves and everything to do with recovery. Third, recovery—the key to housing readiness in this environment—was measured not by objective measures, i.e., number of months sober, but rather by what was widely referred to as one's quality of sobriety, a subjective and consequently often hotly debated measure of attitude and outlook only loosely related to demonstrable abstinence from alcohol. This last finding, that ultimately housing readiness is a subjective judgment, both increases the discretion of shelter staff and generates a systematic disattention to the individual economic issues that are fundamental to an exit from homelessness.     

Psychosocial Problems Associated With Homelessness in Sexual Minority Youths

Sexual minorities are overrepresented among homeless youths, and this is often related to reactions to their status as sexual minorities. While on the streets, they are at increased risk for victimization, substance and alcohol use, sexual risk behaviors, and mental health issues compared to homeless heterosexual youths. This article uses ecological systems theory to examine psychosocial problems associated with homelessness among sexual minority youths and reviews empirical literature examining outcomes related to homeless sexual minority youths including mental health, substance use, and sexual risk behavior. Implications for social work are discussed including practice, policy, and suggestions for future studies.     

A Theory of Mental Health and Optimal Service Delivery for Homeless Children

Homeless children are a vulnerable group with high risk for developing mental health disorders. The pathways to disorders among homeless children have not been fully elucidated, with significant logistical and measurement issues challenging accurate and thorough assessment of need. The environments of homeless children are uniquely chaotic, marked by frequent moves, family structure changes, household and neighborhood disorder, parenting distress, and lack of continuous services. Despite high rates of service use, mental health outcomes remain poor. This paper reviews the literature on homeless children’s mental health, as well as prior theoretical explorations. Finally, the paper proposes a theoretical model that explains elevated rates of mental health problems among homeless children as consequences of harmful stress reactions triggered by chronic household instability along with repeated service disruptions. This model draws upon existing conceptual frameworks of child development, family poverty, health services utilization, and the biology of stress to clarify the role of environmental chaos in the development of child emotional and behavioral problems. Potential strategies to mitigate the risk for mental health disorders among homeless children and future research directions are discussed.     

Social control correlates of arrest behavior among homeless youth in five U.S. cities

This study identified homelessness, substance use, employment, and mental health correlates of homeless youths' arrest activity in 5 cities. Two hundred thirty-eight street youth from Los Angeles, Austin, Denver, New Orleans, and St. Louis were recruited using comparable sampling strategies. Ordinary least squares (OLS) regression results reveal that being arrested for criminal activity is associated with length of homelessness, history of juvenile detention and incarceration, receiving income from theft, substance abuse, and mental illness. Arrests are also associated with interactions between lack of formal employment income and receiving income from theft and between drug and alcohol abuse/ dependency. Understanding the health and situational factors associated with homeless youths' delinquent activity has implications for providing more comprehensive health, mental health, and substance abuse services.     

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.