Rural Homeless Shelters: A Comparative Analysis

Although there has been some increased attention to the issue of homelessness and homeless shelter services, little effort has been made to understand the operation of rural homeless shelters. This situation persists despite decades of effort showing that the rural environment provides a very different context for the delivery of services than an urban environment. This study hypothesized that contextual differences in rural environments would produce various strategies of service delivery among homeless shelters. A typology of rural environments was created. Homeless shelters within each of four cells of the typology were selected. Comparative case study analysis provided partial support for the hypothesis.     

Schizoid Personality Traits Among the Homeless Mentally Ill: A Quantitative and Qualitative Report

This paper examines the interplay among schizoid personality traits, chronicity of homelessness, and engagement in treatment in a homeless mentally ill population. Both qualitative and quantitative information will be provided about a sample of 125 homeless mentally ill individuals receiving psychiatric treatment in a comprehensive services drop-in clinic. Naturalistic observations and a case vignette suggested that schizoid traits were prevalent and may have been playing a role in treatment engagement and chronicity of homelessness. This hypothesis was tested using quantitative research methods. The results showed that schizoid personality disorder and schizoid personality traits were prevalent in the sample. The presence of schizoid traits was positively correlated with chronicity of homelessness. Further, two schizoid traits (being content without sexual involvement with others, and lacking close friends or confidants) were positively correlated with remaining in treatment at 3 months. Implications of these findings for future research and treatment design will be discussed.     

Policy Implications from the Study of the Homeless

The article presents contemporary research results, reviews the case histories of selected homeless, discusses inferences deduced from participant observation, and delineates conclusions drawn from an analysis of intake data in facilities for the homeless. Although the problems described by individuals served by the three agencies have different manifestations, the root causes are similar. The data supports the conclusion that although substance abuse and mental illness are often associated with being homeless, they are not usually the principal cause. Clearly the root cause of homelessness is the critical lack of low-cost housing compounded by the inability to find a job. Several complicating factors that contribute to the growing problem of homelessness are also discussed within the context of the increasing importance of the effects of concentrated poverty and the social isolation of the poor. Policy options are outlined that are critical to developing an intelligent response to the problems of homelessness.     

Factors in the transition to homelessness in the chronically mentally Ill

Although there is a great deal of literature on homelessness and mental illness, few studies have examined the factors which may lead to homelessness in the mentally ill. The objective of this research was to examine the factors in the length of time between when a client of the Los Angeles County Department of Mental Health entered the system and when he or she was first homeless on admission to a service (time before homelessness, TBH). Past psychiatric records of 142 currently homeless clients were examined through the Automated Information System of LACDMH. Results showed that total admissions to any service and total admissions to prison services were predictors of shorter TBH; being younger and being both African-American and female were predictors of longer TBH. TBH shortened dramatically from 1973 to 1993; mental health funding levels for theprevious year were significantly correlated with TBH. Results show that demographic, clinical, and system variables all impact on homelessness in the chronically mentally ill.     

Characteristics of the Homeless Mentally III in Case Management: Differentiation Using Major Diagnostic Categories

The homeless mentally ill are more disabled than other homeless people and require more services, but important variations exist. This study examined relationships between broad Axis I diagnostic clusters and demographic and service variables for 328 clients receiving case management at a community program for the chronic mentally ill homeless. Demographic characteristics, medical history, educational, psychological, and marital history, and case management variables were examined for psychotic, affective, and miscellaneous other clients. Differences were found in such areas as suicide attempts and current suicide status, psychiatric treatment history, education, overall impairment of functioning, length of time homeless, and time in case management but not in status at termination or number of senlices required. Psychotics had lower adaptive functioning, spent less time in case management, but had as successful outcomes as affective clients. Psychiatric diagnosis provides information that might assist case management for the homeless mentally ill.     

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

Rolling forward: addressing needs in the homeless community

ABSTRACT

The purpose of this pilot study was to use a bottom up, or grounded, approach to understand, from the perspective of the individuals living in the homeless community, what they feel would enable them to become housed and stay permanently housed. Organizations which serve homeless individuals often use a top down approach and implement programs without asking the homeless what they most need to find permanent housing. This project used intensive interviews to determine the needs of unhoused individuals in a mid-sized city with a tourist-centered economy in the south eastern United States. Working local homeless shelters, and various other intermediaries we collected data from 102 homeless individuals and 11 service providers. The major theme that emerged in our research is that the homeless individuals we interviewed were, for the most part, they were able to meet many of their basic needs, such as securing food, clothing, a place to bathe and wash their clothes, as well as obtain physical and mental care. However, they perceived lack of reliable and affordable transportation to be a significant barrier to obtaining and maintaining employment, making and keeping appointments, and maintaining their social support network.     

Young and Older Caregivers at Homeless Animal and Human Shelters: Selfish and Selfless Motives in Helping Others

In the present study, young (n = 34) and older(n = 70) adult volunteers at either animal (n= 48) or human (n = 56) homeless shelters were asked to complete measures of caregiver stress/satisfaction, volunteer motives, and social desirability. Young compared to older volunteers assisting animals, but not humans, reported a significantly higher caseload and spending significantly more time per visit with their clients. In addition, young volunteers reported significantly higher levels of caregiver stress with humans more than animals. Also, volunteers at human (but not animal) homeless shelters claimed the need for meeting social expectations as a motive for community service. Furthermore, younger compared to older volunteers reported gaining relevant career experience, obtaining a knowledge of the plight of others, relieving aversive emotions, and meeting normative expectations as significant motives for volunteering. These results may have important implications for recruitment and training of community volunteers at homeless shelters.     

Current and Prior Mental Health Treatment of Jail Inmates: The Use of the Jail as an Alternative Shelter

Changing policies in mental health and welfare are altering the character of urban jail populations. Homeless people, many of them ex–mental-hospital patients, occupy jail space in increasing numbers. They almost never commit violent crimes and seldom commit any real crime. They are given a charge and put in jail as a way to take them off the streets. The way in which official statistics are created and kept makes it difficult to demonstrate the nature and extent of this problem. This paper reports on one way this can be done.     

Meeting Family Housing Needs: Experiences of Rural Women in the Midst of Welfare Reform

Though sometimes overlooked, the availability, affordability, and quality of housing in rural communities are a potential barrier to transitioning from welfare to work. In this investigation we examine housing issues confronting 17 rural women and their families who were recipients of welfare benefits in 1997. Respondents' housing accounts illustrate the significance of reliance on both government housing subsidies and informal subsidies supplied by friends, family, and more distant relatives. The study focuses on concerns women have in meeting their families shelter needs and the complexities involved in doing so. The findings of the research suggest that additional housing policy initiatives, as well as a targeted research agenda are needed, especially for families whose welfare benefits are nearing termination.     

Homeless violence and the informal rules of street life

Successful adaptation to street life requires that risk of violence, an often present aspect of this lifestyle, be reduced to as low a level as possible. This means knowing the informal rules which permit avoiding the pitfalls of street life. It is argued in this paper that safety and security are a function of interactions occurring within a specific place, with particular associates, and involving safe and unsafe behavior. Carelessness with respect to any of these factors can result in victimization. These issues are discussed using survey and ethnographic data collected in Chattanooga.     

Characteristics of urban male homeless veterans and non-veterans in Omaha,Nebraska

The current study examined differences between urban homeless veterans and non-veterans on sociodemographics, housing, clinical characteristics, and psychosocial factors. We recruited a sample of 196 homeless men (101 veterans, 95 non-veterans) from the Omaha, Nebraska metropolitan area. Structured interviews were conducted by research staff. The results showed that the two groups were similar in most respects, though there were several notable differences. Homeless veterans were found to be older and more educated than non-veterans, more likely to have married, and reported having fewer non-adult children. Multivariable models controlling for age further showed that veterans reported a higher number of medical problems and were more likely to report being diagnosed with major depression or PTSD than non-veterans. Comparison with previous studies suggests changes in certain characteristics of homeless veterans over the past few decades that may reflect the growing proportion of veterans from the all-volunteer force, initiated after the draft ended in 1975. Findings from this study were consistent with previous comparative studies suggesting limited changes in recent decades in the characteristics of homeless veterans as compared to non-veterans, although the high prevalence of major depression and PTSD merit special treatment for these disorders.     

The Application of Artificial Neural Networks for Outcome Prediction in a Cohort of Severely Mentally Ill Outpatients

SUMMARY

Social workers and other mental health workers lack clinical decision support tools to predict which clients are at greatest risk of psychiatric rehospitalization. Artificial neural networks (ANNs), are computer decision support tools that make prediction and classification decisions based on accumulated experience and information contained in successfully solved cases (correct decisions). This study evaluates the use of ANNs in predicting rehospitalization of severely mentally ill outpatients. Eight Bayesian ANN models achieved correct prediction rates ranging from 75% to 93% for two prediction conditions. These results support the utility of Bayesian ANN models in the development of clinical decision support tools.     

Meeting the Needs of Visually Impaired People Living in Lifetime Homes

ABSTRACT

This article explores perceptions on the suitability and effectiveness of Lifetime Homes standards (LTHS) for those with visual impairment in Northern Ireland. LTHS are a series of mandatory United Kingdom public-sector housing design interventions, providing a model for ensuring accessible and adaptable homes throughout an occupant's life span. An aging demographic with increasing incidence of diabetes has led to rising numbers of elderly, visually impaired people wanting to remain in their homes for longer. Qualitative semi-structured interviews were conducted with 13 key stakeholders and thematically analyzed. Although findings show that employing LTHS offers benefits to visually impaired residents, shortcomings were also identified. Evidence indicates a need for policy makers, health-care professionals, and housing associations to modify practices to better meet the housing needs of visually impaired people. Findings may also be applicable to those with other impairments and disabilities in relation to housing for elderly residents.     

Changing Attitudes Toward the Homeless: The Effects of Prosocial Communication With the Homeless

One hundred, thirty-four undergraduate students participated in a field experiment designed to examine the effects of extended, prosocial communication with homeless persons, upon attitudes toward the homeless problem, of behavioral intentions towards the homeless, and of causal attributions about homelessness. It was expected that prosocial interaction with the homeless would produce shifts in attitudes and behavioral intentions toward the homeless and homelessness and result in greater attributions of external causes to explain homelessness. Nineteen experimental participants worked 15 hours at a local homeless shelter. Their responses to a posttest questionnaire that measured a range of attitudinal and behavioral orientations toward the homeless were compared with control participants who did not work at the shelter. Subsequent analyses furnished strong evidence of positive changes in attitudes and intentions toward homelessness among the shelter workers. These participants evaluated homeless people as less blameworthy and more socially attractive than did control participants; moreover, shelter workers indicated more personal responsibility and behavioral commitment to helping the homeless than control participants. They also perceived the homeless problem to be more serious and were more likely to attribute homelessness to bad luck than control participants. However, the two groups were equally likely to attribute homelessness to various external causes such as the economy, housing costs, and governmental policies. The results are interpreted as having policy implications for volunteer service.     

Neighborhood Outcomes of Formally Homeless Veterans Participating in the HUD-VASH Program

Research regarding how neighborhoods affect the people who live in them has grown in recent years. However, the neighborhood outcomes of formally homeless veterans have not received the attention this group warrants. This article examines the neighborhood outcomes of two groups of housing voucher holders. Using administrative data, this exploratory study finds that U.S. Department of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) voucher holders receiving comprehensive case management reside in higher quality neighborhoods than those who do not receive these services. Additionally, this effect seems to be a more critical factor for African Americans than Whites. Use of case managers with housing vouchers may improve African American residential outcomes in terms of neighborhood quality.     

Integrated Program Development: A Model for Meeting the Complex Needs of Homeless Persons

Homelessness is caused both by structural and personal factors. Thus, comprehensive services are required to meet the complex needs of homeless persons. This article reviews case management and group work practice with homeless persons and argues that effective social work practice must incorporate both intervention methods. Integrated Program Development (IPD), a program framework for shelter services, is presented. A pilot project at the Salvation Army Family Haven in St. Louis, Missouri illustrates the costs and benefits of empowerment-oriented group work with homeless persons. Three approaches for establishing group work for homeless people are suggested. Each approach requires that group workers, with community organizing skills, be employed by social service administrators.     

A Knowledge Based System for Assisting in Differential Diagnosis of Chemically Dependent/Mentally Ill Patients

Summary

This paper discusses the use of Knowledge Base 2.1, a computer program that administers a response dependent, structured interview to evaluate the presence of psychiatric disorders within the chemical dependency treatment setting. The writer reviews the problems commonly encountered when conducting clinical interviews, psychometric examinations and differentially diagnosing psychiatric disorders within this special population. Knowledge Base 2.1 utilizes combined computer techniques of rule driven logic, pattern matching, and an original algorithm that accomplishes a “real time retandardization” of the complete database. With each administration, standardization is implemented in an effort to adequately consider the effects of chemical dependency on psychological test performance and normative information regarding symptoms. Knowledge Base 2.1 also functions as a research tool inasmuch as all patient responses to this structured interview are permanently stored in computer files for ongoing analysis.     

Discrepancies in Reporting of Physical and Sexual Abuse Among Homeless Young Adults

This study investigated risk factors for discrepant reporting of physical and sexual abuse among 172 homeless young adults. Discrepant reporting includes situations in which a respondent denies experiencing abuse in general but reports being a victim of specific forms of maltreatment. The results revealed that discrepant reporting rates tended to be highest for minor physical assault and for noncontact sexual abuse. Multivariate results revealed that demographic characteristics were important correlates of both discrepant physical and sexual abuse reporters. Family background characteristics also played a role in discrepant reporting for physical abuse. Overall, some young people with abuse histories are not adequately labeling their maltreatment experiences and, as a result, may not be receiving the necessary treatment.     

The Social Relationships and Social Support of Aging Mothers Whose Adult Daughters Are Mentally Ill

Guided by a conceptual framework highlighting multiple facets of social relationships and social support, this study examined the extent to which aging mothers of adult daughters with a serious mental illness were socially integrated with members of their network. It further examined the relational content of these mothers’ social ties as tangible or intangible support and the nature of their supportive exchanges with network members, particularly their adult daughters with mental illness. A structured face-to-face interview was conducted with 22 aging mothers of these adult daughters. Two methods of analysis were used to analyze data: counting and content analysis. Findings showed aging mothers of daughters with mental illness were socially integrated with relatives and nonrelatives, evidenced relational content of tangible and intangible support in their social ties and engaged in bidirectional and asymmetrical support exchanges with network members, including their daughters with mental illness. These findings suggest that social resources in the form of social relationships and support are embedded in the networks of aging mothers who have adult daughters with serious mental illness. Practitioners should assess support contributions to the aging mothers of adult daughters with serious mental illness from a wide range of social relationships including their daughters.