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.     

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.     

Factors in the Transition to Homelessness in the Chronically Mentally III

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 the previous year were significantly correlated with TBH Results show that demographic, clinical, and system variables all impact on homelessness in the chronically mentally ill.     

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.     

Women and homelessness,a complex multidimensional issue: findings from a scoping review

Homelessness is an increasingly prevalent issue worldwide. Women represent the fastest growing segment of the homeless population and have differing needs to men. These differences need to be considered by service providers and other stakeholders working with homeless women. A scoping review was conducted to address the question “What is known about issues relating to homeless women in the existing literature?” PubMed, PsycInfo, Embase, CINAHL, Scopus and Web of Science were searched up until March 2018 with no date limits. The final sample of articles included in this scoping study was 232 from which six themes were extracted: (1) pathways into homelessness, (2) trauma, victimization and adverse childhood experiences, (3) mental and physical health issues, (4) barriers to accessing treatment and experiences with service providers, (5) social support and life satisfaction and (6) strengths, hopes and leaving homelessness. This review suggests a strengths-based approach to addressing women’s homelessness. This approach emphasizes people’s self-determination and strengths and views clients as resilient to problems they encounter in their lives. Future research and service provision should take into account the complexities in the lives of homeless women and recognize the autonomy of women to move out of homelessness.     

A psychiatric nurse's role

1. Homelessness in America is a result of complex social, political, and economic forces; approximately one third to one half of the homeless have severe emotional problems. 2. The person with chronic mental illness who is also homeless will face numerous obstacles when the need for psychiatric care arises. 2. The person with chronic mental illness who is also homeless will face numerous obstacles when the need for psychiatric care arises. 3. The federal government is beginning to address the problems of the homeless chronically mentally ill population by establishing pilot programs in Veterans Administration hospitals. 4. The psychiatric nurse is in a unique position to provide services to those who are homeless and 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.     

Characteristics of the homeless mentally ill 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 services 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.     

Deinstitutionalization: a public policy perspective

1. Deinstitutionalization was initiated in an era of social reform to protect the rights of the mentally ill; however, a strong research base was absent and led to major flaws in the policy's implementation. 2. The chronically mentally ill are frequently poor advocates for themselves and, without even the most simple needs fulfilled, end up homeless. 3. The homeless mentally ill require comprehensive support systems with assured continuity of care. An emerging concept to deal with this issue is that of case management. 4. The mental health professional can strive to influence future public policy as patient advocate and nonpartisan educator.     

Obstacles to research analysis

1. The homeless population is composed of subgroups with varying mental health status and needs. 2. Different research designs and data collection methods require differing psychosocial abilities and skills on the part of the respondent. 3. As a result of the psychosocial abilities required and method of sampling, studies are likely to either underrepresent or overrepresent the severely mentally ill homeless. 4. Caution must be exercised in drawing conclusions from any one study.     

Homeless identities: enacted and ascribed

Homelessness has been a perennial concern for sociologists. It is a confronting phenomenon that can challenge western notions of home, a discrete family unit and the ascetics and order of public space. To be without a home and to reside in public places illustrates both an intriguing way of living and some fundamental inadequacies in the functioning of society. Much homelessness research has had the consequence of isolating the 'homeless person' as distinct category or indeed type of individual. They are ascribed with homeless identities. The homeless identity is not simply presented as one dimensional and defining, but this imposed and ill-fitting identity is rarely informed by a close and long-term engagement with the individuals it is supposed to say something about. Drawing on a recent Australian ethnographic study with people literally without shelter, this article aims to contribute to understandings of people who are homeless by outlining some nuanced and diverse aspects of their identities. It argues that people can and do express agency in the way they enact elements of the self, and the experience of homelessness is simultaneously important and unimportant to understand this. Further, the article suggests that what is presumably known about the homeless identity is influenced by day-to-day lives that are on public display.     

“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.     

Racial Differences Regarding Shelter and Housing in a Sample of Urban Elderly Homeless

A sample of elderly homeless persons in Detroit is discussed with an emphasis on distinctions between black and white racial strata. The analyses, based on a field survey conducted in 1988, reveal that several variables distinguish racial groups, including social relationships and kinship, frequency and duration of homelessness, and previous insitutional experiences. Economic differences were not found between black and white elderly homeless men who are the subjects of many urban sociological studies of skid row, while the black elderly homeless are presented as a newly emerged subset of homelessness.     

Life Experiences and Vulnerabilities of Homeless Women: A Comparison of Women Unaccompanied Versus Accompanied by Minor Children,and Correlates With Children’s Emotional Distress

The histories and service needs of 2 groups of homeless women, those unaccompanied by minor children (n = 46) and those accompanied by minor children (n = 22), were compared, on the basis of their responses to a biennial survey of homeless people in a midsize city in the southeast United States. Mothers of children aged 2-10 also completed a measure of stress symptoms for their children (n = 20). Irrespective offamily status group, problems such as substance abuse, history ofmental illness, health problems, chronicity of homelessness, and crime victimization tended to cluster together. The findings also suggest that declining and/or inadequate levels ofpublic benefits, Temporary Assistance to Needy Families, and Medicaid-funded health care in particular, have adversely affected the 2 groups, particularly families with children. The young children in this sample experienced elevated levels ofstress, and significant associations were found between children’s stress levels and certain riskfactors oftheir mothers. Implications for service delivery are discussed.     

Social Communities and Homelessness: A Broader Concept Analysis of Social Relationships and Homelessness

Pathways to and from homelessness were examined from the perspective of people who were both employed and homeless in Calgary, Alberta. Based on data collected through semi-structured open-end interviews (n = 61) with employed homeless people (N estimated at 2,400), we found that respondents identified aspects of five predominant social relationships that had the greatest impact on their present homeless situation: relationships with friends and family, acquaintances in shared accommodation, landlords and employers, other homeless people, and the social service delivery system. The findings provide a model for beginning to understand the complex social communities in which homelessness exists. Further research needs to explore the relationship between service providers and individuals' other social relationships and the role those can play in finding a pathway from homelessness.     

The health of the homeless

Studies of homelessness and health date back to at least the 1970s. The current paper presents a summary on the state of the literature on homelessness and health since the onset of Housing First initiatives. Housing First initiatives represent a change in the previously used model used by social services providers and government agencies from recovery first to housing first, a recognition that homeless people should be housed before contending with other issues such as mental health treatment. Since this time, researchers have pushed research inquiry into areas that were only touched on lightly before. These new areas of research fall generally into that categories of access and utilization, newer demographics, and emerging health concerns. Each of these areas is thoroughly reviewed in the paper. Despite Housing First legislation, homelessness continues to threaten the health of the urban population and will continue to do so as long as it is allowed to persist.     

“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 Among Older Adults with Severe Mental Illness

ABSTRACT

This article tackles a problem that is often overlooked in the literature-the plight of homeless elders with severe mental disabilities. Drawing on his personal experience working with sheltered homeless persons who were mentally ill, the author argues for a focus not on self-sufficiency but on closely supervised care for this vulnerable population.     

Gender Differences in Self-Reported Reasons for Homelessness

The purpose of this paper is to illustrate some of the ways in which the perceived pathways into homelessness are socially structured. We do this by examining the relative frequency of 11 different reasons homeless males and females cite for being homeless. Males were more likely to cite the following as their main reasons for homelessness: loss of a job, discharge from an institution, mental health problems, and alcohol or drug problems. Women were more likely to cite the following as their main reason for homelessness: eviction, interpersonal conflict, and someone no longer able or willing to help. Self-reported reasons for being homeless are also related to age, marital status, race, and being a veteran. As expected, they are also linked to receptiveness to treatment. Gender differences in reasons for homelessness may require different approaches to building helping relationships with homeless men and women.