Early access and use of housing: care leavers and other young people in difficulty

This paper presents findings from a study of how care leavers access and use housing services, and what they said had helped them to do so. The sample comprised 80 care leavers, and, for comparison, a group of 59 young people (termed ‘in difficulty’) who met certain criteria of disadvantage. Care leavers were found to have fewer crisis transitions and less experience of homelessness, together with a much higher level of autonomy and support in their first accommodation, relative to other young people in difficulty. Several factors are identified that, from the care leavers' point of view, contributed to their better access and use of housing services, including having family and friends to turn to, and leaving care teams that negotiated on their behalf with housing services. The paper concludes that care leavers had more positive housing experiences than other young people in difficulty, helped by the improved preparation for independence and ongoing support available to them from leaving care teams.     

“It's hard work,believe me!”: Active efforts to optimise housing by people who live with mental illness and access housing assistance

Secure and appropriate housing is critical for the well‐being of people living with mental illness (consumers). Yet it is often difficult to achieve. Housing assistance is available, but is often difficult for consumers to access and negotiate. While the need for support is well‐recognised, little is known about the active part consumers play in finding and keeping appropriate accommodation. This paper addresses the research question: How do consumers who use housing assistance actively manage their housing situations? In‐depth interviews were conducted with 18 consumers who had used housing assistance within the past five years. These were analysed using constant comparative analysis, based on a grounded theory approach. Participants engaged in a range of activities to address six major concerns: working toward my home; following the rules to keep what I have; managing and improving my accommodation; working with housing services; living within my current situation; and finding and using supports. All participants described times when their mental health negatively affected their ability to do these activities. The findings highlight the need for housing services and mental health services to collaborate to develop policies and protocols that place reasonable demands on consumers and support their abilities to actively manage their housing situations.     

Someone to check in on me: social capital,social support and vulnerable parents with very young children in the Australian Capital Territory

Although knowledge of how social support can mediate stress is now well known, finding ways to enable isolated parents to access social resources that could make a positive difference for children during their critical early years remains difficult. This paper reported on the findings of a telephone survey aimed at understanding levels of social capital and social support experienced by isolated parents raising young children on their own in Canberra, Australia. Specifically, it discussed a successful methodology for reaching isolated parents, those whom services find hard to reach. The survey found that despite the relative affluence of Canberra's population, there is a significant group of parents who are isolated from both formal and informal support and the social capital that can help them cope with the stresses and demands of raising young children. These parents were unsure where to get parenting information and had a strong sense that they were judged by their local communities and services. We identified lost opportunities by general practitioners and other widely used systems such as public housing and security to take more proactive roles and connect parents to formal service support systems. Flexible, affordable child care was identified as an unmet need for these parents, not only as a source of relief from extreme isolation but also to enable them to work or prepare for work through study.     

"Just like I'm saving money in the bank": client perspectives on care coordination services

Older adults face many challenges to community living. The literature has not sufficiently explored the roles of care coordination in the maintenance of housing and access to health care among older adults, particularly from their own perspectives. This qualitative study analyzes the findings from 25 interviews and 6 focus group discussions (48 participants) with a multiethnic sample of older adults in the New York City area. Care coordination services appear to assist older adults access health care, and to a lesser extent, maintain affordable housing. Disparities in access to care coordination appear to remain for immigrant, minority and suburban populations.     

“Just Like I'm Saving Money in the Bank”: Client Perspectives on Care Coordination Services

Older adults face many challenges to community living. The literature has not sufficiently explored the roles of care coordination in the maintenance of housing and access to health care among older adults, particularly from their own perspectives. This qualitative study analyzes the findings from 25 interviews and 6 focus group discussions (48 participants) with a multiethnic sample of older adults in the New York City area. Care coordination services appear to assist older adults access health care, and to a lesser extent, maintain affordable housing. Disparities in access to care coordination appear to remain for immigrant, minority and suburban populations.     

Means Testing and the Heterogeneity of Housing Assets: Funding Long-Term Care in Spain

The access to publicly funded long‐term care (LTC) in Spain has been traditionally rationed through the use of means tests based on individuals’ current income and needs. However, individuals’ wealth, primarily housing assets, is progressively taken into account. Parallel to this feature, the responsibilities for the organization of LTC services have been devolved to region‐states – autonomous communities (ACs), giving rise to some regional heterogeneity, though limited evidence has been reported on the underlying determinants. This paper examines the current role of housing assets in determining public and private funding for long‐term care in Spain. Secondly, we present a qualitative and quantitative examination of the regional heterogeneity in the provision and public funding criteria determining eligibility for public support for LTC. Finally, we report survey evidence on the individual's willingness to sell (WTS) their housing assets in order to either totally or partially finance the access to LTC. Our findings suggest that housing assets are the main source of wealth accumulation at old age. Yet there is significant regional heterogeneity in the access to LTC resulting from regional differences in the means testing criteria. Progressively, all ACs are considering housing assets in their means testing criteria. Interestingly, individuals’ willingness to sell their housing assets declines with age and is more common among less skilled and widowed individuals.     

Is Housing First for Mental Health Community Support Possible During a Housing Shortage?

Supported housing programmes for people with chronic mental health needs have shifted towards approaches that rely on housing first, which prioritizes access to a permanent home in the community. How do support programmes with this assumption manage the market constraints of a shortage of affordable housing? The article examines empirical mixed method data (interviews and programme data) about the experience of managing this problem in the Mental Health Housing and Accommodation Support Initiative (HASI) in New South Wales, Australia. HASI provides clinical mental health services, housing support and housing if needed, for people who are not yet living independently in the community. It found that the housing shortage affected the ability of the providers to implement the intended programme design at three early steps in the support: determining eligibility; prioritizing access between people with and without housing; and managing entry to the programme when they did not have housing. As a result, some otherwise suitable applicants were not prioritized for entry into the programme or their entry was delayed until they were housed. The providers adjusted the programme to the housing market realities, which compromised the programme intentions. The policy lessons are that programmes need strategies to provide housing for people who require it; assist people to find or apply for housing; and support people while they wait for housing. These approaches enhance the coherence of programmes, build on integration mechanisms and respond to the housing context.     

Navigating Housing Instability and Substance Use: Hidden Tensions Facing Youth in Small Town America

Abstract

Recent scholarship indicates that youth homelessness is a significant problem outside urban areas. However, previous studies have not examined how local contexts shape the experiences of youth who are homeless in rural areas and small towns with high rates of poverty and epidemic drug use. To address this gap, this analysis draws from two components of a large national study of homelessness among youth, using data collected in a small non-urban setting in the Northwest including (1) a subset of 41 (out of 215 nationally) in-depth interviews with youth and (2) a subset of 16 surveys (out of 523 nationally) with service providers. We explored availability of services and how youth navigate housing instability and the service landscape in small communities. We discovered that current or prior addictions sometimes posed risks to the safety of youth and compromised their ability to rely on family supports – a support proving critical in the absence of a formal service infrastructure. Our results suggest that youth experiencing housing instability in the context of high rates of drug use and limited formal services must often choose between meeting competing needs: a place to stay versus sobriety. We discuss the implications for policy, practice, and research.     

Resettlement challenges faced by refugee claimant families in Montreal: lack of access to child care

Adult refugee claimants experience several well‐documented post‐migratory challenges. Little is known about the resettlement process for refugee claimant families with children. This study reports on 75 open‐ended, in‐depth interviews with refugee claimant families in Montreal about their resettlement challenges and their proposed solutions to them. These interviews were conducted with 33 dyads and triads of children and parents attending a paediatric hospital. Experiences accessing formal and informal child care in Montreal were addressed. Subsequently, a comparative policy analysis was conducted on residency eligibility criteria for child care subsidization. Twenty‐eight out of 39 parents (73%) report a lack of informal or formal child care and 15 out of 33 families (39%) propose improving access to formal child care services. They describe a lack of informal child care as a result of reduced social networks, and affordability as a barrier to formal child care services. Refugee claimants are not eligible for subsidized child care in Quebec. A comparative policy analysis within Canada and comparable countries reveals that this situation is not unique to Quebec. However, most provinces and European countries offer child care subsidies to refugee claimants. Refugee claimants should qualify for child care subsidies. Social workers and community organizations should consider their clients' child care needs in designing programmes and services.     

Rurality's Influence on Women's Intimate Partner Violence Experiences and Support Needed for Escape and Healing in Australia

A key factor for increasing help-seeking behavior among women experiencing intimate partner violence (IPV) lies in better understanding how social environment affects decisions about when and why individuals take action to end IPV. This article presents original data from 36 in-depth qualitative interviews conducted with women IPV survivors living in rural Australia to address urban-centric and quantitative biases in much IPV research. Derived from first-hand experiences, results reveal rurality's systemic challenges (economic disadvantage, unemployment, lack of informal support, limited availability/access to sociolegal and formal support services due to transportation and parenting responsibilities, quality alternative housing, and timely/relevant crisis counseling) exacerbated personal capacity to end IPV and sociopsychological factors (stigma, isolation, lack of anonymity, abusive partners’ controlling behavior, and normative violence) thwarted IPV disclosure, help seeking, and healing in rural communities. Collectively, women's experiences evidence IPV's complexity as a social problem, misperceived definition, and breadth of influence. In-depth insights highlight location and culture's relevance to IPV knowledge, experience, service provision, and uptake, suggesting benefits may arise if practitioners and policy makers tailor IPV information and services, specifically crisis housing and counseling, in light of how rurality systemically stymies and psychologically affects women's best efforts to escape and heal.     

Poverty, Social Exclusion and the Politics of Disability: Care as a Social Good and the Expenditure of Social Capital in Chuadanga, Bangladesh

People labelled with disabilities in Chuadanga, Bangladesh, are denied equitable access to social networks and formal services. In terms both of funding future formal service programmes and of designing community‐based outreach programmes, this lack of access is not a simple reflection of one's impairment but a facet of the social exclusion and stigma that is culturally ascribed to disability in Chuadanga. We utilize a social model to focus on the cultural processes initiated by the onset of illness or impairment. Our participants are drawn from four types of diagnosed disability: blindness, orthopaedic impairment, hearing impairment and mental disorder. Although this inquiry is in line with Daly's focus on how future spending on formal services to promote care and equity in Europe can be helped by searching out information that is often ignored, the particular focus of this study is Chuadanga and the research questions incorporate a disability studies perspective. The authors consider care as a social good and an expenditure of social capital, in reviewing findings from a recent empirical study of disability and employment in the Bangladesh district of Chuadanga. Regardless of disability, poverty can be a morally and socially devastating ordeal. However, the authors conclude that the added loss of social solidarity and equitable access, due to the social exclusion and stigma of disability for the families concerned, make it statistically far less likely that they will access formal services or be able to escape poverty.     

Providing Care for Persons with Dementia in Rural Communities: Informal Caregivers’ Perceptions of Supports and Services

Dementia is one of the costliest and most time-consuming diseases among older persons. Although informal caregivers provide the majority of care for persons with dementia, little is known about the self-perceived need for social services of caregivers of persons with dementia within rural areas. This pilot study examined the knowledge, access and intent of the practice-oriented service model of caregivers of persons with dementia in rural communities in the Midwest U.S. After a systematic training, researchers interviewed 11 rural caregivers of persons with dementia (n = 11). Data were analyzed using thematic analysis. Although similarities with other caregivers of persons with dementia were found, important differences suggesting unique issues among these rural caregivers of persons with dementia. Many participants found strength in their community, which often served as a safety net of support. Consistent with existing literature, participants expressed financial concerns, geographic barriers and lack of dementia-specific services when using formal services. The need for more specialized formal services in rural areas to supplement existing informal care networks is discussed. Policies and services based on rural caregivers’ unique concerns and challenges and that build upon their existing care networks are recommended.     

Exploring Formal Service Use by Older Chinese: A Case Study on a Naturally Occurring Retirement Community

ABSTRACT

This study examined secondary data from a naturally occurring retirement community in which 296 older Chinese were interviewed to understand and identify the factors related to formal service usage. Regression analysis found that the importance of perception of formal services impacts predicting service use. The results also indicated older female Chinese participants were more likely to use services. Implications for practice and policy to improve access to services by older Chinese were presented and the development of culturally sensitive services for this group is encouraged.     

Financial access and household’s borrowing: Policy perspectives of an emerging economy

This paper analyzes access to finance based on the usage of financial services by Indian households. Based on two rounds of nationally representative All India Debt and Investment Survey (AIDIS) for 2002 and 2012, we examine how access to credit is associated with a household's socioeconomic and demographic characteristics using Heckman’s two-step approach procedure. Our results show that belonging to higher asset quintile groups has a statistically significant positive effect on the household's decision to take loans only from the formal sector in both rounds and significant negative effects on taking a loan only from the informal sector. Similarly, social and religious groups play a significant role in the decision of the household to take a loan. Households with more educated adults are more likely to take a loan. Households involved in regular wage-earning occupations in urban areas are more likely to take a loan from formal sources. Thus, the importance of policy placing greater emphasis on demand-side barriers rather than on improving the physical availability of formal financial services to promote financial inclusion in India.     

Supportive Housing for Addicted,Incarcerated Homeless Adults

ABSTRACT

Homeless populations often suffer from mental illness, substance abuse, and criminality. Interventions, such as supportive housing, can have positive impacts, although benefits can be limited. This study examined outcomes for clients (N = 102) of a new supportive housing intervention. Use of formal treatment, jail contact, and community stability were compared pre- and post-housing. Jail bookings and residential substance abuse treatment significantly declined post-housing, while clients improved in income level, access to food, and housing stability. Results from official justice and treatment system data suggest that supportive housing can lead to significant changes. Future research is necessary to understand the relationship between client characteristics and outcomes.     

Care of Older Adults in Iceland: Policy Objectives and Reality

ABSTRACT

We examine the implementation of the Icelandic government's policy on formal care of older adults in Iceland. The policy as expressed in legislation and other policy documents is to ensure access of older adults to the appropriate level of health and social care services. How does the actual level of formal care compare with the policy objectives? Does there exist an implementation deficit, and if so, why? We address the question by analyzing Icelandic and international statistical databases. The findings reveal a gap between the aims of the current policy and its delivery. As elsewhere in the Nordic region, the policy allows for the emphasis to be on home-care services in which the individual's needs are assessed comprehensively. Administrative problems and insufficient resources to better understand and explain the problem are identified. Current steps to address the problem include the necessity of a comprehensive evaluation of the level and quality of elder-care services in Iceland, which would help compensate for the shortcomings of the existing public statistical databases. In future research, it is necessary to analyze how services can be coordinated while increasing responsiveness to the voices of older adults and their relatives on the care of older people.     

Leaving an Institution in Flanders (Belgium): A Road to Homelessness?

People living in an institution will leave this residential context one day and have to proceed to a stable independent way of living. This transition is not without difficulties as it turns out this socially vulnerable group runs an increased risk of becoming homeless. Research in Flanders (Belgium) has shown that a considerable share of the homeless population has previously stayed in an institutional setting, mostly in youth care (48.7%), psychiatric (34.4%) and penitentiary (33.1%) institutions. Moreover, the share of homeless people with a history in one of these institutions has increased in the past decades. Institution leavers, face at least three obstacles to a stable housing situation in Flanders: a lack of affordable housing, a lack of access to (non-residential) social assistance and personal difficulties in coping with living independently. Yet, there are several programs that support institution leavers and prepare them for the transition to an independent living situation and legal developments that strengthen their position in society and on the housing market. In this paper, we explore these initiatives and developments in three case studies (Antwerp, Ghent and Leuven). Based on in-depth interviews with “street-level bureaucrats” who work in these institutions (youth care, psychiatric and penitentiary settings), social support services and social housing organizations, we reconstruct the pathways of institution leavers to the housing market, the support they receive and the experienced difficulties.     

Needs and Supports in Transitional Housing for People Living with HIV/AIDS in Ontario,Canada

ABSTRACT

There is a paucity of research on transitional housing for people living with HIV/AIDS (PHA) and even less so within the Canadian context. The present work addresses that gap and reports on the results from the Transitional Housing Study, a province wide community-based research collaboration involving PHA, service providers, and university researchers in Ontario Canada. This article answers the following research questions: What supports do residents in transitional housing for PHA access and what needs do these supports address? Developing from a thematic analysis of in-depth qualitative interviews with 25 residents in one of three transitional housing agencies in Ontario for PHA, the findings reveal that participants benefited from four key supports while in transitional housing: the provision of a safe environment, co-coordination and management of HIV (and other) drug therapies, assistance with appointments, and referrals to health and social services. Until more resources are available to increase availability of transitional housing for PHA, the nonprofit housing sector must fill the gap that exists by offering the types of supports identified in this study in order to address the needs of PHA. Future research may link these supports efficiently with concrete health improvements and permanent housing stability among PHA.     

The roles of social support and family resilience in accessing healthcare and employment resources among families living in traditional public housing communities

This study relied on theories of family resilience to examine and differentiate the roles of community social support and family resilience in regards to access and utilization of healthcare and employment resources for public housing residents. The study assessed 234 public housing residents and used structured regressions to test the role of family resilience, internal and external community social support on outcomes associated with economic mobility. Results suggest that external community social support is associated with increased access to and use of health and employment resources. Additionally, residents with higher levels of resilience sought social support from outside of their communities to a greater degree, thereby increasing their access and use of resources. Increases in internal community support were associated with increases in external community support, but alone, limited access to and use of resources. Implications of the findings for policy, interventions, and future research are discussed.     

The Effectiveness of Housing Management

This article examines the performance of different kinds of landlords in providing housing management services to their tenants by reviewing a number of recent studies on housing management effectiveness. In particular the performance of mass-landlords (councils and larger housing associations) is contrasted with that of small-scale, locally-based, resident controlled landlords such as co-operatives or community-based housing associations. Although the evidence is not conclusive, it points to worse performance by large landlords. The paper then assesses the relevance of this evidence to current housing policies and argues that they are unlikely to lead to more effective housing management which is often held by the Government to be one of their major objectives.