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.     

Applications of Machine Learning Methods to Predict Readmission and Length-of-Stay for Homeless Families: The Case of Win Shelters in New York City

ABSTRACT

New York City faces the challenge of an ever-increasing homeless population with almost 60,000 people currently living in city shelters. In 2015, approximately 25% of families stayed longer than nine months in a shelter, and 17% of families with children that exited a homeless shelter returned to the shelter system within 30 days of leaving. This suggests that “long-term” shelter residents and those that re-enter shelters contribute significantly to the rise of the homeless population living in city shelters and indicate systemic challenges to finding adequate permanent housing. This article focuses on our preliminary work with Win (Women-in-Need) shelters to understand the factors that predict readmission and length-of-stay of homeless families. We create a unified, comprehensive database of the homeless population being served by Win shelters, accounting for more than 6,000 homeless families. We apply logistic regression models and an unsupervised clustering algorithm to identify predictors of re-entry and long-term length-of-stay. Citizenship, age, medical conditions, employment, and history of foster care or shelter stays as a child are found to be significant predictors. The results of the K-means clustering identify three primary groups, consistent with previous typologies characterized by transitionally homeless, episodically homeless, and chronically homeless.     

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.     

Homeless mothers and depression: misdirected policy.

This paper is a critique of recent service-intensive shelter programs for homeless mothers and the policies that underlie these shelters. We first document the process by which mental health problems and family homelessness became so closely but mistakenly linked. We then demonstrate empirically that shelter programs for homeless families nonetheless presume that mental health problems are part of the causal nexus of family homelessness and indiscriminately deliver mental health services to homeless mothers. Simultaneously, shelter programs encourage the isolation of their residents from what they presume to be their "problematic" social networks. We show that, while mental health services had little impact on depression levels among homeless mothers, isolation from social networks did increase depression among homeless mothers. Our findings suggest that policy should put more emphasis on rapid reintegration into the community through providing housing, and it should put less emphasis on providing services.     

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.     

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.     

The experiences of adolescents and young adults residing with their families in emergency shelters in Canada

Emergency homeless shelters can be stressful environments for families. They can be associated with emotional distress and feelings of restriction for parents, and with behavioural, social, and developmental challenges for children. However, little is known about the experiences of accompanied youth residing in shelter with their families, as the literature about this age group's experiences of homelessness has mainly focused on unaccompanied youth. Findings from the current study are drawn from qualitative interviews with 16 adolescents and young adults (aged 16–21) who were homeless and living with their families in family homeless shelters in Ottawa, Ontario, Canada. Youth described family homeless shelters as stressful environments but also found that the shelters provided support to them and their families. Youth discussed the various strategies they used to cope in facing the challenges of shelter life. These findings add to our understanding of youth who are homeless and highlight the ways in which they adapt to the challenges of living in a family homeless shelter with their families. Recommendations are included for ways that shelter staff and policymakers can enact operational and systemic changes that could potentially improve the experiences of such youth and their families.     

Community Case Management Intervention for Hard-to-Place Homeless Families Leaving Emergency Shelter

Abstract

The Community Case Management Intervention was designed to fill a gap in services for hard to place homeless families who leave emergency shelters. There were 51 adults and 78 children who participated in the research. Families who met the criteria and volunteered for the study were randomly assigned to an intervention or comparison condition. Intensive case management was provided to families in the intervention condition upon their exit from the shelter. Services included referral, advocacy, support, and assistance with family problem-solving and decision-making. Comparison families did not receive similar services. Results of the study are encouraging and show that families in the intervention felt greater levels of social support and greater family unity.     

Child welfare involvement among children in homeless families

An analysis of 8251 homeless children in New York City found that 18% of them received child welfare services over the five-year period following their first shelter admission, and an additional 6% had a history of having received such services before their first shelter admission. Recurrent use of public shelters, exposure to domestic violence, older age at first episode of homelessness, and larger number of children in a household were associated with an increased risk of child welfare involvement. The high rate of crossover between homelessness and the child welfare system suggests the need for service coordination for children in homeless families.     

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.     

“If you’re gonna help me,help me”: Barriers to housing among unsheltered homeless adults

Despite a legally-mandated right to shelter and extensive outreach efforts, an estimated 3,675 homeless individuals were living on the streets of New York City in 2018. Through interviews with 43 unsheltered homeless individuals in the borough of Manhattan (age range 21–74 years), this qualitative study examined barriers they face in accessing housing and other services as well as experiences surviving on the street. Through thematic analysis of the interview data, the most common barriers found were obtaining required identification documents, lack of accessibility of shelters amid complex healthcare needs, waiting as part of the process, and exclusion of pets from shelters and housing options. Themes capturing survival on the street included sleeping safe, avoiding shelters, and meeting daily needs. Virtually all barriers street homeless New Yorkers face stem from bureaucratic policies that, however well-intentioned, do not address their diverse needs. Thus, long delays and poor communication, combined with crowded, unsafe shelters, lead to frustration and alienation. While homelessness is ultimately the result of a severe and chronic shortage of affordable housing, creating accessible, safe, pet-friendly shelter and safe haven options and instituting a smoother, more transparent process for moving from the streets could substantially reduce street homelessness.     

“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.     

Meeting the Needs of the Mentally Ill Homeless in Massachusetts-Based Emergency Shelters

A statewide survey (response rate = 79.5%) of the emergency shelters designed for homeless individuals was conducted in Massachusetts to determine the prevalence of serious mental illness among residents and extent to which they received psychiatric services. An average prevalence rate of 22%, ranging from 1% to 70%, was reported despite the fact that 87% of the shelters restricted admission of those exhibiting severe behavioral problems. Nearly three-quarters of the shelters reported providing some mental health services as part of their program, and 80% had established ties with professional mental health agencies. Linkages with these mental health agencies greatly enhanced placement options for mentally ill persons. When queried on the most pressing community-based service needed for the homeless mentally ill, nearly two-thirds of the shelters reported a need for additional housing alternatives.     

Implementing an HIV Rapid Testing Intervention for Homeless Veterans in Shelter Settings within Los Angeles County,USA

Abstract

We implemented and evaluated an HIV rapid testing intervention in collaboration withthe US Department of Veterans Affairs and the Los Angeles County Department ofHealth to 1) increase HIV testing/receipt of results, and 2) increase veteran access to VA homeless services.

Ninety-seven veterans recruited in 9 shelters as part of the Los Angeles Homeless Services Authority (LAHSA) emergency shelter program were randomized (2-to-1 ratio) into one of two interventional arms: rapid test (RT) arm (on-site HIV rapid testing/referral to VA homeless program) and referral arm (VA referral only).

Recruiters approached 2664 individuals; 136 (5.1%) were eligible. Ninety-seven (71.3% of those eligible) accepted enrollment. Testing rates were 100.0% in RT arm and 3.3%in Referral arm (p<0.001). Test result receipt rates were 98.5% in RT arm and 0.0% in Referral arm (p<0.001). There was no increase in visits to VA homeless programs in either arm. HIV prevalence/rate of new incidence was 1.5%. While more than half admitted high-risk behaviors in the past 12 months, 78% reported chances of HIV infection as “none” or “low” rather than “moderate” or “high.”

On-site rapid testing in homeless shelters is feasible and acceptable for testing hard-toreach and vulnerable populations. More robust outreach efforts are needed to improve linkage to care.     

Supporting family life: A survey of homeless shelters

Survey data from a national sample of homeless family shelters (N=59)were analyzed to describe the family support programming available to residents. Data were reported on facility and resident characteristics and family support programming, as well as on facility admission criteria and program participation requirements. Four independent variables (length of stay, shelter capacity, sponsorship, and program philosophy) were examined for their relationship to the family-oriented services offered. Facilities sheltered an average of 17 families, with a range of 2–200; the average length of stay for families was slightly over 5 months. Regarding family programming, services of an educational nature were more popular than those focused on providing support or therapy/intervention; services to parents to further adult development were more often offered than those either directed to parents in their parenting roles or to the family as a unit. Virtually all shelters (98%) applied eligibility criteria to families seeking admission. The most common reasons for exclusion were active drug (86%) and alcohol (83%) abuse by a family member; 40% also refused acceptance to families with adolescent males. Seventy-eight percent of facilities mandated participation in some support services. Smaller shelters operated with greater numbers of exclusions (¯x=5.98773; p<.05);larger shelters had higher percentages of mandatory family programming (¯x= 9.21823; p<.06).These findings shed light on shelter directors' beliefs about the etiology of family homelessness and proper steps to solve the problem.     

Exiting shelter: an epidemiological analysis of barriers and facilitators for families

This study examines the role of individual- and family-level factors in predicting the length of shelter stays for homeless families. Interviews were conducted with all families exiting one of six emergency family shelters in Worcester, Massachusetts, between November 2006, and November 2007. Analyses, using an ordinary least squares regression model, find that families with a positive alcohol or drug screen in the year prior stay 85 days longer than those without a positive screen; families leaving shelter with a housing subsidy stay 66 days longer than those leaving without a subsidy. Demographic factors, education, employment, health, and mental health are not found to predict shelter stay duration. Consistent with prior research, housing resources relate to families' time in shelter; with the exception of a positive substance abuse screen, individual-level problems are not related to their time in shelter. Efforts to expand these resources at the local, state, and national levels are a high priority.     

Cold-related injuries in a cohort of homeless adults

People experiencing homelessness have an increased risk of cold-related injuries. This study determined the rate of emergency department (ED) visits for cold-related injuries among homeless adults and low-income controls in Toronto, Canada. Homeless individuals were recruited at shelters and meal programs. Age- and sex-matched controls living in low-income neighborhoods were selected. ED utilization was ascertained over 4-years of follow-up (2005–9) using administrative databases. A total of 16 ED visits for cold-related injuries were observed among 587 homeless men and 296 homeless women. The rate of ED visits was 6.7 (95% CI, 4.2–12.4) per 1000 person-years of observation among homeless men and 0.9 (95% CI, 0.03–5.6) among homeless women. ED visit rates were significantly higher among homeless men compared to low-income men (P?<?0.001) and significantly higher among homeless men compared to homeless women (P?=?0.03). Targeted public health interventions are needed to reduce the risk of cold-related injuries among people experiencing homelessness.     

The need for safe spaces: Exploring the experiences of homeless LGBTQ youth in shelters

Studies indicate LGBTQ youth are at higher risk of homelessness (2–13 times) than their heterosexual cisgender counterparts and that they represent a substantial portion of youth utilizing housing and shelter services. Some authors have provided anecdotal (rather than empirical) examples of LGBTQ youth experiencing abuse or mistreatment in shelters; most studies focusing on LGBTQ homeless youth have been conducted in large cities and have rarely collected data from both youth and providers. Using an exploratory, grounded theory approach, this study utilized data from interviews with LGBTQ youth with a history of homelessness as well as service providers working with this population in a mid-sized Northeastern city. Findings suggest youth experience multiple challenges, barriers, and mistreatment in the shelters; further, data suggests several ideas about how to transform shelters to better meet the needs of LGBTQ youth.     

Creating safe spaces: designing day shelters for people experiencing homelessness

Day shelter programs are an important resource for people experiencing homelessness, offering respite from inclement weather, social stigma, victimization, and access to essential services and resources. Creating functional day shelter spaces requires that staff, services, and facilities support the needs of this vulnerable and marginalized population. Little guidance, however, is available regarding the design of day shelter spaces that support service engagement and positive service outcomes. This systematic review was conducted to support the development of a new day shelter in Fort Worth, Texas, identifying and reviewing interdisciplinary resources relevant to the design of these facilities. Based on the review, a preliminary taxonomy emphasizing day shelter client safety, security, dignity and health and well-being is proposed. Additional discussion identifies practical considerations affecting the implementation of the taxonomy, design priorities, and how the taxonomy was applied to the design of the Fort Worth day shelter.     

The Christmas Box House: Developing a Best Practice Model for Emergency Shelter Care and Assessment

ABSTRACT

In many states, emergency shelter care facilities are the main point of entry into the child welfare system. Despite this important “gatekeeping” role, emergency or crisis shelters serving abused and neglected children have been overlooked as research settings, and little has been written about them in the child welfare literature. This article describes the evolution, design, and implementation of the Christmas Box House, a new model for shelter care in the State of Utah. Emphasis is placed on the public-private partnerships that not only spurred the development of the Christmas Box House model, but will now be critical to the success of planned research efforts.