Identity in transition: how formerly homeless individuals negotiate identity as they move into housing

It is unclear what happens when stigmatized individuals undergo status transitions into non-stigmatized groups. This paper explores changes in housing status, identity, and social relationships over time and their impact on formerly homeless individuals. Drawing on longitudinal qualitative interview data collected over six months from seven individuals transitioning out of homelessness and into government supported housing, this paper examines identity changes during such a status shift. Analysis shows that individuals distanced themselves from both homeless and formerly homeless people, and connected with others through groups not affiliated with homelessness or shelter life. When exiting a stigmatized status, like homelessness, social distancing may be particularly important as it helps redefine the self as apart from that previously held stigmatized status. Implications for research and policy are discussed.     

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.     

Eschew Obfuscation in Discussing Political Correctness

ABSTRACT

Despite the spectrum of available resources, homelessness is a persistent societal and public health challenge throughout the United States and in San Diego County. Beginning in January 2014, San Diego began the integration of a Coordinated Entry System into its homeless system-of-care. This historical prospective study examined the predictors of establishing eligibility for permanent housing resources among 15,042 single homeless adults enrolled in the Coordinated Entry System Multivariable logistic regression was conducted to assess the relationship between client vulnerability as measured by the triage tool VI-SPDAT and establishing client eligibility for permanent housing. Overall, being of moderate or high vulnerability was associated with establishing eligibility for a permanent housing resource. Veterans established eligibility faster and more frequently than others, regardless of their vulnerability score. However, the demand for services far outweighed the ability of the system to respond to those with moderate to high vulnerability. More housing navigators and fewer client “hand-offs” between housing professionals are recommended to increase the efficiency of the process. Additional research examining the second and third steps is also needed to more fully understand the factors that promote permanent housing solutions for those seeking services.     

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.     

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.     

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.     

Homelessness in Sweden–discussion,patterns, and causes

In a number of countries in Western Europe and in North America homelessness has come to the fore once again over the last 15-20 years, a fact to which many books and surveys bear witness. In a number of countries, organizations have been formed both for and by the homeless.¹Newspapers sold on the street to promote the cause of the homeless are becoming an increasingly common sight.²Despite this trend there is at present still no generally acknowledged explanation of the cause of homelessness and we do not know whether the causes are the same in the social democratic European welfare states, in the USA and Canada, or in countries with a poorly developed welfare system. Nor do we know whether homelessness for the individual is a short-term or permanent state. This article highlights Swedish homelessness. It is based on the results of a research project which I ran from 1993 to 1998.³The article has three objectives. First, I wish to provide a brief presentation of the issue of Swedish homelessness using, among other things, a study of how the media have dealt with the issue. Secondly, I wish to discuss the pattern of homelessness in Sweden and provide an explanation of why the length of homelessness varies. Thirdly, I wish to highlight the question of how we explain why people can be homeless in a country where social welfare and housing policies have, decade after decade, been directed at eradicating housing problems. The last two questions were highlighted in a case study conducted by me in Malmö, the country's third largest city.     

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.     

Can't do it alone: housing collaborations to improve foster youth outcomes

Research documents that youth transitioning out of the foster care system experience a variety of negative outcomes, including homelessness. Housing collaborations, which aim to comprehensively address resource and service needs for transitioning youth, including permanent connections, education, and employment, have resulted in innovative programming and forged new relationships among child welfare, social service and housing developers, and providers. This article describes the partners, models, and resources several collaborations used and their progress and outcomes; shares insights gained; and explores productive directions for future work.     

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.     

Does a Baby Help Young Women Transition Out of Homelessness? Motivation,Coping, and Parenting

Homeless young women experience high levels of stress, challenges to mental health, substance use and abuse, and a lack of housing or of secure housing. This article explores one of the findings from a longitudinal qualitative study designed to follow homeless young women for a 2-year period as they make efforts to transition out of homelessness. Our objective was to determine the assets used by these young women as they survived on the street and to transition out of homelessness. The authors found that one of the primary reasons discussed for leaving homelessness was becoming pregnant and having a baby. However, most of the mothers reported increasing levels of stress as the baby became a toddler. They described themselves as using “soft drugs” as a mode of coping with this stress.     

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.     

Employment among unaccompanied women experiencing homelessness

ABSTRACT

Women represent one of the fastest growing segments of the homeless population and employment is often central exiting homelessness. However, little research considers employment experiences among unaccompanied women, a particularly vulnerable sub-population. This study explored how unaccompanied women experiencing homelessness (n?=?20) perceived and negotiated employment in a mid-sized community. Thematic analysis revealed four themes: limited work experience, limited aspirations, the holding pattern, and individual barriers. Findings endorse the need for Housing-First interventions to prioritize stable housing and employment-friendly shelters.     

Understanding the Psychodynamics of Chronic Homelessness from a Self Psychological Perspective

Self psychology can help explain multiple meanings and experiences of being chronically homeless. While it is clear that homelessness is primarily caused by structural deficits and not individual characteristics, for people who are chronically homeless, this way of existence may have developed to serve a variety of coping, cohesive, and self-preserving functions as they have learned to survive and adapt to hostile environments. Through the use of self psychologically informed clinical practice, this paper explores the subject’s multiple meanings and experiences as well as the nuanced processes that led her to successfully attain permanent housing. The paper begins by discussing macro etiologies of homelessness, constructs in self psychology and strives to link the two in theory and practice by exploring one person’s life of chronic homelessness. The paper also explores ethical challenges as coercive elements factor into the case.     

Sense of community through supportive housing among formerly homeless individuals with serious mental illness

Much research documents the correlation between homelessness and mental illness. Often, existing research focuses on deficits that live at the intersection of these phenomena. The present study utilizes a sense of community (SOC) framework to interrogate the ways in which formerly homeless individuals with serious mental illness perceive and experience community in supportive housing. Through focus groups with 18 consumers, this study contextualizes dimensions of SOC (membership, emotional connection, needs fulfillment, and influence) for the aforementioned population. Analysis of focus group data produced 16 themes and subthemes that support and extend our understanding of SOC for a population often conceptualized as isolated and alone. Implications for policy and practice emphasize: (1) the importance of supportive housing communities and the call for policymakers to increase funding for such programing; and, (2) that practitioners facilitate housing members’ voices to effectuate change in supportive housing and increase SOC.     

Successfully exiting homelessness: experiences of formerly homeless mentally ill individuals

This study aims to identify and describe processes of change enabling achievement of stable housing among homeless individuals. Twelve previously homeless individuals who had maintained stable housing for a period of at least 24 consecutive months provided information through semi-structured interviews on the following topics: (1) the personal experience of homelessness, (2) the process of becoming housed, and (3) the role of significant life relationships. Only the second and third topic areas were included in this discussion. Eight categories were developed and analyzed from the qualitative interviews, including: work/employment difficulties, substance use and/or mental illness, cyclical nature of homelessness, personal motivation, housing-related issues, lessons learned, relationships with family/friends and relationships with service providers. The participants highlighted relationships with family, friends and service providers as central in the processes of achieving stable housing.     

Public housing agency preferences for the homeless as a policy lever: Examining county-level housing subsidy receipt and maltreatment rates

This study examines the relationship between county Public Housing Agency (PHA) practices that prioritize families experiencing homelessness and county-level child maltreatment rates. Using data from a survey of PHAs and the National Child Abuse and Neglect Data System (NCANDS) with a sample of 534 counties, we find that policies which give preference to homeless households for housing assistance are associated with reduced victimization and substantiation rates, while policies that reduce barriers to assistance eligibility are associated with reporting rates. Our findings suggest that beyond prioritizing homeless families for housing assistance as a means of ending homelessness, providing families with more expedient access to a valuable public subsidy may have important positive externalities, such as reduced CPS involvement. Additional partnerships between child welfare agencies and housing providers, particularly those that provide housing subsidies, may be worthy of additional investment and evaluation.     

On the Edge of Homelessness: Rural Poverty and Housing Insecurity1

Abstract Homelessness in rural America is a problem hardly recognized, little understood, and only minimally studied by rural sociologists. This article, based on long-term field research in upstate New York, sets the problem of rural homelessness in context, explains the increase in rural poverty that puts more people at risk of homelessness, and examines some trends in rural housing that reduce the ability of poorer residents to secure adequate shelter. The nature of housing insecurity and the strategies poor rural people use to keep themselves from becoming literally homeless are noted. Interviews and questionnaires conducted among insecurely-housed low-income people and interviews and records supplied by agencies and institutions serving the poor provide the information on which arguments are based. The conclusion is that the definition of homelessness should be broadened for rural usage to encompass poor people on the edge of or at high risk of homelessness; also, programs to assist the homeless and prevent homelessness must be appropriate for rural situations.     

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.