Étude comparative de dix sujets SDF fréquentant un centre d’hébergement d’urgence et de dix sujets SDF vivant uniquement dans la rue : acceptation et refus de l’hébergement d’urgence

Abstract

ObjectivesThe last decades have seen an increasing number of homeless people (SDF) in Western societies. Public authorities have developed a solid assist device to treat this “homeless problem” by creating emergency shelter. Generally, this type of accommodation does not set any condition of admission and answers an immediate need of safekeeping of the person. Yet many homeless people refuse emergency shelter, even in winter. They prefer to sleep outside in extreme conditions. The purpose of this article is to help understanding the refusal and the acceptance of emergency accommodation for the homeless population. Patients/materials and methodsIn this study, a group of ten homeless subjects using emergency shelter (CHU) is compared to a group of ten homeless subjects who are refusing the emergency shelter and living only on the streets. To each subject, a semi-structured interview, an evaluation of the HAD scale (Zigmond AS and Snaith RP, 1983) and one of the self-esteem scale are conducted (Rosenberg, 1969). The analysis of data, collected during research interviews, will be completed with the statistical analysis of the results of the scale's test. Thereby we will highlight the similarities and the differences explaining the denial or the approval of emergency shelter. ResultsThe common point between these two groups of subjects is the following: each of them has a traumatic or painful past. These subjects experienced many failures, dropouts, deficiencies which have seriously disrupted and affected them. The accumulation of chronic and traumatic life events made that the most recent event is identified by these subjects as the cause of their homeless situation. Survive from day to day involves a constant acting out in the street space, reflecting an impossible psychic crystallization or development. These two groups of subjects differ mainly in their ways of understanding their homeless situation. Thus, the acceptance/refusal of emergency shelter refers to an acceptance/refusal of the homeless identity, a fitting/misfitting to the homeless conditions, an acceptance/refusal of assistance, and acceptance/rejection of the collective space. In quantitative terms, there is a link between anxiety/depression and the denial of emergency shelter. Subjects refusing emergency shelter have a depression level significantly higher (10.3 against 7.1) and anxiety level significantly lower (11 against 14.1) than subjects users of emergency shelter. ConclusionsThis study allows us to consider the denial of accommodation of the homeless as a will not to passively suffer from their situation of social exclusion. Those homeless subjects voluntarily maintain a difficult lifestyle causing a greater psychological suffering than the ones using emergency shelter, and this not to settle in their situation. At the opposite, regular users find in emergency shelter a social frame and some new benchmarks. This leads to a relief and to a lower mental suffering that promote an over-adaptation of their living conditions.