Causes Of Homelessness Research Articles

Is there room at the inn? Palliative care for the homeless

One of the main themes of the 2006 World Hospice and Palliative Care Day was to ensure ‘access for all’ and over 75 countries including the UK took part in the celebrations. This remains a welcome goal as it reiterates the view held in palliative care settings that everyone has a right to high quality end-of-life care. Most people come from family homes into palliative care facilities, and there is documented evidence (Gomez et al, 2011) that most people prefer to die in their own homes. In that case, facilities and services are brought to their homes to enable their wishes. While efforts are being made to ensure such preferences and access for black and minority ethnic groups, the needs of other vulnerable groups such as travellers, prisoners and homeless people require extra commitment from palliative care service providers. The profile of homeless people suggests their symptoms may not always be cancer-related, but may include liver failure due to alcohol abuse, HIV/AIDS, and self-neglect (St Mungo’s, 2004). With liver failure, jaundice is the overt symptom to look for, together with capsular pain. The work of St Mungo’s (2004) together with Marie Curie hospice services highlighted how homeless people tend to present with spontaneous bleeding, low mood, social isolation and self-harm/neglect, which may suggest a perceived lack of purpose in life. Judging by the continued presence of homeless people, it makes sense to conclude we have failed to eradicate the causes of homelessness, which makes the argument for their accessing palliative care more important. But it must be acknowledged that homeless people and the nature of their profile pose a challenge for accessing palliative care services., for example, where they live (on the streets or temporary unsuitable accommodation), communication issues or tensions with health professionals, stigma and prejudice they may experience. GPs and community nurses may not always register and visit them on the streets. Unlike younger homeless people, whose numbers are well documented (Warnes and Crane, 2000), older homeless people are not well accounted for. Warnes and Crane (2000) report on an analysis of the Hansard which showed less than 1% of items on older homeless people, compared to 24% on young homeless in the same period. The lack of statistical evidence may also suggest low priority being given to their plight. Conversely, it may suggest the complexity of identifying the homeless, rough sleepers or missing persons. Homeless people over 50 tend to be invisible as they often stay hidden away from public view. Definitions of homeless do not help, as the suggestions point at those over 50, sleeping rough and/or living in temporary/inappropriate accommodation, and even those at risk of imminent homelessness. Because of their profile, homeless people might benefit from specially designed caring services embedded in the palliative care philosophy, with a focus on the psychology of homelessness and the lifestyle and street families network inherent in their life. The preference for dying at home seems to work better when the patient has a supportive family or friends. With a homeless patient, the ideas of discharge and home visits need reviewing. A coordinator role, which has worked well at St Mungo’s hospice, might be crucial across the country. And lessons could be learnt from joint-working between St Oswald’s Hospice and Macmillan Cancer Support when they collaborated with Northumberland Tyne and Wear NHS Trust to develop a specific service for people with learning disability approaching the end of life. Doing it this way means that homeless people can be afforded access to palliative care services without restrictions on their lifestyles and behaviours, often found in hospitals. If effective palliative care is to be delivered to homeless people, health professionals within the field must have further awareness of the complexities inherent in being homeless, for example, a high mortality rate, which suggests prompt decisions and immediate intervention are important. In addition, homeless people tend not to have surrogate decision-makers and health professionals may end up acting in their ‘best interest’. With that in mind, palliative care training should be offered to staff in hostels and other temporary accommodation. Collaboration with community nurses working in palliative care settings about homeless people should also be encouraged. Politicians must provide extra funding to hospices and other palliative care settings to enable this. Homeless people approaching end of life can be supported to enhance their quality of life, albeit briefly. Services that recognise the complex symptoms and lifestyle inherent within homelessness should be supported. BJCN

Health Care for Homeless and Unstably Housed: Overcoming Barriers

The causes of homelessness are complex and multifactorial and the solutions equally complex. Though homelessness is not a disease process, it is directly linked to poor health outcomes. It is thus incumbent on health care professionals to know the various definitions of homelessness, the ramifications of unstable housing, and the specific living conditions of each homeless patient. These factors needed to be accounted for when designing treatment plans in a way that will increase access to care and promote adherence. Increasing compliance and addressing barriers to care will improve outcomes and may reduce overall health expenditures.

Locating and Designing 'Journeys Home': A Literature Review

In this paper we review previous longitudinal research on homelessness with the aim of identifying the necessary design features of Journeys Home to enable researchers and policy makers to fill the gaps in our knowledge of the causes and consequences of homelessness. We show that despite substantial progress in homelessness research in some areas, particularly in the areas of definition and enumeration, there remains a need for large scale longitudinal data to better understand pathways into and out of homelessness. This requires a survey that is representative of a broader population of people experiencing homelessness as well as people vulnerable to homelessness. A large sample of this sort will enable researchers to rigorously examine pathways into and out of homelessness, the structural and individual level causes of homelessness, and key outcomes of homelessness.

Homelessness Coverage in Major Canadian Newspapers, 1987 – 2007

This article describes how the Canadian printed news media depicted the homeless and their situations between 1987 and 2007. Our study used a descriptive, cross-sectional design and a content analysis was conducted on selected newspaper articles on homelessness issues. The main themes were housing-related issues, profiling of homelessness, health-related issues, economic factors, illegal activities, community aid and support, and social factors as cause of homelessness. Housing related issues, community aid and support, profiling of homelessness and economic factors were addressed in 85.3% of the stories. This study provides a retrospective examination of the media’s interests in and portrayal of the homeless and homelessness issues.

The Economics of Housing the Homeless: What Causes the Problem and Why Haven’t Federal Policies Helped?

In the mid-1980s, homelessness increased in visibility across the United States, and interest rose as to the causes and possible solutions to the problem. Among others studying the issue, economists focused much of their attention on the central problem faced by the homeless – a lack of housing. Among the reasons economists cited for homelessness included a rise in housing prices, the filtering out of low-quality units in the housing market, increasing income inequality, and income shocks; these issues, combined with other factors that can make a person or family more susceptible to homelessness – such as substance abuse, mental illness, or social isolation – likely led to the increasing numbers of homeless in the 1980s. Looking at the causes of homelessness from an economic perspective also reinforces the reasons why many federal policies have been unable to solve or greatly decrease the problem in the past several decades. Since homelessness is still a concern across the country – especially in the wake of the recent recession – there continues to be a need to evaluate and find additional solutions to the problem.

Are the Homeless Mentally Ill?

In Australia, it is widely believed that most homeless people have mental health issues and that mental illness is a primary cause of homelessness. This paper uses information from a study of 4,291 homeless people in Melbourne to investigate these propositions. The research found that 15 per cent of the homeless had mental health issues prior to becoming homeless. This challenges the community perception that mental illness is the primary cause of homelessness. The research also found that 16 per cent of the sample developed mental health issues after becoming homeless. Homelessness causes mental health issues for some people, particularly anxiety and depression. The claim that most homeless people are mentally ill sends the wrong message to policy makers about the services that are needed to assist homeless people.

Displaced and Barely Visible: Archaeology and the Material Culture of Homelessness

Every night nearly 800,000 people living in the United States are homeless, largely “invisible” to most Americans. Archaeological investigations of the material culture of homelessness in St. Paul and Indianapolis suggest that although causes of homelessness are complex, often related to broader issues of political economy, displaced people still manage to retain a cultural heritage of sorts. They carry some materials with them as part of a nomadic lifestyle, as reminders of “home,” while caching other elements in semipermanent camps, objects that refect their cultural origins. The remainder of their material culture is geared toward shelter and subsistence and is largely disposable. Archaeological perspectives can provide information useful for providing aid to the homeless, especially for assistance outside of homeless shelters.

Developmental and Psychosocial Characteristics of Young Adult Homeless in Prague

The objective of the study is about educational environment of young adult homeless. The study design combined qualitative and quantitative approaches and sample consisted of 90 homeless persons (60 were males) in age 18 to 26. Large majority of the young adult homeless grow up in an incomplete family (47%). Developmentally disadvantaged are especially those who lived in a state institution (34%). Over one third of the subjects reported serious physical punishment or abuse in the family. Dysfunctional family of origin, physical abuse and other forms of traumatic events in childhood are main causes of homelessness of young people in Prague.

Young runaways and adulthood: a difficult transition

The transition to adulthood can be a difficult time for young people, both financially and emotionally. A number of additional factors make this transition more difficult for young people in vulnerable housing situations, such as lower rates of the minimum wage and benefits, increased likelihood of unemployment and exclusion from housing registers. Many of the causes of homelessness, such as unemployment, shortage of housing and family problems, affect young people across the spectrum. However, there are some young people who are more at risk of becoming homeless.

Faith, Welfare, and the City: The Mobilization of Religious Organizations for Neoliberal Ends

Studies of neoliberalism have focused on the rollback/rollout nature of the process as it manifests in different urban geographies. According to this narrative, neoliberalism and its proponents mobilize to roll back Keynesian or socialist institutions, while simultaneously or subsequently mobilizing a rollout of institutions that might reproduce a neoliberal social order in the future. Somewhat lost in this narrative, with its emphasis on the creation of new neoliberal institutions, is the role of existing institutions as vehicles of neoliberalism. This study focuses on the way that gospel rescue missions function as vehicles of neoliberalism within the present context in the United States. Gospel rescue missions, most of which predate the neoliberal turn, provide a form of care for America's urban homeless that emphasizes personal responsibility (and failure), and de-emphasizes the structural causes of homelessness. Many require their clientele to attend chapel before receiving services, and most shun government funding whenever possible. Although this approach is not explicitly motivated by neoliberalism, such organizations are willing vehicles of the neoliberally inspired individualization of poverty and homelessness. But importantly, this relationship has an incredibly uneven geography, as three case studies show. The unevenness of this geography complicates the picture considerably, belying any simple description of (or dismissal of) faith-based agencies as vehicles of neoliberalism.

Homelessness among older people and service responses

SummaryThis paper reviews the limited evidence on the causes of homelessness in old age and on the circumstances and problems of older homeless people, and it describes the few services dedicated to the group. Health care and social care professionals rarely encounter homelessness among the many problems of older people that present to them, but in many developed countries there is evidence that the number of older homeless people has recently been growing. Some among them have been homeless intermittently or continuously for years, but many became homeless for the first time in later life. The reasons for becoming homeless and the problems and needs of the group are exceptionally diverse. Many have been estranged from their family or have no living relatives, and they have a high prevalence of health problems and functional limitations. Although services for homeless people in general have improved since the early 1990s, few have targeted the needs of older people.

The New Homelessness Revisited.

The 'new homelessness' has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus.

SES AND USE OF PSYCHIATRIC SERVICES OF PEOPLE SUFFERING FROM SCHIZOPHRENIA IN A COMMUNITY-BASED SYSTEM OF CARE

Available evidence suggests that individuals with schizophrenia and other severe mental illnesses are at increased risk for homelessness in contemporary societies with diverse cultures and socioeconomic conditions. Yet the prevention of homelessness among individuals with mental illness has rarely been a focus of global health programs. We propose that it should be. In any given society, the overall risk of homelessness will reflect broad societal factors such as income inequality, housing, migration, economic conditions, and family ties. We strongly advocate for addressing these societal causes of homelessness. We also believe, however, that we need to develop special programs in parallel to prevent homelessness among individuals with severe mental illness. We use historical examples to draw attention to ways in which individuals with mental illness have been – and still are – explicitly excluded from societies. We suggest that this social exclusion requires us to take special measures to protect the rights of individuals with mental illness, and to develop programs to ensure they have access to basic necessities including a home. The form these measures take will of necessity vary widely according to local conditions. We describe mental health initiatives in two middle-income countries (Brazil and Argentina) which illustrate different approaches, and allude more briefly to efforts being made in other countries including low-income countries. Finally, we consider some of the efforts that are already being made by various international groups to further this agenda within the global health movement.

SCHIZOPHRENIA, THE PREVENTION OF HOMELESSNESS, AND THE GLOBAL HEALTH MOVEMENT

Available evidence suggests that individuals with schizophrenia and other severe mental illnesses are at increased risk for homelessness in contemporary societies with diverse cultures and socioeconomic conditions. Yet the prevention of homelessness among individuals with mental illness has rarely been a focus of global health programs. We propose that it should be. In any given society, the overall risk of homelessness will reflect broad societal factors such as income inequality, housing, migration, economic conditions, and family ties. We strongly advocate for addressing these societal causes of homelessness. We also believe, however, that we need to develop special programs in parallel to prevent homelessness among individuals with severe mental illness. We use historical examples to draw attention to ways in which individuals with mental illness have been – and still are – explicitly excluded from societies. We suggest that this social exclusion requires us to take special measures to protect the rights of individuals with mental illness, and to develop programs to ensure they have access to basic necessities including a home. The form these measures take will of necessity vary widely according to local conditions. We describe mental health initiatives in two middle-income countries (Brazil and Argentina) which illustrate different approaches, and allude more briefly to efforts being made in other countries including low-income countries. Finally, we consider some of the efforts that are already being made by various international groups to further this agenda within the global health movement.

Skeletons at the feast: A review of street homelessness in South Africa and other world regions

Homelessness on the streets has been of concern to governments and civil society for hundreds of years, and the number of homeless tends to rise when economic conditions take an adverse turn. Laying stress on questions of access to housing, livelihoods and services, this paper compares the historical causes of homelessness in Britain and Europe, India, the US and South Africa, in order to approach a better understanding of South Africa's own homelessness situation. Internationally, the key debate is whether homelessness is due to simple lack of affordable housing, or to a range of complex factors involving poverty and unemployment. The paper argues that spatial access to street livelihoods and access to the metro core zones are critical factors linking housing access to poverty economics, and it questions whether in South Africa's situation street homelessness can be eliminated in the foreseeable future.

The Changing Structure of the Homeless Population in Cork City: Implications for Theories of Homelessness and Service Provision

Michelle Norris, Lecturer in Social Policy, Dept. of Applied Social Studies, University College Cork, Ireland. and Noreen Kearns, Research Officer, Department of Applied Social Studies, University College Cork, Ireland. The last two decades have seen extensive reform of policy on homelessness in Ireland, but these changes have not been underpinned by any extensive research which would shed light on the causes of homelessness and help in the design of settlement services. This article, which describes the results of the first detailed survey of the homeless population of Cork city, is intended to address the dearth of empirical evidence on homelessness in Ireland. This information is presented in three parts. The opening section of this article outlines the methods which were used to collect data on the homeless population in Cork. The findings of this research are outlined in the middle part of the article and where possible compared to the results of other equivalent research which has been carried out in other parts of Ireland and abroad. This section presents evidence on: the numbers of homeless people; their personal characteristics; a socio-economic profile of respondents, their housing history and

Najčastejšie príčiny bezdomovectva u seniorov

Príspevok je obsahovo zameraný na príčiny bezdomovectva. Bezdomovectvo je multidimenzionálny jav a dotýka sa všetkých vekových kategórií, nevynímajúc seniorov. Jav, ktorého dôsledkom nie je len absencia uspokojenia základných životných potrieb, ale aj čosi oveľa bolestnejšie. Devalvácia hodnoty ľudského života, sociálna izolácia, stigmatizácia, absencia súkromia, bezpečia, to všetko sa spája so sociálnym vylúčením, ktoréhoho extrémnu podobu bezdomovectvo predstavuje.Príspevok poukazuje na nejednoznačnosť vymedzenia, resp. definovania príčin, ktoré sú spúšťačom bezdomovectva, ich širokú variabilitu a vzájomnú prepojenosť (multifaktoriálnosť) faktorov individuálneho zlyhania (tak ako im dáva prednosť bežná populácia) a štrukturálnych faktorov (vplyvu spoločnosti - nezamestnanosť, prístup k vzdelaniu, dostupnosť bývania, zdravotnej starostlivosti).Život a prax poukazujú na obrovské medzery a prázdne miesta tak z pohľadu legislatívy v podobe absencie definovania samotného termínu bezdomovec, nejednoznačnosti a problematickosti vymedzenia kompetencií jednotlivých subjektov (zriaďovateľov - poskytovateľov) sociálnych služieb, ako aj z pohľadu samotného pokrytia sociálnymi službami z kvantitatívneho a kvalitatívneho hľadiska.Súčasná kapacita sociálnych zariadení zameraných na pomoc ľuďom bez domova je nedostačujúca, nereaguje na komplexné zabezpečenie potrieb spojených s cieľom reintegrácie bezdomovcov do bežného života. Z tohto pohľadu sa javí ako najvýraznejším problémom:- absencia podpory komplexných služieb spojených so základným stupňom reintegračného procesu (absentujú hlavne denné centrá a terénna sociálna práca);- zabezpečenie reintegračného procesu z pohľadu nadväznosti podporných služieb, či už v podobe bývania (azylové domy, domy na pol ceste, chránené bývanie, nájomné byty), rozvoja, resp. znovuzískania pracovných zručností (chránené dielne, špeciálne pracovné programy), dostupnosti a kvality služieb sociálnej intervencie, sociálneho poradenstva;- vzájomná spolupráca jednotlivých subjektov podieľajúcich sa na riešení bezdomovectva (štát - samosprávne kraje - obce - mimovládne a charitatívne organizácie);- absencia podrobného zmapovania bezdomovectva v rámci celého Slovenska;- spoločná koordinácia aktivít tretieho sektora realizovaných na báze celoslovenskej pôsobnosti.Uvedené problémy načrtávajú okruhy, ktorých riešenie by malo byť do istej miery spojené aj s pripravovanými legislatívnymi zmenami.

Neo-coporatist governance of homeless services in Dublin: Reconceptualization, incorporation and exlusion

This article examines neo-corporatist arrangements for governance of homeless services in Dublin, which are modelled on parallel arrangements for the negotiation of economic and social policy nationally. It reveals that these two policy making structures have achieved similar outcomes - policies which are neo-liberal in orientation, but not entirely so. Achieving the aims of this unusual marriage of corporatism and neo-liberalism necessitated the redefinition of the causes of and solutions to homelessness from the structuralist to the individualist and the incorporation of formerly independent third sector service providers into the influence of the state. This process has been opposed by some third sector groups but supported by others who see opportunities in these reforms for their organizations. The outcomes of this process have been largely positive - levels of homelessness have fallen for instance - but not entirely so. Lack of attention to tackling the structural causes of homelessness has led to under provision of long-term accommodation for homeless people, while overemphasis on its individual causes and consequently on controlling the behaviour of service users has excluded some `challenging' clients from access to services.

Rearranging the Deck Chairs or Reallocating the Lifeboats? Homelessness Assistance and Its Alternatives

Problem: At present, homelessness in the United States is primarily addressed by providing emergency and transitional shelter facilities. These programs do not directly address the causes of homelessness, and residents are exposed to victimization and trauma during stays. We need an alternative that is more humane, as well as more cost-efficient and effective at achieving outcomes. Purpose: This article uses research on homelessness to devise alternative forms of emergency assistance that could reduce the prevalence and/or duration of episodes of homelessness and much of the need for emergency shelter. Methods: We review analyses of shelter utilization patterns to identify subgroups of homeless single adults and families with minor children, and propose alternative program models aimed at the particular situations of each of these subgroups. Results and conclusions: We argue that it would be both more efficient and more humane to reallocate resources currently devoted to shelters. We propose the development of community-based programs that instead would focus on helping those with housing emergencies to remain housed or to quickly return to housing, and be served by mainstream social welfare programs. We advocate providing shelter on a limited basis and reserving transitional housing for individuals recently discharged from institutions. Chronic homelessness should be addressed by permanent supportive housing. Takeaway for practice: Changing existing shelter-based responses to homeessness could produce better outcomes for homeless individuals and families. Research support: None.

Homelessness in the Czech Republic

This article discusses homelessness in the Czech Republic. In doing so the authors have used an operational definition common in the European Union. In order to explain homelessness in the Czech Republic, the article examines the relevant laws and governmental policies. Then the article discusses some causes of homelessness in the Czech Republic, a recent census of the homeless in the nation, the activities of service‐providing organizations, the financing of social services in the nation, health and health care among homeless people, a new food bank, and the harmonization of the Czech Republic with the common objectives of the rest of the European Union.