Homeless Research Articles

Rehabilitation Potential Among Institutionalised Homeless Persons with Mental Illness during COVID-19: A Cross-Sectional Study

Aim: To assess the rehabilitation potential and social well-being among homeless persons with mental illness. Methods: The study utilised quantitative methodology to assess rehabilitation potential and social well-being. It was conducted at Udayam Shelter Home, Kozhikode, Kerala. The district administration initiated the Udayam Project in Kozhikode to rehabilitate destitute individuals rescued from the streets during the Corona Virus Disease 2019 (COVID-19) outbreak in March 2020 and to provide shelter across various camps in the district. The researcher prepared a rehabilitation potential checklist, validated by experts, and a standardised scale was used to assess social well-being. Descriptive statistics were used for quantitative data analysis. Ethical clearance was obtained from the NIMHANS Institute's ethics committee. Results: Over one-third (40%) of the participants were older adults aged above 60 years. All the participants in the study were male. The homeless women identified as needing care and protection were shifted to other centres due to the lack of facilities at the Udayam shelter care home. Previous occupational status revealed that before coming to the rehabilitation centre, most respondents were employed as unskilled labourers. They included daily wagers, lottery sellers, and helpers in hotels and restaurants. Others were skilled labourers, including masons, carpenters, and electricians. Most respondents were from urban and semi-urban areas. Homeless persons with mental illness (HPMI) with mood disorders exhibited better social well-being compared to those with other diagnoses. HPMI diagnosed with psychosis were reported to have very little social actualisation compared to others.

Embodied Thermal Insecurity and Counter‐Hegemonic Heat Mapping

AbstractLived experiences with urban heat are often rendered invisible, shrouded under the cloak of neoliberal resilience discourse and sanitised heat mapping and messaging. This is particularly tragic for disadvantaged at‐risk populations in white, settler colonial contexts where heat tolerance is worn as a badge of honour. Here, drawing upon semi‐structured interviews and focus group discussions in Perth, Western Australia, and with feminist emphasis on the embodied, the everyday, and bodily difference, we illustrate how corporeal thermal insecurities among rough sleepers, people with disabilities, and across intersectional disenfranchisement immobilise and dehumanise. By employing the logic of structures of violence to thermal suffering, we reveal how housing and energy precarity exacerbate entrenched racism and normalised discrimination. Our aim is to expand current debates on heat action plans (HAPs) and cool refuges by examining what “better weathering” could mean in practice, via the materialities of heated urban bodies (HUBs) and to demonstrate how such counter‐hegemonic heat mapping serves as a corporeal critique of the neoliberal resilient subject.

Defining vulnerabilities and enabling community engagement in epidemics preparedness: the CAVE model from Austria.

During the COVID-19 outbreak the transdisciplinary research project CAVE (Community Engagement and Vulnerability Assessment in Epidemics) investigated perceptions and practicability of public health communication among stakeholders of care and social facilities in Austria. It aimed at finding accurate definitions of vulnerability in the context of epidemics and at developing operational models for engagement of vulnerable groups in co-creating epidemic response mechanisms. Transdisciplinary methods included semi-structured interviews, focus group discussions, and desk reviews as well as spatial analysis and composite indicator-based mapping methods. Informants and participants in the community engagement phase represented clients as well as middle and lower management levels of Austrian care and social facilities for older persons and persons with cognitive impairments, persons depending on mobile healthcare services, homeless people, and socially deprived communities. A narrow definition of vulnerability as well as missing strategies for participation and community engagement limited communication with stakeholders and the implementation of protective measures. An inclusive definition of vulnerability beyond medical and physical indicators should be employed to account for social, psychological, and emotional aspects contributing to a higher risk of being affected by epidemics. The CAVE model provides a multi-level definition of vulnerability that allows for participatory engagement in co-creating adapted crisis response measures. We suggest policymakers and health authorities to consider a broader definition of vulnerability and to commit to pro-active engagement with stakeholders representing these sectors. This requires the establishment and maintenance of communication structures as well as political recognition of civic participation in the creation and implementation of epidemic response measures.

Exploring Students’ Feelings in the Initial Phase of a Community-Based Research Service-Learning Course: A Qualitative Approach Using Content Analysis

The emotional experience of situations and interactions with other people plays an important role in teaching and learning processes and interacts with cognitive as well as motivational and intentional factors in the acquisition of knowledge. In our qualitative investigation, we explored participants’ experiences in the initial phase of a community-based research service-learning project that dealt with issues of social inequality, poverty and homelessness. We were particularly interested in the affective processes in the project’s planning phase and during the first meetings between community partners, homeless people and the participating students. After completing the course, we conducted guided qualitative online interviews with the course participants. The interviews were fully transcribed verbatim. We then coded and analysed the data using qualitative content analysis approach. It became apparent that the students were particularly anxious and apprehensive about working with vulnerable groups of people. This manifested itself in uncertainty, nervousness, fears and negative feelings. Regarding the collaboration with the community partners, the emotional situation varied among the students in the initial phase. We conclude that students’ fears, anxieties, and uncertainties in the planning phase of a service-learning or community-based research project should be taken seriously. A relaxed and positive atmosphere at the first meetings can be viewed as particularly important for project progression and the students’ future learning success.

Restroom access and health among people experiencing homelessness: A focus on San Diego, CA

ABSTRACT Access to restrooms is vital to personal and public health, particularly among people experiencing homelessness (PEH). This study investigated how restroom access is associated with three domains of self-reported physical health (voiding and defecation-related conditions; skin conditions; and hypertension) among PEH in San Diego, CA. Data from 115 structured interviews with PEH (67.8% male, 40.0% mono-racially White, 57.4% rough sleeping) indicated that 37.4% (n = 43) reported typically using public restroom facilities, 38.3% (n = 44) reported typically using private facilities, and 23.5% (n = 27) reported typically engaging in open defecation. There were moderate to strong associations between urinary, gastrointestinal, and dermatological health conditions and stressors/barriers related to restroom access. The proportion of participants with ≥1 skin-related health conditions who engaged in open defecation was substantially higher (40%) compared to participants who reported no skin-related health conditions who engaged in open defecation (17.9%) (χ2(df = 1,108) = 5.25, p = 0.02). Participants who reported ≥3 voiding or defecation-related health conditions or ≥1 skin-related health conditions reported higher mean restroom-related impediments to health relative to participants without these health conditions. Restricted restroom access may prevent PEH from fulfilling their basic sanitation and hygiene needs, and may exacerbate urinary, gastrointestinal, and skin health conditions.

Study on access to social protection policies by homeless people during the COVID-19 pandemic

Abstract The study analyzed the access of homeless people (HP) to health and social protection policies, including emergency measures, during the COVID-19 pandemic in Belo Horizonte (BH), capital of the state of Minas Gerais, Brazil. Its main objective was to provide data on the profile of HP in the municipality, in addition to evaluating existing public policies focused on HP, based on the time frame of the health emergency. Study with mixed methods design with triangulation of quantitative and qualitative data. It used official databases in parallel with document analysis, interviews and focus groups. As a result, the cartography showed that in the first months of the pandemic the municipality had difficulty reorganizing the health system, which underwent constant protocol updates, consolidating, however, over the months. Important emergency interventions in the municipality of BH involved activities that facilitated HP’s access to the provision of services, including intersectorality between health services, social assistance and the third sector. The temporary offer of various intersectoral services, simultaneously with the offer of daytime shelters by organized civil society, was considered a key factor for the expansion and intensification of care networks for HP during the emergency phase. Itinerant services were among those with the greatest positive evidence of service to HP, with emphasis on the ‘Consultório na Rua’. The study concluded that understanding the profile of homeless people in BH and the intersectoral variables that impact HP contributes to better directing investments in interventions for these individuals and increasing the effectiveness of health and social protection systems, in line with with the work carried out by the third sector. Key messages • Understanding the inter-sector variables that impact Homeless People contributes to better targeting of investments in interventions in protection social. • Knowing the profile of the homeless population makes it possible to organize more effective health care and social assistance.

Mobile street clinics and harm reduction: pathways to provide care to homeless people in Brazil

Abstract Homeless people (HP) are defined as a heterogeneous group that lives in extreme poverty, with weakened or severed family ties, lacking access to conventional housing, and using public spaces as residence. In terms of health, mental health conditions are prominent as a primary treatment demand, with care aimed at addressing needs arising from the use of alcohol and other drugs being a priority in serving HP. In this context, mobile street clinics (MSC) provide health services directly in street environments, focusing on individuals who use alcohol and other substances through harm reduction approaches. Harm reduction is defined as a set of practices aimed at minimizing the adverse health effects of alcohol and drug use without necessarily eliminating usage. Moreover, it represents an ethical and political direction in care, confronting the logic of criminalization and compulsory abstinence, enhancing access to health care for alcohol and other drug users through strategies that foster autonomy development. In the current study, we conducted an integrative review assessing the facilitators and barriers for HP access to mental health services. Preliminary results indicated that MSC, the connection between healthcare workers and the HP they serve, and the implementation of local street-based actions were the main facilitators of access for individuals who engage in harmful use of alcohol and other drugs to mental health services. Conversely, stigma, services’ lack of adjustment to the lifestyles of homeless people, and excessive bureaucracy were identified as the principal barriers of access. MSC, through their harm reduction activities, have emerged as a potential care technology to facilitate access to health services for homeless people. This research aims to present harm reduction as an ethical and political direction of care through the actions of mobile street clinics, as a way to facilitate access to health services for the homeless people. Key messages • Homeless people require mental health care tailored to the use of alcohol and other drugs, and harm reduction strategies implemented through mobile street clinics prove to be an effective form of care. • Mobile street clinics and harm reduction are important care technologies that enhance access to health services for the homeless population.

Cancer prevention for homeless people: Qualitative evaluation of the Health Navigator Model

Abstract Background People experiencing homelessness (PEH) face significant barriers when accessing cancer preventive services. The Health Navigator Model (HNM) seeks to address these challenges by improving access and engagement with cancer preventive care through tailored navigation services. This study aimed to explore PEH’s and health navigators’ experiences with the HNM. Methods This qualitative evaluation involved semi-structured interviews with a total of 61 PEH receiving the HNM intervention and 11 health navigators across four pilot sites in Austria, Greece, Spain, and the UK. Data were analyzed thematically using a cross-national coding framework. Results Following overarching themes were identified: (1) State of health and perception of health of PEH; (2) Experiences and understanding of cancer prevention; (3) Perceived effects of the Health Navigation intervention; (4) Navigators’ experiences with the implementation of the Health Navigation intervention; and (5) Effects of the Health Navigation intervention from the navigator perspective and sustainability of the intervention. Participants reported a general lack of access to healthcare services and low cancer prevention literacy. The HNM intervention led to increased engagement in cancer prevention activities, such as screenings, facilitated by the personalized support from health navigators. Navigators played a crucial role in bridging the gap between PEH and healthcare systems, though challenges such as mistrust and logistical barriers persisted. Conclusions The HNM has shown potential in enhancing cancer preventive care access for PEH by providing personalized guidance and support. The navigators’ role was pivotal in overcoming systemic and individual barriers, suggesting the need for integrated services that cater specifically to PEH. Future implementations should consider continuous training for navigators and further integration into local health systems to expand the benefits of the intervention. Key messages • The Health Navigator Model effectively enhanced cancer prevention engagement among people experiencing homelessness and empowered them through tailored and person-centered support. • Health navigators bridged healthcare gaps for people experiencing homelessness, improving their access to cancer preventive care services in their local settings.

Researching moral foundations using the Bayesian approach

Moral foundations theory describes a complex space of human morality along five moral foundations: care/harm, fairness/cheating, loyalty/betrayal, and sanctity/degradation. The first aim of this study is to explore the role of socio-demographic variables in endorsing the five moral foundations and to provide insight into the role of moral foundations in attitudes towards homeless people. The second objective of the study is to provide an example of employing the Bayesian statistical approach. There were 162 participants in our study (27% male, mean age 36 years). Convenience sampling method was used. Age and education found to be the most important predictors of moral foundations, with Bayesian factors showing the strongest evidence for age as a positive predictor of moral foundations. Gender, political affiliation, care and authority were found to be important predictors of attitudes towards homeless people, with Bayesian factors showing much stronger evidence for moral foundations than sociodemographic variables. This study lays the groundwork for research on moral foundations in Slovenian samples and provides a practical example of Bayesian approach application in social science.

“It's not that we Feel Incompetent, We Simply Lack the Institutional Solutions” Applying a Collective Capabilities Perspective to Voluntary Organisations in the Homelessness Field

ABSTRACT In today’s changing care and welfare landscape, voluntary organisations play an important role in providing care to homeless people. The limited literature on such initiatives is often sceptical about their effectiveness, although they do point to their positive contributions. In this paper, we use a Collective Capabilities lens to analyse the role, value, and limitations of volunteer initiatives addressing homelessness. We apply this framework to four case studies of volunteers-only initiatives providing care to homeless people in Brussels, Belgium. Data were collected through participant observation, interviews and document analysis. Our results highlight the trade-offs that voluntary organisations make between organisational capacities and agency. While formalisation and cooperation may contribute to an organisation's mission, these processes are sometimes avoided to preserve the unique contributions these organisations believe they make, such as providing care for people who fall between the cracks of the welfare state. Our results suggest that while voluntary organisations working with homeless people are aware of their limited capabilities regarding structural solutions, they do respond to unmet needs precisely because of their agency. However, there is a risk that fledgling organisations may take reckless and unsustainable actions.

How “helping” can sustain the stigmatization of homeless people

Summary The article presents findings of an ethnographic study carried out in Poland with homeless people living on the street and in a hostel. Interpretative orientation was used to ensure the opportunity to gain in-depth knowledge about their perspectives. The paper has two aims. First, it reconstructs the limits and risks of “(un)helpful help” and its impact on experiences of stigma. Second, it addresses how good intentions and policy efforts can have negative consequences, drawing on data from two separate research studies. The first research included seven male homeless people living on city streets. The second was carried out with 20 homeless people served by an agency working for homeless people. A qualitative methodology was employed for this critical ethnography, according to which the authors analyzed the data using a constructivist grounded theory approach. Findings The research revealed a number of support measures which, instead of positively changing their situation from the participants’ points of view, can exacerbate it by further stigmatizing homeless people with support based on helpers’ stigmatizing approaches which can compound homeless people's negative experiences of “help.” Applications An understanding of the mechanisms of structural and systemic stigmatization from the participants’ perspectives can help shift responsibility for their situation away from homeless people themselves toward society's responsibility as a whole. It highlights how there needs to be a change of consciousness and approaches within assistance systems, shifting the balance from an asymmetrical to a symmetrical relationship based on partnership and collaboration.

IMPLEMENTASI PENANGANAN GELANDANGAN DAN PENGEMIS TERHADAP KETERTIBAN UMUM DI KOTA SERANG

Serang City is one of the areas that has social problems, in this case the presence of homeless people and beggars which is quite disturbing for public order. In an effort to deal with this, it has been regulated in Serang City Regional Regulation Number 2 of 2010 concerning Prevention, Eradication, Management of Disease and Society, However, if you look at the current reality, there is no visible decrease in the number of homeless people and beggars on the streets, in fact homeless people and beggars are increasing every year. This research aims to determine and analyze the implementation of handling homeless people and beggars on public order in Serang City in accordance with Regional Regulation Number 2 of 2010 and to find out and analyze sanctions for regulating public order towards homeless people and beggars in Serang City. This research uses a qualitative method in the form of observing phenomena that occur in society in depth. This type of research uses empirical juridical, an approach based on data obtained directly from the community as the first source through field research, which is carried out either through observations, interviews. as well as by reviewing statutory regulations. The results of this research show that: (1) Regional Work Units have not implemented the Regional Regulations optimally so that there has not been a reduction in the number of homeless people and beggars, (2) Existing sanctions in accordance with the applicable Regional Regulations have not been implemented for homeless people and beggars

Oral Health Epidemiological Investigation in an Urban Homeless Population.

The purpose of this clinical epidemiological investigation was to examine the oral health conditions of homeless people in the city of Rome, Italy. A total of 157 homeless subjects were subjected to a first dental visit, during which anamnestic information was recorded in a digital medical record. A diagnosis of dental disorders was performed by assessing oral hygiene conditions, periodontal health, the presence of caries and/or root residues, and the presence of partial and/or total edentulousness. Caries and missing teeth were evaluated by the DMFT index. The first major criticality was represented by poor or absent oral hygiene. The examined sample showed a major percentage of high DMFT (63.0%); the most common clinical condition was the presence of numerous root residues. Regarding periodontal health, 73.2% of patients had gingivitis, 21.6% periodontitis, while 11 patients had periodontal pathologies with tooth mobility (7%). Finally, 8.9% of patients had one or two missing elements, 22.9% had partial edentulousness, and 8.9% of the sample had total edentulism. This analysis provides an important basis for strengthening health promotion and the importance of accessible and effective care for this population. It will therefore be necessary to continue to adopt a patient-centered approach geared towards addressing the demands that this population faces in maintaining their oral health.

A Case Study Analysis of Library Services for Adults Experiencing Chronic Homelessness in Harrison County, Mississippi

ABSTRACT The author partnered with the Harrison County Library System (HCLS) to create a multilevel program plan for expanding library services to the growing number of homeless people who seek refuge in the library’s facilities. The research for this program plan involved evaluating existing library resources such as collections, programming, and available staff resources; identifying the best practices for providing services to people experiencing homelessness; identifying staff perceptions of working with the homeless; and identifying potential partners for expanded service offerings. The author used document analysis to research data on the library system (IMLS 2021 and reviewed library policy to identify barriers to providing service for the homeless. The author applied qualitative and humanistic research methods involving personal narratives (scenarios) provided through two separate one-on-one interviews with the library director to discuss the library system in general, and one one-on-one interview with six library staff working in the three libraries with the highest use by people experiencing homelessness. This paper discusses the findings from this mixed methods research project and their application to expanding services for chronically homeless patrons who use the HCLS.

Disgendered

In US literary history, the Great Depression stands as a wellspring of poetry and prose that imagines homelessness otherwise, that reads the embodiments and relationalities of homeless dispossession as an abolitionist horizon, cutting across the structural, epistemic violence of urban sociology, welfare bureaucracy, and the carceral state as well as practicing radical alternatives of relating to housing. Arguably influenced by discourses on subproletarian pathology, myriad Depression-era writers regarded the homeless as bereft of futurity, and they understood the condition of unhoused immiseration as a state of social death that marked the homeless as kinless. This literary vein conceived of homelessness as a disgendering experience in which the homeless body becomes an aberration from the heteropatriarchal gender binary. Alongside this literature of homeless nonfuturity, this article locates a literary countercurrent that explores how homeless persons continue to build kinships and collective futures that manifest through and exceed their bare existence. In particular, the article examines the poem “Homeless but Not Motherless” (1935) and the novel The Girl (ca. 1939), finding in both a recognition not only of the disgendering violence of homelessness but also of the potentialities for forging kinship across exclusions from labor, housing, family, and civil society.

Psikoedukasi Pendidikan Sek Guna Mencegah Kekerasan Seksual Pada Anak Tunawisma

The phenomenon of sexual violence against children is increasing, demanding serious attention in prevention efforts. Psychoeducation regarding sex education for children, especially homeless people, is important to equip them with the knowledge and skills to protect themselves. This program aims to provide information about types of sexual violence, signs, and how to protect yourself. The methods used include providing materials, motivation and mentoring, with a focus on an interactive and inclusive approach. Results showed increased children's knowledge about reproductive health and ability to identify dangerous situations. Support from parents and the community is crucial in creating a safe and supportive environment. It is hoped that this collaboration can reduce the risk of dangerous sexual behavior and increase collective awareness about the importance of early sex education.

SUPPORTED EMPLOYMENT – THE WAY TO INTEGRATION AND INDEPENDENCE FOR PEOPLE IN A HOMELESSNESS CRISIS

The supported employment model for homeless people is based on a holistic approach that combines professional, housing, health, and social support. The innovative nature of the presented model includes students as assistants supporting people in a homelessness crisis since young people particularly appreciate professional activity as a way to develop and meet basic needs and, as a result, to solve problems. Students make a personal effort and, at the same time, invest in their professional future. Simultaneously, their enthusiasm and commitment to solving some problems and their innovative approach may be important for the people who are supported in a homelessness crisis. A key element of the supported employment directed at such people is an individual approach to the needs of each person and long-term cooperation between institutions.Thanks to this, people with the problem of homelessness have a chance to permanently integrate into the labor market and return to full independence in their lives.

Conflicted social mix and the ambivalence toward urban Others: Ethnographic exploration of urban regeneration in a liminal space in Tel Aviv

ABSTRACT This article offers the term conflicted social mix to address newcomers’ dilemmas in a transforming liminal space. It is based on ethnographic fieldwork conducted in 2019–2021 in Gan HaHashmal, a regenerating area located between Tel Aviv’s wealthier north and relatively lower-income south. The area is characterized by a mix of upper-middle-class newcomers, homeless people, and drug users, and a lack of community cohesion due to spatial liminality. The proposed conceptualization reveals that although the newcomers may have originally wished to be part of this “raw” urbanity and urban development process, in practice, they aim to establish a sterile community of their own, while excluding urban Others. They express empathy for the latter’s vulnerability while confessing their difficulty to share the space with them. Newcomers’ perceptions, narratives, and spatial experiences highlight the theoretical significance of the conflicted social mix concept for Tel Aviv’s morphology, as well as for other contested neoliberal spaces.

Analysis of the Influence of Various Factors on the Prevalence of Tuberculosis in Ukraine

A medical approach to the analysis of socio-economic, medical and demographic factors affecting the prevalence of tuberculosis in Ukraine is insufficient for timely prognosing the prospects for the development of the tuberculosis epidemic and developing an appropriate plan to address its challenges. Objective — to analyse influence of various factors on tuberculosis prevalence in Ukrainian population. Materials and methods. For the analysis, data were collected over the past sixteen years, covering all regions of Ukraine, including information on the number of specialized hospitals, the number of fluoroscopic examinations per 100,000 people, vaccination data, the number of Mycobacterium tuberculosis excretors, the prevalence among urban and rural residents, and the percentage of different demographic groups (workers, health care workers, students, pupils, retirees, the unemployed, homeless people, released prisoners, private sector workers). Results and discussion. The analysis, conducted through the Stacking model, enables the identification of crucial variables that significantly influence the prevalence of tuberculosis. Evaluating the significance of each element in the model enables a deeper comprehension of morbidity dynamics and the optimization of intervention strategies. The creation and validation of machine learning models such as linear regression, random forests, and adaptive boosting have enabled accurate predictions of tuberculosis prevalence. The use of 5-fold cross-validation increased the reliability of the predictions, ensuring stability and accuracy across different demographic groups. Conclusions. The application of artificial intelligence in analyzing socioeconomic, medical, and demographic data has facilitated the identification of key factors influencing the prevalence of tuberculosis in Ukraine. Specifically, the analysis has verified the substantial effects of the quantity of specialized hospitals, the rate of fluoroscopic examinations, and the frequency of bacterial excretion on the prevalence rates.

The Everyday Lives of Street Homeless People in the Context of Welfare Initiatives during the COVID-19 Pandemic

The Everyday Lives of Street Homeless People in the Context of Welfare Initiatives during the COVID-19 Pandemic