Reductions In Homelessness Research Articles

Personalisation under the Homelessness Reduction Act 2017: how personal are personal housing plans?

ABSTRACT This article explores the personalisation of homelessness services in the context of the Homelessness Reduction Act 2017. This ambitious piece of legislative reform introduced requirements on local housing authorities in England to assess an individual’s circumstances and develop personalised housing plans for people experiencing homelessness (s.3 HRA 2017, inserting s.189A Housing Act 1996). This article analyses research data (including 26 interviews) collected in 2018–2019 from ethnographic studies completed in two local authorities in the Midlands, across a period of four months in each site. Exploring the implementation of personalised housing plans in practice, this article investigates barriers to the application of the personalisation narrative, finding it operates as a tool of neoliberal governance rather than one of social justice. It asserts that if personalisation has the potential for more satisfactory and sustainable outcomes in preventing and relieving homelessness, then the inability for this narrative to manifest suggests the goal of the HRA 2017 in ‘reducing homelessness’ is being hampered.

Unconditional cash transfers reduce homelessness

Homelessness is an economic and social crisis. In a cluster-randomized controlled trial, we address a core cause of homelessness-lack of money-by providing a one-time unconditional cash transfer of CAD$7,500 to each of 50 individuals experiencing homelessness, with another 65 as controls in Vancouver, BC. Exploratory analyses showed that over 1 y, cash recipients spent fewer days homeless, increased savings and spending with no increase in temptation goods spending, and generated societal net savings of $777 per recipient via reduced time in shelters. Additional experiments revealed public mistrust toward the ability of homeless individuals to manage money and demonstrated interventions to increase public support for a cash transfer policy using counter-stereotypical or utilitarian messaging. Together, this research offers a new approach to address homelessness and provides insights into homelessness reduction policies.

Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis.

Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis.

Initiation of opioid agonist treatment and subsequent substance use and other patterns among adolescents and young adults in Vancouver, Canada

BackgroundOpioid agonist treatments (OAT) are effective interventions for reducing illicit opioid use; however, less is known about OAT among adolescents and young adults (AYA). This study sought to examine OAT retention and discontinuation among AYA. MethodsData were derived from the At-Risk Youth Study, a prospective cohort of street-involved AYA in Vancouver, Canada, between September 2005 and December 2018. Multivariable Cox regression analysis was employed to identify sociodemographic, substance use, and other factors associated with time to first OAT. Substance use, homelessness, service utilization, and criminal justice patterns among AYA who did and did not initiate OAT were examined using before and after analysis. ResultsOf 676 AYA who reported weekly illicit opioid use, 454 (67.2%) reported not being on OAT at some point over the study period and 217 (32.1%) initiated OAT over follow-up. In non-linear growth curve analysis, only participants retained in OAT demonstrated significant reductions in daily illicit opioid use when compared to ‘no OAT’ controls (p < 0.05). Nevertheless, reductions in homelessness (p = 0.070) and increases in difficulty accessing services (p = 0.078) were observed between participants retained in OAT vs. ‘no OAT’ controls, while reductions in homelessness (p = 0.085) and weekly non-medical prescription opioid use (NMPOU) (p = 0.061) were observed between ‘OAT discontinuers’ vs. ‘no OAT’ controls. ConclusionsDespite finding that OAT retention was associated with significant reductions in daily illicit opioid use, no significant improvements in other key indicators were observed. This underscores the importance of providing supports alongside OAT to improve treatment outcomes among AYA.

The Homelessness Reduction Act 2017: furthering not fracturing marginalisation of those experiencing homelessness

AbstractThe Homelessness Reduction Act 2017 represents the most significant change to the rights of homeless people in England for decades. Through an analysis of the history of homelessness legislation in England, but focusing on the ‘ground-breaking’ 2017 Act, this paper explores how the homeless population is represented and ‘constructed’ in this new legislation and what this tells us about the place of homeless people in our society. In so doing, this paper exposes how the 2017 Act – a state instrument of apparent homelessness prevention – can be read and understood as contributing to rather than obviating the marginalisation and social exclusion of homeless people.

Reconceptualising Homelessness Legislation in England

AbstractThis article has two central aims. First, it problematises the long‐held consensus that homelessness legislation in England operates according to the concept of need and, secondly, it advances an alternative reading and reconceptualisation of homelessness legislation according to the notion of risk. Through examination of the two major sources of current homelessness law, the Housing Act 1996 and the recently enacted Homelessness Reduction Act 2017, this article locates and explores how risk is operationalised, the precise conceptions of risk engaged and the implications and potentiality of this risk reconceptualisation. In so doing, it is argued that risk exhibits a stronger explanatory power of the current homelessness legislation than need and presents opportunities for how we understand local authority decision‐making and the shape of future reform.

Governing “The Homeless” in English Homelessness Legislation: Foucauldian Governmentality and the Homelessness Reduction Act 2017

ABSTRACT This article contributes to the growing body of work exploring governmentality theory in housing and homelessness law by engaging, for the first time, a Foucauldian neoliberal, governmentality and risk framework to the recently enacted Homelessness Reduction Act 2017. This article locates the place of governmental activity to be scrutinized as the homeless population and contends that the Homelessness Reduction 2017 (‘HRA 17ʹ) can be interpreted as operating according to three intersecting modes of problematization of the homeless: (1) biopolitical problematization; (2) governmental problematization; and (3) ethical problematization. In so doing, this article reveals that the 2017 Act reflects a shift in neoliberal thinking on homelessness in constructing images of the homeless as a “risk population”, as subjectified, autonomized individuals exhorted to self-work and ethical self-fashioning as responsibilized citizens taking account of their own housing precarity.

Exiting Homelessness, The Perspectives of Those Experiencing Housing Instability

Background: For nearly thirty years homelessness has increased steadily in major cities around the globe, including Alberta Canada. Strategies adopted by the Canadian and Alberta governments to manage homelessness has yielded limited success. Signaling that Individuals experiencing homelessness are yet to be included adequately in search of solutions. Comprehension of homelessness phenomenon remains a challenge, as well as ending homelessness. The purpose of this phenomenological investigation study was to understand homelessness phenomenon from the experience of people who do not have homes and are experiencing housing instability. Methods: A total of 15 respondents were recruited. We performed in-depth, open-ended interviews for data collection. Following hermeneutic and phenomenological principles, interview data was retrieved, transcribed, summarized, described, and explained. Results: The prominent themes indicated a need to make housing, and utilities affordable, and rent and mortgage qualification criteria easy; a need for revising of credit bureau and criminal record policies; people at the shelters entitled to welfare or other benefits requires grace period of at least three months before withholding payment of their entitlements; vital skills training is necessary to secure a job, for financial management, for positive behaviour, and supervised spending. Shelter awareness is necessary, and making government support services efficient, and non-discriminatory. End all discriminations and provide 40hrs/week regular full-time jobs. Conclusion: The homeless, public, public health, and homeless service providers would benefit from the findings. Findings could help to stir homelessness reduction strategies to keep people out of the street in Canada.

Meeting the needs of homeless people attending the emergency department.

Homelessness is on the rise in the UK and, over the past few years, there has been a significant increase in the number of emergency department (ED) attendances and admissions by homeless people. Those attending the ED will often have multiple unmet health, housing and social care needs. While it is not possible to meet all these needs in the ED, emergency nurses should be equipped with the knowledge and skills required to communicate with, refer and signpost patients who are homeless. Under the Homelessness Reduction Act 2017, ED staff have a duty to refer homeless people, with their consent, to local authorities for assistance. This article details the barriers that homeless people may experience when accessing healthcare services and explains how these can be addressed. It also outlines the actions that emergency nurses can take to improve the care of homeless people in the ED at an individual and a systems level.

Homeless Canadians’ Perspectives on Homelessness in Calgary

Since the 1990s, homelessness has increased in Canada, but the strategies of the government and public health service providers to manage the situation have had limited success. Researchers have also noted the lack of inclusion of those experiencing homelessness in homelessness research to better understand and develop a solution to the issue. In the present study, this is addressed through inclusion of homeless participants from diverse backgrounds. The purpose of this phenomenological study, framed by social cognitive theory, reciprocal determinism, and symbolic interaction, was to understand homelessness from the perspectives of people who do not have homes. Data were collected from open-ended interviews with a purposeful sample of 15 individuals who were homeless. Several themes emerged after interview data were transcribed via hand coding and analyzed using cognitive data analysis. The prominent themes were lack of money, home, privacy, and support; discrimination directed primarily toward First Nations people and those of African descent; mental illness and addiction; the need for a review of housing policy that addresses rent, mortgage qualification criteria, and house tax; and the creation of awareness of government support systems and the services that they provide. Public health service providers and designated authorities can use the findings of this study to understand the phenomenon from the perspective of people who are experiencing homelessness, which can influence the development of better homelessness reduction strategies that could improve the lives of those experiencing homelessness and their communities. Because homelessness is a public health issue, bringing it under control could positively impact the health and safety of the public.

Making the Prevention of Homelessness a Priority: The Role of Social Innovation

AbstractMass homelessness emerged in Canada in the wake of neoliberal policies that reduced government production of housing and other supportive measures. Efforts to reduce homelessness have occurred in three stages: 1) an emergency response in the 1990s that consisted mostly of investment in shelters, soup kitchens, and day programs, 2) the implementation of community plans to end homelessness, combined with the adoption of Housing First as a strategy that seeks to provide reliable shelter as a first step to anyone without it, followed by other remedial services, and 3) the recent development in Canada of early intervention strategies to prevent homelessness from its inception. The second stage was highly successful in dealing with the situation of chronically homeless adults, and many communities have begun to see reductions in homelessness. However effective, this approach does not break the cycle by intercepting potentially homeless individuals in their youth, which is when it begins for many people. Canada is at the beginning stages of the move towards a stronger focus on prevention, aided by a social innovation agenda to identify, design, test, and evaluate preventive interventions to determine which ones will be most strategically effective, setting the stage for implementation and going to scale.

Improving the care of inpatients who are homeless: why we need to ask ‘have you got somewhere safe to go when you leave hospital?’ and use the Homelessness Reduction Act 2017 ‘duty to refer’ process

‘Homelessness’ is an increasingly important UK healthcare issue. Mean age of death of people who are homeless is 43–47 years and there were 726 homeless deaths in England and Wales in 2018.1,2 People who are homeless have complex health needs reflected in increasing emergency attendances and admissions.1 One in three deaths might have been preventable with timely treatment, yet ‘homelessness’ is often not identified by clinicians as a health issue and is poorly documented in health records.1,3 The Homelessness Reduction Act (HRA) 2017,4 which came into place in October 2018, imposes a legal duty on NHS trusts to refer people experiencing / at risk of homelessness to ‘their’ local authority (LA) housing …

Solving Homelessness from a Complex Systems Perspective: Insights for Prevention Responses.

Homelessness represents an enduring public health threat facing communities across the developed world. Children, families, and marginalized adults face life course implications of housing insecurity, while communities struggle to address the extensive array of needs within heterogeneous homeless populations. Trends in homelessness remain stubbornly high despite policy initiatives to end homelessness. A complex systems perspective provides insights into the dynamics underlying coordinated responses to homelessness. A constant demand for housing assistance strains service delivery, while prevention efforts remain inconsistently implemented in most countries. Feedback processes challenge efficient service delivery. A system dynamics model tests assumptions of policy interventions for ending homelessness. Simulations suggest that prevention provides a leverage point within the system; small efficiencies in keeping people housed yield disproportionately large reductions in homelessness. A need exists for policies that ensure reliable delivery of coordinated prevention efforts. A complex systems approach identifies capacities and constraints for sustainably solving homelessness.

Reducing Homelessness or Re‐ordering the Deckchairs?

The Homelessness Reduction Act 2017 has come into force trumpeting nothing less than the need for a ‘culture change’ among local housing authorities implementing it. Although it aims to reduce homelessness, it is more likely to hide long‐term systemic issues in the housing system. It is argued that the 2017 Act's significant alterations are likely to result in a re‐ordering of the deckchairs on the Titanic of housing policy. Following a biography and critique of the homelessness legislation as being out of time and place, as well as a discussion of the 2017 Act itself, three central points are made: the 2017 Act has ushered in a form of neo‐liberal government of the homeless; the understanding of the household seeking assistance has fundamentally altered, from passive applicant to active citizen; the private rented market provides the sole mechanism for performing the duties but remains problematic.

Policy responses to ‘rough sleepers’: Opportunities and barriers for homeless adults in England

In the winter of 2018, high profile debates about ‘rough sleepers’ intensified following reports about men who died in freezing conditions. Government since pledged to cut the number of rough sleepers by half by 2022 and eliminate it by 2027. This commentary reviews two pieces of legislation which could support this target: the Care Act 2014 and the Homelessness Reduction Act 2018. It argues that policies offer opportunities to improve outcomes for rough sleepers, given historic failings to provide for this social group. However, financial and institutional barriers remain.

Having a voice

PurposeThe purpose of this paper is to understand the lived experience of people who have experienced homelessness and street activity, and professional stakeholders’ views about the challenges faced by this client group. The study sought to identify measures to improve the current situation for both individuals experiencing homelessness and professionals working with them.Design/methodology/approachPeer researchers with lived experience of multiple and complex needs conducted semi-structured interviews/surveys with 18 participants (eight individuals experiencing homelessness and street activity and ten professional stakeholders). The authors of the paper conducted a thematic analysis of the data.FindingsThis paper offers insights into both the current challenges and assets for people who are or have been homeless in an urban setting. Key findings include the need for a coordinated partnership approach to address pathways to support, and the importance of developing opportunities for meaningful activity and building on local resources including giving homeless people a voice. These findings are discussed within the context of current policy (Housing First) and legislation (Homelessness Reduction Act 2017) and the impact on integrated care for people who have experienced homelessness.Research limitations/implicationsThe views explored in this study are specific to one city centre in the West Midlands; thus, generalisability may be limited.Originality/valueThis study presents a participatory research approach with peer researchers exploring the perspective of individuals experiencing homelessness and wider stakeholders. The findings of this research are considered with reference to the provisions of the HRA 2017.

Young and homeless

Young and homeless

Using Peer Navigators to Address the Integrated Health Care Needs of Homeless African Americans With Serious Mental Illness.

The study examined the impact of a peer navigator program (PNP) developed by a community-based participatory research team and used with a group of African Americans with serious mental illness who were homeless. Sixty-seven research participants were randomly assigned to receive PNP or treatment as usual (control) for one year. Data on general health and mental health, recovery, and quality of life were collected at baseline and at four, eight, and 12 months. Findings from group × trial analyses of variance of omnibus measures of the four constructs showed significant impact over the year for participants in PNP compared with those in the control group, with analyses showing small to moderate effect sizes: general health status (η2=.24), psychological experience of physical health (η2=.42), recovery (η2=.36), and quality of life (η2=.14). These differences emerged even though both groups showed significant reductions in homelessness and increases in insurance coverage. Implications for improving in-the-field health care for this population are discussed. Whether these results occurred because navigators were peers per se needs to be examined in future research.

Can Housing and Service Interventions Reduce Family Separations for Families Who Experience Homelessness?

Family break-up is common in families experiencing homelessness. This paper examines the extent of separations of children from parents and of partners from each other and whether housing and service interventions reduced separations and their precursors among 1,857 families across 12 sites who participated in the Family Options Study. Families in shelters were randomized to offers of one of three interventions: permanent housing subsidies that reduce expenditures for rent to 30% of families' income, temporary rapid re-housing subsidies with some services directed at housing and employment, and transitional housing in supervised facilities with extensive psychosocial services. Each group was compared to usual care families who were eligible for that intervention but received no special offer. Twenty months later, permanent housing subsidies almost halved rates of child separation and more than halved rates of foster care placements; the other interventions did not affect separations significantly. Predictors of separation were primarily homelessness and drug abuse (all comparisons), and alcohol dependence (one comparison). Although housing subsidies reduced homelessness, alcohol dependence, intimate partner violence, and economic stressors, the last three variables had no association with child separations in the subsidy comparison; thus subsidies had indirect effects via reductions in homelessness. No intervention reduced partner separations.

Policies and programmes to end homelessness in Australia: Learning from international practice

Parsell C, Jones A, Head B. Policies and programmes to end homelessness in Australia: Learning from international practice.Many welfare states throughout the industrialised world have recently implemented policies to achieve targeted reductions in homelessness. These policy and welfare initiatives differ across national contexts. They are similar, however, in moving away from social programmes that have essentially ‘managed homelessness’ towards interventions that seek to permanently end homelessness. Australia has recently adopted similar homelessness policy objectives. This article examines the manner in which Australian homelessness policy has been converging with international policy directions. More specifically, the article scrutinises Australian social programmes adopted from the UK and USA as a means to achieve strategic goals of reducing homelessness. It argues that although Australian homelessness policy objectives are converging with international policy, Australian programmes modelled on international successes do not have some of the elements shown elsewhere to be crucial for achieving sustainable reductions in homelessness. This may become central to explaining programme outcomes in future years.Key Practitioner Message:•Strategies aimed at permanently ending homelessness represent a significant shift to contemporary professional practice;•Homelessness programmes internationally are now characterised by their branding or identification with evidence‐based models;•It is important to critically scrutinise these models, examining their core elements and the manner in which they are appropriated and incorporated across jurisdictions.