Services For Homeless People Research Articles

The Process of Going/Settling on the Streets: The Relations between Gender, Being Homeless and Access the Health Services

The objective of this article was to understand the relationship between gender constructions and the process of going/settling on the streets, as well as their effects on access to health services for homeless people in the city of Florianópolis/SC. Gender relations were analyzed in the trajectories of 28 gay, lesbian and heterosexual homeless people in the city of Florianópolis/SC/Brazil, based on a social constructionism research developed from December 2017 to February 2018. Family conflicts and non-acceptance of the gender identities were narrated as a fuse of going to the street and as aggravating for violence situations in the street context. The stigma for being homeless and non-heterosexual was understood as an obstacle to the use of health and social services. It is concluded that gender relations and male domination are related to the process of breaking of family ties and going to the street. Women and LGBT people are more vulnerable. Heterosexual men suffer for maintenance their dominant position. Further studies are recommended to deepen the relationship between gender, homeless and access to public policies.

Services for homeless people in Germany during the COVID-19-pandemic: A descriptive study.

A cross-sectional study was conducted in December 2020/January 2021 in the five significant cities of Germany. 135 of 244 identified service institutions took part in the evaluation. This evaluation included changes in institutions' operating hours as well as capacity for homeless people. Service institutions described changes in guests' characteristics, moods, and mental burden. Finally, equipment including face masks, coveralls, and gloves was investigated. In addition, the study examined how the cooperation with the health authorities works. Institutions reduced their operating hours and capacity for guests (62.4%). Increased costs, which they had to cover themselves, were reported by 70.9% of institutions. Institutions reported, that guests showed more symptoms of aggression (15%), anxiety (25%), and desperation (32%) and fewer signs of being relaxed (75%). The institutions reported room for improvement in PPE supplies and collaboration with health authorities. Services are limited for a vulnerable population, which shows changes in moods and mental health. Health authorities are not sufficiently engaged to take over the role of institutions in caring for homeless people. In the future, in-depth investigation to improve this is necessary.

Factors Associated with Free Hospital Outpatient Service Use among Middle-Aged and Older Urban Homeless Adults in Taipei.

Homeless individuals have many negative experiences with inequality regarding access to and the use of primary healthcare services, so policies to eliminate the disparities in and barriers to primary care access for these people are needed. The aim of this study was to explore the use and determinants of free hospital outpatient services for homeless people, in order to describe the provision of free healthcare policies for this vulnerable population in Taipei. One cross-sectional survey was conducted to recruit homeless people aged 45 years old and over in Taipei in 2018. A structured questionnaire was used, and face-to-face interviews were conducted by three social workers to collect the data. Finally, 129 participants were recruited in the study. The results show that 81.4% of the homeless people had made free hospital outpatient care visits (mean = 5.9 visits) in the last three months. An unadjusted logistic regression analysis showed that those homeless people who reported having usual healthcare providers, with higher depressive symptom scores, who used medication and had been hospitalized within one year, and had more chronic diseases, were significantly more likely to make free hospital outpatient visits. The adjusted logistic regression model indicates that homeless people with severe depressive symptoms (odds ratio (OR) = 9.32, 95% CI = 1.15–56.07), who had received medication (OR = 3.93; 95% CI = 1.06–14.52), and who had more than five chronic diseases (OR = 1.06, 95% CI = 1.35–13.27), were significantly more likely to make free hospital outpatient visits than their counterparts. The findings highlight that homeless people have higher healthcare requirements than the general population, and the healthcare system should pay more attention to factors associated with higher outpatient service use, such as homelessness, severe depressive symptoms, the receipt of medication and chronic diseases.

Array of Services for Homeless Mentally Ill in Six Canadian Cities: Non-Governmental Organizations’ Contributions and Perspectives

During the period 2010–2011, when the At Home project was conducted, a questionnaire was sent to 420 non-governmental organization (NGO) key managers in six Canadian cities to enquire about their collaboration with public services and their perspective on the services for homeless people with serious mental illness (SMI). NGOs constituted a dense network of collaboration among themselves. With regard to public services, housing and shelters were two services that NGOs had frequent contact with, followed by the healthcare addiction sectors and, to a lesser extent, social service and the justice sectors. Education and employment were both located in the network periphery. In general, NGOs viewed housing availability and accessibility to health services as largely unsatisfactory. They called for better public support, coordination, and funding.

Mental health services for single homeless people

SUMMARYHomelessness has long been associated with high rates of psychosis, alcohol and substance misuse, and personality disorder. However, psychiatric services in the UK have only recently engaged actively with homeless people. This article provides some background information about homelessness and mental illness and describes the elements of inclusion health and some of the models of service for homeless people that have been established over the past 30 years.

Photovoice nei luoghi di lavoro: quali caratteristiche organizzative influenzano il lavoro con le persone senza dimora?

The experiences documented in the literature of using photovoice to analyze work situa-tions appear to be quite limited, including the literature on services for homeless people. Few studies have analyzed the organizational characteristics that actually facilitate working with the homeless and determined the elements that help social workers to work in contexts that are often difficult and put them at risk of stress. The aim of the present research is to explore, through the photovoice methodology, which factors are perceived as hindering or facilitating the work effectiveness in teams working with homeless people. In this paper the results related to the point of view of social workers working in services for homeless people in Italy will be presented. In total, three photovoice projects were carried out, involving 18 social workers who took 195 photographs. The results suggest the importance of the relationship with other local services and of providing tools to support the professional team. Indeed, the themes emerged from the discussion of the photos are related with the feeling of impotence experienced by social workers.

Women’s homelessness: causes, impact on health, survival strategies and forms of social assistance for homeless women

only abstract and keywords in English; full article, abstract and keywords in Lithuanian]
 This article presents a scientific literature review of foreign and Lithuanian publications revealing the specifics of women’s homelessness. The concept of homelessness, types of homelessness, general homelessness and the causes why women are becoming homeless are discussed. The peculiarities of women’s homelessness are analyzed, revealing the vulnerability of homeless women and the victimization they experience, and describes the various consequences that homelessness has for physical and mental health. The article also presents a summary of strategies applied by homeless women that help them survive on the street: they involve having an intimate partner as a protector, changing their image according to particular circumstances, strategies of invisibility and breaking the rules of public space as well as using alcohol as a means of reconciliation with homelessness. We discuss the services provided by the Special Help Centers in Lithuania, which are provided for victims of domestic violence, other specialized forms of assistance for women and social assistance measures provided by the Vilnius and Kaunas municipalities to homeless people and social risk persons. Finally, we suggest directions for future empirical research. The analysis shows that homeless women are more stigmatized and more socially excluded, and that they are more vulnerable to the effects that homelessness has on health. Violence is both a common cause of women becoming homelessness and a “companion” in during periods of homelessness. Studies conducted in foreign countries show that homeless women apply various survival strategies and tactics that increase the physical safety of women, reduce the opportunities for violence and abuse, and allow them not to feel as if they are excluded from society. The use of alcohol as a measure of reconciliation with a given situation (and often the cause of homelessness) is very widespread among homeless men and women, which, on the one hand, helps to keep in touch with other homeless people but otherwise hinders reintegration into the society. The state and its municipalities are increasingly focusing on improving social assistance and services for homeless people and social risk groups. Municipalities should carry out regular assessments of how much social assistance is focused on the individual needs of homeless women, what part of this social group it has managed to reach out to and how to measure the effectiveness/adequacy of the assistance provided.

Client Experiences With Shelter and Community Care Services in the Netherlands

Purpose: To gain insight into client experiences with shelter or community care services for homeless people, homeless youth, and abused women and identify priority improvement areas. Methods: Seven hundred and forty-four clients rated their experiences and 116 clients rated the services’ importance. Results: Clients had most positive experiences with the client–worker relationship and least positive experiences with the results of services. Abused women’s service providers scored higher than homeless adults and youth service providers. Day and night shelters scored lowest, followed by crisis shelters, supported housing, and outreaching teams. The results of care have the highest need for quality improvement for homeless adults and youth. Discussion: Clients’ experiences with shelter and community care services in the Netherlands are generally positive, with a strong client–worker relationship forming the basis of good quality care. Monitoring outcomes and increasing the focus on results are integrated in recent approaches aimed at improving the quality of shelter care.

Evaluation of a specialist physiotherapy service for homeless people

and learners. Benefits included: developing confidence and self-efficacy to support independent learning; consolidating practical skills and theoretical knowledge as well as contextualising university based skills and knowledge. Implications:A peer tutoring system offers a non threading supportive learning environment and helps to develop a community of learners across andwithin programmes.A peer tutoring systemcan enhance student learning experiences and assist students in developing graduate attributes.

The effect of local policy actions on mortality among homeless people: a before-after study.

Homeless people have a 3-5-fold increased risk of mortality compared with general populations. After 2005, policy actions being implemented in Rotterdam, the Netherlands, have improved the living conditions of this group. This study examines the effect of policies aimed at improving living conditions on mortality risks of the homeless. Register-based 10-year follow-up study of homeless in Rotterdam, the Netherlands. The participants are homeless adults (aged 18+ years) who visited one or more services for homeless people in Rotterdam in 2001. The intervention of local policies after 2005 was to get homeless people into housing, increase their participation in employment and other regular daytime activities, and controlling drug and alcohol addictions. The main outcome measure is mortality rate ratios calculated using Poisson regression. Differences in mortality between the periods 2001-05 vs. 2006-10 were assessed. The cohort of homeless adults in 2001 consisted of 1870 men and 260 women, with a mean age of 40.3 years. During the 10 years of follow-up, 265 persons (232 male and 33 female) died. Adjusted for age and sex, no significant difference in mortality was observed between the periods 2001-05 and 2006-10 (P = 0.9683). A different splitting in periods did not change the results. Five years of local policy efforts improved their living conditions, but left the mortality rate of a homeless cohort unchanged. Incomplete reach of the program and long previous histories of homelessness ask for additional policies beyond the provision of housing and other services. Attention to the prevention of homelessness seems needed.

A Rapid Evidence-Based Economic Evaluation of a Nursing Service for Homeless People

This report outlines a rapid economic evaluation of a nursing service for homeless people, taking as an example a service in Wirral, a borough of c.320,000 people in the North West of England. This service cost £60,393 ($96,876) in the year from April 2012-March 2013. The main outcome we looked at was the estimated change in quality adjusted life years (QALYs) experienced by clients. From looking at the evidence for cost effectiveness of some individual elements of this service, it would be regarded as cost effective using a willingness to pay threshold of £20,000 - £30,000 per QALY (quality adjusted life year) gained which is the UK standard recommended by NICE (the National Institute for Health and Care Excellence), or a threshold of less than $50,000 per QALY gained. Looking at six elements of the service; hep B and flu vaccinations, screening for gonorrhoea, chlamydia and hep C, and referral to alcohol treatment, the overall cost per QALY compared to no intervention is estimated at £8,876 ($14,238). There are likely to be a lot more elements of the service that are cost effective in improving people's health and wellbeing, reducing unnecessary Accident & Emergency presentations, and reducing the spread of infectious diseases.

Psychologically informed services: a response from the housing, care and support sector

Purpose – This paper seeks to offer a commentary on Psychologically Informed Services: A Good Practice Guide, a recently published operational guidance document on developing psychologically informed environments (PiEs) in services for homeless people.

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.

Exploring Occupation and its Meaning among Homeless Men

Few studies have been conducted that address homelessness from the perspective of those who have experienced it. Studies tend to focus on services for homeless people, with little description of occupational engagement and the experiences of the homeless people themselves. This qualitative study, conducted within a phenomenological tradition, explored the lived experiences of adult men living in an inner-city shelter. Eight individual, unstructured interviews were carried out. In addition, three visual notebooks were compiled by the men, using photographs and text that illustrated the occupational realities of their life-world. Inductive, narrative analysis revealed four themes: keeping busy; street-life environment; loss; and revelation and sharing of self. The findings provide insight into the lives of homeless men. They therefore help to inform occupational therapy within a shelter environment in order to facilitate the homeless men moving forward to increased and more meaningful engagement in occupation and independent lives.

Between the street and the consulting room: The role of therapeutic frame in working with homeless clients

This paper explores the context of psychotherapy with people who are homeless and the kinds of dynamics and challenges that typically arise in this work. The paper specifically considers the process of therapy as it takes place with clients who have been recurrently homeless and who have difficulties with sustaining shelter that has its roots in deficits in early containment. Clinical case material from psychotherapy conducted with two homeless men is presented and the implications of the approach adopted are explored both in relation to policies around the provision of services for homeless people and the more specific issue of psychotherapy intervention. It is argued that a clear, well-articulated set of expectations has to be developed around this work in order to protect it and to provide it with the greatest opportunity for providing the kind of safety that is required for the development of this work. It is argued that the most important issue here relates to the provision of a consistent therapeutic framework and a care around the development of the specific psychotherapeutic frame within, and in relation to, the other frames present in the person's life.

New Wave of Homeless Requires Creative Psychiatric Intervention

New Wave of Homeless Requires Creative Psychiatric Intervention

Who uses services for homeless people? An investigation amongst people sleeping rough in London

AbstractFrom a sample of 389 homeless people in London, the characteristics of those who used services for homeless people are presented and the implications for service planning and delivery explored. Staff providing services for this client group need knowledge about drug use and the confidence to work effectively with homeless drug users. Copyright © 2002 John Wiley & Sons, Ltd.

Overcoming Barriers to Homeless Delivery Services: A Community Response

Homelessness is one of the most pressing social problems today. The.lnstitute of Medicine defines the problem as a failure in the support systems created to prevent the problem and a tighter housing market. The assumption is that the support system should help to prevent the occurrence of homelessness. The Eastern Fairfield County area peiformed a study to look at the relationship between those services serving people who are homeless and near homeless to determine the availability, accessibility, and adequacy of services for homeless people. The study identified several barriers in the service delivery system. A strategy was then developed to address these barriers. This paper shows how a research process can facilitate a community response to a social problem. The paper presents the steps that were taken so other communities may replicate the process.

NO WHERE TO GO: AN ANALYSIS OF THE SUPPORTED ACCOMMODATION ASSISTANCE PROGRAM

The Supported Accommodation Assistance Program (SAAP) provides services for homeless people. After demonstrating that the Program is intended to assist people to move on to independent living, the following paper examines the implications of remaining in SAAP services for longer than would otherwise be necessary because there is no where else to go. In particular, the broader social functions of SAAP are examined in the light of the work of Michel Foucault. It is suggested that SAAP serves a specific social function in exerting socially approved power over SAAP users who are forced to remain in SAAP services for longer than would otherwise be required if affordable and appropriate accommodation were available.

Special care services for homeless people

Special care services for homeless people