ABSTRACT Narrative therapy conversations seek to develop and enrich the strengths, skills and values people hold that can be storied through wonderfulness interviews. The practice of wonderfulness interviews requires therapists to draw on decolonising discourses and resist discourses that may individualise and essentialise skills, values and attributes. Taking up a decolonising discursive position in Aotearoa New Zealand involves the ongoing restoration and uplifting of mātauranga Māori (Māori knowledge). This article lays out a decolonising therapeutic approach, weaving Māori worldviews and narrative therapy in order to respond to two key questions. The first is how can we speak about the wonderfulness of rangatahi Māori (Māori young people) in ways that strengthen their cultural identity? The second, how can rangatahi take up the idea of a poho kererū (pride—see glossary for explanation) whilst also holding onto hūmārie/whakaiti (humbleness)? The article introduces Te Whare Pouhāpai (A House of Support), an approach to engage rangatahi alongside their whānau (family) in wonderfulness conversations. The approach has been developed alongside rangatahi and whānau Māori in both wharekura (Māori medium schools) and kura auraki (mainstream schools) but is still relevant for pākeke (adults). Central to this approach is the metaphorical use of te whare tūpuna (ancestral house), representing the influential figures in the life of rangatahi. The pou (posts/carvings) of the whare (house) become entry points for conversations that explore collective mana (strength, prestige and ability), uara (values), intergenerational knowledge, pūmanawa (skills passed down) and pūkenga (skills). The approach honours multiple forms of mana, recognising that identity and ability are shaped relationally, not individually. Whakataukī (proverbs), the metaphor of the whare tūpuna, and mātauranga Māori are presented to guide ways of understanding identity and wonderfulness. Together, these whakaaro (ideas/thoughts) construct an approach that can assist therapists to resist dominant discourses that individualise strengths, skills and wonderfulness.

Alcohol Use Disorder (AUD) is a leading contributor to global morbidity and mortality, disproportionately affecting people experiencing homelessness. Managed Alcohol Programs (MAPs) represent a harm reduction-based strategy for individuals with severe AUD and homelessness, providing controlled amounts of alcohol alongside comprehensive health and social supports. While evidence of MAP benefits continues to grow, important questions remain about how best to integrate social and medical care, and how to tailor services to align with participants' goals, values, and broader social and structural contexts. This commentary explores the operational strategies and clinical practices of the Ottawa Inner City Health (OICH) MAP, which has been running since 2001. We describe how the program is embedded within supportive housing and leverages an interdisciplinary team-including peer workers and an Indigenous healer-to deliver person-centered care. Key components include structured alcohol delivery tailored to individual needs, meal provision, social supports including life skills training, medication administration and comprehensive physical and mental health services. Clinical care is tailored to participants' day-to-day circumstances, challenges, and goals in managing their AUD, with particular attention to hygiene and nutrition, proactive screening for health decline, and timely management of common health complications. The program operates through strong partnerships with community organizations, pharmacies and subspecialists, to enable integrated, coordinated care. Collaborative and trauma-informed approaches reduce reliance on emergency care and foster a sense of dignity, stability, and community. MAPs have evolved from experimental interventions into internationally recognized harm reduction models. The OICH MAP demonstrates how the integration of housing, healthcare, and social supports can address the complex needs of individuals experiencing homelessness and severe AUD. However, challenges remain in scaling these models, refining screening protocols, and developing evidence-based policy frameworks. This commentary offers practical insights to inform the effective operation of MAPs and calls for continued research and dialogue to ensure they remain adaptable, sustainable, and aligned with the realities of the populations they serve.

ABSTRACT Organized groups frequently appeal to the president of the United States for support of their policy agenda. However, even if presidents are broadly supportive of the groups in question, they may not always be able or willing to meet their demands. Social movements, in particular, which seek change that presidents might view as a threat to their existing party coalition and public support, face imposing challenges in forming partnerships with the White House. How can social movements pressure the president to support their objectives? We explore the relationship between presidents and social movements through a historical case study of the interactions between President Barack Obama and the LGBT movement during Obama's first term in office. While Obama was broadly supportive of gay rights, the relationship between the White House and social activists during his first term in office was often rocky. On the basis of in‐depth interviews with LGBT activists, White House officials, and Democratic politicians, we show how gay rights activists, with critical support from Democratic party leaders, won the White House's support on issues such as the repeal of Don't Ask Don't Tell and same‐sex marriage by pressuring Obama publicly while simultaneously providing the administration with data and guidance in private. We conclude that the relationship between presidents, parties, and social movements, while highly contentious, is a critical dimension of contemporary partisanship.

Clubhouses are an international community-based psychosocial approach to mental health recovery. The aim of the study was to investigate whether the current and future needs of Kindred Clubhouse members were being met. A co-design ethnographic methodology was used. Kindred Clubhouse met many needs of its members. It provides a collaborative, consistent, supportive and inclusive environment fostering connections, skill development, a sense of purpose and the maintenance of health and well-being through peer support and participation in meaningful activities and occupations. Areas for development were expanded operating hours, sufficient meaningful work to sustain a work-ordered day, and support for employment and housing. Lack of stable funding limits Kindred's ability to fully meet the needs of its members. Despite insecure funding, Kindred Clubhouse is a valued community service offering a member-led recovery approach supporting many of the occupational, social and community needs of people with mental health challenges.

Social determinants of health (SDOH) can impact recovery after traumatic injury, but specific social needs of firearm injury survivors have not been well documented. The objective of this study was to document the resources provided to urban firearm injury survivors immediately after hospital discharge, highlighting their outpatient SDOH needs during recovery. This was a retrospective cohort review of all firearm injury survivors seen at an outpatient clinic in a Midwestern, U.S. urban Level I trauma center, from November 2020 through October 2022. Patients were evaluated by the clinic's master's-level social worker, who conducted comprehensive biopsychosocial assessments and documented resources provided in routine care notes. The resources provided were abstracted from social work notes and grouped by SDOH domains. Of the 255 patients evaluated, most were young (32.1years), Black (80.4%), and male (81.6%); 43.1% sustained severe injuries (Injury Severity Score ≥ 16). Most patients received at least one resource (74.5%). Over half of patients received a financial resource (53.7%), with the most common being Crime Victim Compensation assistance (40.0%). Housing or rent support was also common (22.4%). Financial and housing assistance are the most frequently needed resources among urban firearm injury survivors. The SDOH assessments by social workers, combined with strong partnerships to provide resources, can help trauma centers promote comprehensive recovery after firearm injury.

People with forced migration backgrounds, such as refugees, experience disproportionate mental health conditions related to complexities associated with acculturation, separation from family, traumatic events due to war or persecution and precarious journeys in their effort to find protection and care. Intersecting social determinants of refugee mental health include navigating and finding health care resources, employment, housing and social support. Because of the complexity of health and social needs that refuges experience, there is a need for robust integration of mental health services across services such as settlement organizations and primary health care services. Robust service integration to address mental health for refugees can benefit from a theory-driven approach to understanding integrated mental health service delivery. This study engaged in deliberative dialogues with multidisciplinary interest group holders from settlement services, primary health care, mental health, a survivor advocacy group and a policy analyst (N = 24) to understand how services work to promote refugee mental health in a Canadian context. Adopting a participatory realist approach, we developed an initial program theory on the integration of refugee mental health across services. We found trust, connection, proactivity and moral commitment to be key mechanisms that enabled better integrated mental health care across refugee clients, providers and services. Mechanisms which hindered integration included alienation, stagnation, burnout and fragmentation. Findings indicate that, when funding is allocated to settlement programs, supports like cross-cultural brokers, community health workers and navigators can then be implemented. These resources then address social determinants of refugee mental health and trigger positive mechanisms for equitable, just policy approaches to integrate services for refugee mental health.

California has the largest number of people living with HIV in the United States, and in 2022, there were 4882 new diagnoses. Veterans with histories of substance use, viral hepatitis, sexually transmitted infections, and homelessness carry substantial HIV burden. Testing is essential, yet approximately 12% of Californians with HIV were undiagnosed in 2020, and 50% of veterans in care had never been tested as of 2023. HIV self-tests (HIVSTs) can mitigate stigma, confidentiality, and access barriers, and vending machines (VMs) offer private, convenient distribution. However, the use of VM-dispensed HIVST has not been evaluated for veterans or within Veterans Affairs (VA) settings. We describe a Reach, Evaluation, Adoption, Implementation, and Maintenance-guided pre-implementation protocol to evaluate VM-dispensed HIVSTs in Northern California VA clinics and supportive housing settings. Fifteen VMs will stock oral-fluid HIVSTs (n=900). Program data (de-identified dispense logs), veteran electronic surveys (n=90), and qualitative interviews (n=15) will quantify reach (uptake), early effectiveness proxies (use, results, and next steps), adoption (machine/site dispensing), implementation (stockouts, restocking interval, and costs), and maintenance (dispensing trends). Ethics approval activities (study material development and Institutional Review Board submission) began 2 months prior to the receipt of award funding (January to February 2025). Following funding, the project is planned for over a total of 18 months (12 months original project period + 6 months no-cost extension; March 2025 to August 2026). Ethics approval was obtained in August 2025. Veteran feedback was incorporated into study materials, and HIVSTs were purchased and packaged in September to November 2025. HIVSTs were added to VMs, and data collection is projected to occur from December 2025 through June 2026. Results are anticipated to be available in August 2026. This study will generate practice-ready evidence on the feasibility, acceptability, and early behavioral impacts of VM-dispensed HIVSTs for veterans. By pairing a stigma-responsive delivery channel with pragmatic measures, findings can inform equitable scale-up across VA and community settings, guide comparative evaluations of distribution channels (VMs, mail-to-home, or clinic pick-up), and support privacy-preserving linkage strategies to confirmatory testing, HIV pre-exposure prophylaxis, and treatment. Results will address a critical evidence gap for veteran-focused HIV prevention and provide parameters for multi-site evaluations.

Sex workers who use drugs are disproportionately impacted by the current overdose crisis and face many structural barriers to health and harm reduction services. Delivered in either community (e.g., embedded in supportive housing) or clinic (e.g., hospitals) settings, overdose prevention services are crucial harm reduction interventions. Gaining insight into which services sex workers use, and whether sex worker-specific programs impact this use, is key to identifying targeted prevention strategies and enhancing the continuum of overdose care for this population. Data were derived from An Evaluation of Sex workers' Health Access (AESHA), a prospective, community-based cohort of women (trans-inclusive) sex workers in Vancouver, Canada (March 2017-March 2024). We plotted biannual trends in use of overdose prevention services, comparing community-based and clinic-based services (Aim 1), and used generalized linear mixed models to characterize uptake of overdose prevention services, including potential differences between community and clinic-based services (Aim 2). Finally, we evaluated the association between use of sex worker-specific programs and uptake of overdose prevention services, including potential differences between community or clinic-based services over the 7-year study period (Aim 3). Among 503 sex workers who used drugs, 82.1% (N = 413) used any overdose prevention services over the seven-year study. Uptake of community-based versus clinic-based overdose prevention services was 70.2% (N = 353) and 60.2% (N = 303), respectively. Use of sex worker-specific programs was positively associated with use of overdose prevention services (adjusted odds ratio [AOR] 2.18, 95% confidence interval [CI] 1.82-2.62), and this association was strongest for community-based services (AOR 2.66, 95% CI 2.21-3.20) as opposed to clinic-based services (AOR 1.73, 95%CI 1.41-2.13). Uptake of overdose prevention services among sex workers is relatively high, but faced concerning declines over the study period, highlighting the need for additional interventions to scale-up access. Use of sex worker-specific programs facilitated wider access to overdose prevention services. Findings underscore the importance of expanding sex worker-specific and peer-led programs as part of scaling up overdose prevention efforts.

Adverse social and economic conditions negatively impact mental health and well-being. To the best of the authors' knowledge, the present systematic review is the first to investigate the association between housing insecurity and mental health outcomes among renters, with a focus on housing affordability and instability. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in December 2022 across four databases (MEDLINE, PsycINFO, Web of Science, and ASSIA). Quantitative studies from OECD (Organisation for Economic Co-operation and Development) member countries were eligible for inclusion if they investigated housing insecurity by examining at least one independent variable related to housing affordability and/or instability, and included at least one mental health-related outcome among adult renters. Studies needed to specifically distinguish effects for renters, not simply adjust for tenure or include an interaction. Studies were excluded if they analyzed other forms of housing insecurity, examining residential satisfaction and general health outcomes, or populations other than adult renters (< 15 years of age). The methodological quality of the included studies was rated with the JBI Critical Appraisal Tools, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Due to heterogeneity of the identified studies, we performed a narrative synthesis. Twenty-two studies with sample sizes ranging from n = 89 to n = 179,037 met the inclusion criteria (resulting in a total sample size of at least N = 336,775), of which 14 applied a longitudinal design, five a cross-sectional design, and three a quasi-experimental design. Based on the JBI ratings, the overall methodological quality of the included studies was good. The overall ratings of certainty of evidence, based on the GRADE ratings, were between low and very low - mainly due to the non-controlled study designs of included studies. Among the nine studies examining housing affordability, six reported significant associations between unaffordable rent and poor mental health in low-income renters. Regarding housing instability, 12 out of 14 studies reported significant associations between unstable housing and renters' mental health issues. Measures of housing insecurity varied, with rent-to-income ratio and forced moves being most commonly employed. Mental health outcomes focused primarily on overall mental health, well-being, and depressive symptoms, while few studies explored other mental health outcomes. Despite methodological limitations due to the non-controlled studies included in the review, the findings suggest overall that experiencing unaffordable or unstable housing has a negative impact on renters' overall mental health and depressive symptoms. Housing insecurity poses a significant challenge for renters in OECD countries, highlighting the need for policymakers to implement supportive housing policies and tenure protection measures in order to improve renters' housing security and ultimately public health. Nevertheless, more research with robust study designs is needed to draw further conclusions. The systematic review has been conducted without external funding. It has not been pre-registered and no study protocol has been published.

Introduction: Substance use is a significant public health concern that is particularly prevalent among individuals experiencing homelessness. This literature review examines the effectiveness of various substance use interventions targeting this population. Methods: A comprehensive search of academic databases was conducted to identify U.S.-based studies, published between 2020 and 2025, that examined substance use interventions among individuals experiencing homelessness. After applying inclusion and exclusion criteria, studies were screened for relevance and quality. The final selection encompassed a range of study designs (e.g., randomized controlled trials, cohort studies, and qualitative research) and diverse intervention strategies (e.g., supportive housing models, harm reduction approaches, and pharmacological treatments). Results: To address the variability of outcomes measured, coding was used to identify commonalities. Three outcome themes were identified: (1) frequency and amount of alcohol and drug use, (2) treatment retention and program adherence, and (3) self-efficacy and participant perceptions. The results demonstrated short-term reductions in substance use and improvements in participant engagement and psychological well-being. However, long-term outcomes were less consistent with reports of high relapse rates, poor treatment retention, and limited program adherence. Conclusions: Given the mixed and inconsistent findings across studies, there is a critical need to explore alternative approaches to treat substance use among homeless individuals. Occupational therapy (OT) is a promising yet underutilized profession in addressing substance use through holistic, meaningful, occupation-based interventions. To develop effective interventions that support sustained recovery, future research should prioritize longitudinal studies that incorporate objective and subjective measures to fully capture the lived experiences of homeless individuals who use substances.

Adverse social and economic conditions negatively impact mental health and well-being. To the best of the authors’ knowledge, the present systematic review is the first to investigate the association between housing insecurity and mental health outcomes among renters, with a focus on housing affordability and instability. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in December 2022 across four databases (MEDLINE, PsycINFO, Web of Science, and ASSIA). Quantitative studies from OECD (Organisation for Economic Co-operation and Development) member countries were eligible for inclusion if they investigated housing insecurity by examining at least one independent variable related to housing affordability and/or instability, and included at least one mental health-related outcome among adult renters. Studies needed to specifically distinguish effects for renters, not simply adjust for tenure or include an interaction. Studies were excluded if they analyzed other forms of housing insecurity, examining residential satisfaction and general health outcomes, or populations other than adult renters (< 15 years of age). The methodological quality of the included studies was rated with the JBI Critical Appraisal Tools, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Due to heterogeneity of the identified studies, we performed a narrative synthesis. Twenty-two studies with sample sizes ranging from n = 89 to n = 179,037 met the inclusion criteria (resulting in a total sample size of at least N = 336,775), of which 14 applied a longitudinal design, five a cross-sectional design, and three a quasi-experimental design. Based on the JBI ratings, the overall methodological quality of the included studies was good. The overall ratings of certainty of evidence, based on the GRADE ratings, were between low and very low – mainly due to the non-controlled study designs of included studies. Among the nine studies examining housing affordability, six reported significant associations between unaffordable rent and poor mental health in low-income renters. Regarding housing instability, 12 out of 14 studies reported significant associations between unstable housing and renters’ mental health issues. Measures of housing insecurity varied, with rent-to-income ratio and forced moves being most commonly employed. Mental health outcomes focused primarily on overall mental health, well-being, and depressive symptoms, while few studies explored other mental health outcomes. Despite methodological limitations due to the non-controlled studies included in the review, the findings suggest overall that experiencing unaffordable or unstable housing has a negative impact on renters’ overall mental health and depressive symptoms. Housing insecurity poses a significant challenge for renters in OECD countries, highlighting the need for policymakers to implement supportive housing policies and tenure protection measures in order to improve renters’ housing security and ultimately public health. Nevertheless, more research with robust study designs is needed to draw further conclusions. The systematic review has been conducted without external funding. It has not been pre-registered and no study protocol has been published.

In Canada, hospitalized patients aged 65 and older with dementia as a primary diagnosis often face delayed discharges due to limited access to long-term care (LTC) facilities and homecare services. This study compares patients aged 65 and older with dementia as the primary diagnosis to those with 16 broad categories of other primary diagnoses—excluding dementia-related conditions where applicable—across three key outcomes: (1) the likelihood of experiencing a delayed discharge, (2) the length of delay among those who experienced one, and (3) among delayed discharge patients, the likelihood of being discharged to one of three destinations—homecare, long-term care with 24-h nurse care (LTC-24), or other post-acute residential care (PARC), including rehabilitation, complex continuing care, group living, or supportive housing. Using 2023–24 data from the Discharge Database (DAD), this study applies logistic, negative binomial, and multinomial logit models. After adjusting for other factors, patients with primary diagnoses other than dementia were about 35% to 95% less likely to experience a delayed discharge, and when delays occurred, their expected duration was roughly 32% to 65% shorter. All estimates were statistically significant at the 1% level. Among patients who experienced delays, those with other primary diagnoses were also less likely to be discharged to homecare, PARC, or LTC-24 rather than home. These findings highlight the urgent need to expand access to specialized, affordable post-discharge care for patients with dementia, as their complex needs strain hospital capacity.

Stimulant and non-stimulant ADHD medication prescriptions for homeless veteran service users with mental illness.

ABSTRACT Building on a theoretical framework, we examine how fertility behavior affects household risky financial asset allocation using microdata from the 2016, 2018, and 2020 waves of the China Family Panel Studies (CFPS). Fertility behavior is characterized along two sequential dimensions: the decision to have children and the decision to continue childbearing. We find that: (1) Choosing to have children significantly increases households’ participation in risky financial markets, whereas continuing to have children significantly reduces both the probability of participation and the share of risky financial assets held. These findings remain robust across a series of robustness checks. (2) The effects exhibit substantial heterogeneity across urban-rural areas, intergenerational support arrangements, housing liabilities, and household characteristics, including education, asset holdings, and child gender composition. (3) Human capital investment and the income penalty serve as key mediating mechanisms. Specifically, choosing to have children increases household investment in education and healthcare and encourages risk-taking, while continuing childbearing reduces per capita income and constrains participation in risky financial assets. (4) Birth spacing emerges as an important temporal factor: longer intervals between successive births alleviate the financial pressures associated with childbearing and promote greater risk-taking in household portfolios.

In 2019, pursuant to a Section 1115 waiver, Florida launched a Statewide Medicaid Managed Care housing assistance pilot to foster housing stability and reduce preventable health care use in adults with serious mental illness (SMI) or substance use disorder (SUD). We conducted a retrospective cohort study to examine the relationship between four housing support services provided in the pilot (transitional housing support, tenancy support, peer support, and crisis management) and health care use and health outcomes among 1,300 pilot enrollees during the period December2017-June2024. Transitional housing support services were associated with a 15percent increase in emergency department (ED) visits. Tenancy support services were associated with 51percent lower odds of all-cause mortality, and peer support was associated with a 20percent reduction in ED use. Crisis management was associated with a 45percent increase in ED visits, a 41percent increase in outpatient visits, and a 90percent increase in psychiatric hospitalizations. Findings highlight the value of tailored Medicaid housing interventions for people with SMI or SUD. Medicaid policy should prioritize high-value, data-driven housing interventions and protect them from budget cuts. Embedding such services within managed care contracts and aligning them with broader care coordination strategies offer a viable path for sustainability.

Nationwide around 226,080 homeless individuals are unsheltered each night. The U.S. Department of Veterans Affairs (VA) Low Demand program is a community-based model which provides supportive transitional housing to hard-to-reach, unsheltered veterans who often have complex needs and may be unable or unwilling to participate in supportive services which aim to prevent or rapidly re-house veterans when facing housing instability or homelessness. The goal of this study was to examine Low Demand community providers' perceptions of the facilitators and barriers to Low Demand model engagement and effectiveness among unsheltered homeless veterans. Semi-structured interviews, composed of 20 open-ended questions, were conducted with a convenience sample of VA Low Demand community providers and VA staff affiliated with the programs. Interviews were transcribed verbatim, and an inductive approach was employed allowing the data to determine the main categories and subthemes. Three coders independently summarized, coded, and compared transcripts. Qualitative analyses were performed in Atlas.ti.Forty-five Low Demand community providers completed the interview. Providers reported an average four years (range: 3 weeks-14 years) of experience in their current role. Five categories were identified from the qualitative data: (1) Barriers to Low Demand model success, (2) Facilitators of Low Demand model success, (3) Collaborative assessments with VA guide Low Demand program resident retention, (4) Recommendations to reduce returns to homelessness among Low Demand residents, and (5) Low Demand model areas for improvement. Community providers consider the Low Demand model to be an effective option for housing unsheltered veterans who have complex needs. Barriers to retaining and transitioning Low Demand residents to permanent housing were noted. In-facility basic life skills education, financial planning, and relationship reconstruction along with onsite mental health services may support positive program exits. Engaging veterans in aftercare programs and/or retention case management is crucial in the prevention of returns to homelessness. Strong community and VA collaborations are essential to maximizing positive Low Demand program outcomes.

Evaluating cannabis substitution for alcohol within the context of a canadian managed alcohol program.

ABSTRACT Individuals with sexual offense histories are subject to heightened public stigma, which significantly hinders their reintegration and rehabilitation. This stigma often manifests in restricted access to employment, housing, and social support, thereby increasing the risk of recidivism. The present study investigated the extent to which empathy and knowledge predict public stigmatization toward this population. A sample of 117 Dutch participants from the general public completed validated measures assessing attitudes, empathy, and knowledge related to sexual offending. Multiple regression analyses revealed that greater knowledge about sexual offending was significantly associated with lower levels of stigmatizing attitudes. In contrast, empathy did not significantly predict stigma. These findings highlight the critical role of accurate, evidence-based knowledge in shaping public perceptions and reducing prejudice. The results underscore the importance of targeted educational interventions that address common misconceptions about sexual offending, as well as the need for responsible media reporting that avoids sensationalism and promotes balanced narratives. Together, these strategies may contribute to more informed, compassionate, and effective societal responses to individuals with sexual offense histories.

This study conducted an empirical analysis of foreign participants in the Gyeongsangbuk-do Regional Specialized Visa Program as a response to the local extinction crisis. Surveys were carried out in 2023 (N=233) and 2024 (N=312), along with in-depth interviews (n=10). Findings revealed that although weekly working hours decreased, overtime increased and wages remained stagnant. Institutional gaps persisted in family, education, and housing support, while daily difficulties were related to limited access to administrative and financial services and experiences of social discrimination. Nevertheless, settlement intentions remained high at over 95% in both years. The study concluded that to evolve the regional specialized visa program from a simple labor supply scheme into a settlement-based social integration policy, improvements in working conditions, expanded family and housing support, and comprehensive settlement support systems would be required.

The study aims to empirically examine the factors contributing to involuntary settlement among single-person households living in a living quarter other than a housing unit. The analysis utilized responses from 7,374 single-person households from the 「Survey on Residential Conditions in Living Quarters Other than Housing Unit」 conducted by the Ministry of Land, Infrastructure and Transport and the Korea Land and Housing Corporation (LH). Latent Class Analysis (LCA) was conducted based on the reasons for remaining in such housing (first, second, and third priorities) to derive their types, followed by multinomial logistic regression analysis to estimate the determinants for each type. These results suggest that the settlement of single-person households living in living quarter other than housing unit is not explained by a single factor, but rather is a multidimensional process formed by the overlapping of economic poverty, spatial inequality, and health and welfare vulnerability. Accordingly, policy responses require income and financial support to prevent payment overdues for those who are economically constrained; expansion of work-nearby public rental housing for those who are constrained by location and convenience; and integrated support for housing, medical care, and caregiving for those in unavoidable settlements. By introducing the concept of ‘involuntary settlement’ and empirically presenting the complex structure of housing vulnerability, this study is significant as it can contribute to the development of tailored housing welfare policies.