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Sample records for single homeless adults

  1. Community-Level Characteristics Associated With Variation in Rates of Homelessness Among Families and Single Adults

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    Fargo, Jamison D.; Munley, Ellen A.; Byrne, Thomas H.; Montgomery, Ann Elizabeth; Culhane, Dennis P.

    2013-01-01

    Objectives. We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. Methods. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Results. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Conclusions. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations. PMID:24148057

  2. Community-level characteristics associated with variation in rates of homelessness among families and single adults.

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    Fargo, Jamison D; Munley, Ellen A; Byrne, Thomas H; Montgomery, Ann Elizabeth; Culhane, Dennis P

    2013-12-01

    We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations.

  3. Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam

    Directory of Open Access Journals (Sweden)

    de Wit Matty A

    2009-01-01

    Full Text Available Abstract Background To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Methods Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. Results among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks, the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08, belonged more often to a migrant group (p = 0.025, and reported more living single (p Conclusion the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

  4. Risk factors for long-term homelessness: findings from a longitudinal study of first-time homeless single adults.

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    Caton, Carol L M; Dominguez, Boanerges; Schanzer, Bella; Hasin, Deborah S; Shrout, Patrick E; Felix, Alan; McQuistion, Hunter; Opler, Lewis A; Hsu, Eustace

    2005-10-01

    We examined risk factors for long-term homelessness among newly homeless men and women who were admitted to New York City shelters in 2001 and 2002. Interviews were conducted with 377 study participants upon entry into the shelter and at 6-month intervals for 18 months. Standardized assessments of psychiatric diagnosis, symptoms, and coping skills; social and family history; and service use were analyzed. Kaplan-Meier survival analysis and Cox regression were used to examine the association between baseline assessments and duration of homelessness. Eighty-one percent of participants returned to community housing during the follow-up period; the median duration of homelessness was 190 days. Kaplan-Meier survival analysis showed that a shorter duration of homelessness was associated with younger age, current or recent employment, earned income, good coping skills, adequate family support, absence of a substance abuse treatment history, and absence of an arrest history. Cox regression showed that older age group Phomelessness. Identification of risk factors for long-term homelessness can guide efforts to reduce lengths of stay in homeless shelters and to develop new preventive interventions.

  5. Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam.

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    van Laere, Igor R; de Wit, Matty A; Klazinga, Niek S

    2009-01-07

    To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands) were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks), the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08), belonged more often to a migrant group (p = 0.025), and reported more living single (p homelessness, in the total group, contacts with any social service were 38% and with any medical service 27%. Despite these contacts they did not keep their house. During homelessness only contacts with social work and benefit agencies increased, contacts with medical services remained low. the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch) men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

  6. Pathways into homelessness: recently homeless adults - problems and service use before and after becoming homeless in Amsterdam

    NARCIS (Netherlands)

    van Laere, I.R.; de Wit, M.A.; Klazinga, N.S.

    2009-01-01

    ABSTRACT: OBJECTIVE: To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. METHODS: Recently homeless adults (last housing lost up to two years ago and legally

  7. Predictors of Transience among Homeless Emerging Adults

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    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2014-01-01

    This study identified predictors of transience among homeless emerging adults in three cities. A total of 601 homeless emerging adults from Los Angeles, Austin, and Denver were recruited using purposive sampling. Ordinary least squares regression results revealed that significant predictors of greater transience include White ethnicity, high…

  8. Perspectives on housing among homeless emerging adults.

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    Ryan, Tiffany N; Thompson, Sanna J

    2013-02-01

    Homeless emerging adults need the safety and stability of housing programs if they are to avoid the elements and victimization of the streets, however, barriers to obtaining housing are numerous. This study identified factors associated with perspectives of housing services among 29 homeless emerging adults (ages 18-23 years) through one-on-one interviews. Data were gathered and analyzed using grounded theory methodology for qualitative information. Major themes of peer support and positive personal and programmatic interactions in the context of emerging adult development were noted as important factors in housing service utilization. These major themes should be taken into consideration for current housing programs, due to homeless emerging adults' oscillation between their desire for formal support and personal independence. Greater emphasis on services that do not require long term commitments and are more flexible in addressing specific barriers to housing for homeless emerging adults may increase use. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Self-harm and homeless adults.

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    Pluck, Graham; Lee, Kwang-Hyuk; Parks, Randolph W

    2013-01-01

    Homelessness is associated with an increased incidence of mental illness and risk of self-harm, including suicide. To assess the prevalence of self-harm (including nonsuicidal self-injury and attempted suicide) among a UK sample of homeless adults and to compare demographic, clinical, and homeless-related variables to determine which are linked to self-harm in this population. A sample of 80 homeless adults were interviewed regarding history of self-harm, mental health history, demographic, and homeless-related information. Sixty-eight percent of the sample reported past acts of self-harm. Those with histories of self-harm started using significantly more substances since becoming homeless and were younger when they first became homeless. They were also significantly more likely to have a past psychiatric admission and thoughts of self-harm in the past year. Self-harm is common among homeless adults and linked to long-term and enduring social and mental health concerns.

  10. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

    Directory of Open Access Journals (Sweden)

    Rebecca T Brown

    Full Text Available Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years, young adulthood (ages 18-25, and middle adulthood (ages 26-49. We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment and lower attainment of adult milestones (i.e., marriage, full-time employment compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  11. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

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    Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  12. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study

    Science.gov (United States)

    Brown, Rebecca T.; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B.

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs. PMID:27163478

  13. Art messaging to engage homeless young adults.

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    Nyamathi, Adeline; Slagle, Alexandra; Thomas, Alexandra; Hudson, Angela; Kahilifard, Farinaz; Avila, Glenna; Orser, Julie; Cuchilla, Manuel

    2011-01-01

    Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. However, little is known how homeless young adults perceive the use of art as messages that can communicate the danger of initiating or continuing drug and alcohol use. The purpose of this study was to solicit perspectives of homeless, drug-using young adults as to how art can be used to design messages for their peers about the danger of initiating or continuing drug and alcohol use. Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica, California. The findings revealed support for a myriad of delivery styles, including in-person communication, flyers, music, documentary film, and creative writing. The young adults also provided insight into the importance of the thematic framework of messages. Such themes ranged from empowering and hopeful messages to those designed to scare young homeless adults into not experimenting with drugs. The findings indicate that in addition to messages communicating the need to prevent or reduce drug and alcohol use, homeless young adults respond to messages that remind them of goals and dreams they once had for their future, and to content that is personal, real, and truthful. Our research indicates that messages that reinforce protective factors such as hope for the future and self-esteem may be as important to homeless young adults as information about the risks and consequences of drug use.

  14. Childhood Risk Factors in Dually Diagnosed Homeless Adults.

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    Blankertz, Laura E.; And Others

    1993-01-01

    Examined prevalence of five childhood risk factors (sexual abuse, physical abuse, parental mental illness, substance abuse, out-of-home placement) among dually diagnosed (mentally ill and substance abusing) homeless adults (n=156) in rehabilitation programs. Findings suggest that childhood risk factors, whether single or multiple, are very…

  15. Are childhood abuse and neglect related to age of first homelessness episode among currently homeless adults?

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    Mar, Marissa Y; Linden, Isabelle A; Torchalla, Iris; Li, Kathy; Krausz, Michael

    2014-01-01

    This study investigates 500 homeless adults and the associations between childhood maltreatment types and the age of first reported homelessness episode. Those first experiencing homelessness in youth (age 24 years or younger; 46%) were compared with those first experiencing homelessness at a later age (older than age 24 years). In individual models, physical abuse, emotional abuse, and emotional neglect were associated with first experiencing homelessness during youth (p homeless during youth (p homeless earlier in life and support the need for early interventions with at-risk families.

  16. Resettlement and reintegration: single mothers' reflections after homelessness

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    Tischler, Victoria

    2008-01-01

    Previous research has identified that most families who become homeless are women with dependent children. Homeless families are reported to have a variety of complex needs however little is known about the experiences of families once they are re-housed. The aim of this study was to explore psychosocial issues related to the resettlement experiences of single mothers following a period of homelessness. Qualitative semi-structured interviews were used to gather data from twenty one women livi...

  17. Perceptions of Resiliency and Coping: Homeless Young Adults Speak Out

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    Thompson, Sanna J.; Ryan, Tiffany N.; Montgomery, Katherine L.; Lippman, Angie Del Prado; Bender, Kimberly; Ferguson, Kristin

    2016-01-01

    This study explored the perceptions of resilience and coping among homeless young adults, a focus that differs from previous research by considering the unconventional resilience and coping of this high-risk population. Semistructured qualitative interviews were conducted with 45 homeless young adults. Individual interviews were audio recorded,…

  18. The responsibility to care for single homeless people.

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    Crane, M; Warnes, A M

    2001-11-01

    This paper examines the reasons why in contemporary Britain many single homeless people with severe physical and mental health problems and welfare needs do not receive the treatment, care and financial support that they manifestly need, and in particular considers the interaction between their personal characteristics and the organisation and the obligations of services. Homelessness is a complex concept associated with problems of housing, health, social care and income. The greatest weaknesses of the service system are that no single agency has a statutory responsibility to ensure that vulnerable homeless people are served, and none of the generalist welfare agencies have a duty to seek out those who do not present. As a result, single homeless people fall between the housing, health and social services and amass exceptional unmet needs. The paper appraises the approaches to single homeless people's problems that have recently been introduced by the Rough Sleepers' Unit (RSU), and discusses the ways in which current reforms of the welfare services may impact on the situation of homeless people. With the possibility that the RSU's prime responsibility for commissioning single homeless people's services will transfer to local authorities in 2002, the paper concludes by specifying the implications for voluntary and statutory providers and makes recommendations about the attribution of the responsibility to care for this vulnerable group.

  19. Aging on the Street: Homeless Older Adults in America.

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    Sorrell, Jeanne M

    2016-09-01

    Older adults are at greater risk for homelessness today than at any time in recent history. Approximately one half of homeless individuals in America are older than 50, which has created serious challenges for how cities, governments, and health care providers care for homeless populations. Systems established in the 1980s to help care for homeless individuals were not designed to address problems of aging. It is critical that nurses and all health professionals have a better understanding of the unique needs and concerns of homeless older adults. Nurses can be an important part of the solution, not only through direct patient care but by advocating for improvements in care for this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 25-29.]. Copyright 2016, SLACK Incorporated.

  20. Predictors of homeless services re-entry within a sample of adults receiving Homelessness Prevention and Rapid Re-Housing Program (HPRP) assistance.

    Science.gov (United States)

    Brown, Molly; Vaclavik, Danielle; Watson, Dennis P; Wilka, Eric

    2017-05-01

    Local and national evaluations of the federal Homelessness Prevention and Rapid Re-Housing Program (HPRP) have demonstrated a high rate of placement of program participants in permanent housing. However, there is a paucity of research on the long-term outcomes of HPRP, and research on rehousing and prevention interventions for single adults experiencing homelessness is particularly limited. Using Homeless Management Information System data from 2009 to 2015, this study examined risk of return to homeless services among 370 permanently housed and 71 nonpermanently housed single adult HPRP participants in Indianapolis, Indiana. Kaplan-Meier survival curves were conducted to analyze time-to-service re-entry for the full sample, and the homelessness prevention and rapid rehousing participants separately. With an average follow-up of 4.5 years after HPRP exit, 9.5% of the permanently housed HPRP participants and 16.9% of those nonpermanently housed returned to homeless services. By assistance type, 5.4% of permanently housed and 15.8% of nonpermanently housed homelessness prevention recipients re-entered services, and 12.8% of permanently housed and 18.2% of nonpermanently housed rapid rehousing recipients re-entered during the follow-up period. Overall, veterans, individuals receiving rapid rehousing services, and those whose income did not increase during HPRP had significantly greater risk of returning to homeless services. Veterans were at significantly greater risk of re-entry when prevention and rehousing were examined separately. Findings suggest a need for future controlled studies of prevention and rehousing interventions for single adults, aiming to identify unique service needs among veterans and those currently experiencing homelessness in need of rehousing to inform program refinement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders

    OpenAIRE

    Brown, Rebecca T.; Thomas, M. Lori; Cutler, Deborah F.; Hinderlie, Mark

    2013-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent sup...

  2. Obesity among chronically homeless adults: is it a problem?

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2013-01-01

    We examined rates of obesity and associated characteristics in the chronically homeless population to explore how a range of factors, including sociodemographics, housing, food source, physical and mental health, and health service use, were related to being overweight or obese. We conducted multivariate regression analyses on a community sample of 436 chronically homeless adults across 11 U.S. cities to examine the prevalence of obesity. The majority (57%) of chronically homeless adults were overweight or obese. Chronically homeless adults who were female or Hispanic appeared to be at particular risk for obesity. There were few differences on physical and mental health by weight group. Although overweight and obese chronically homeless adults were more likely to discuss exercise with a health-care provider, they reported engaging in less exercise than those who were underweight or normal weight. These findings underscore the need for greater attention to obesity in chronically homeless adults and demonstrate a food insecurity-obesity paradox or poverty-obesity link.

  3. Risk factors for homelessness among indigent urban adults with no history of psychotic illness: a case-control study.

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    Caton, C L; Hasin, D; Shrout, P E; Opler, L A; Hirshfield, S; Dominguez, B; Felix, A

    2000-02-01

    This study identified risk factors for homelessness among indigent urban adults without dependent children and with no history of psychotic illness. We conducted a matched case-control study, stratified by sex, of 200 newly homeless men and women and 200 indigent men and women with no history of homelessness. Newly homeless case subjects were recruited from shelter assessment centers in New York City. Never-homeless control subjects, selected from public assistance centers, were single adults applying for home relief. Control subjects were matched with case subjects according to ethnicity, age, and sex. Trained interviewers employed standardized research instruments to probe 3 domains of risk factors: symptom severity and substance use disorder, family support and functioning, and prior use of services. Significant interaction effects by sex were present for symptom severity, heroin use disorder, and prior service use. Greater numbers of the homeless of both sexes lacked a high school diploma and had less income from all sources, including from their families, than of the never homeless. Newly homeless men and women with no history of psychotic illness differed from their never-homeless counterparts in the 3 domains investigated, but socioeconomic factors were also important.

  4. Health Outcomes of Obtaining Housing Among Older Homeless Adults.

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    Brown, Rebecca T; Miao, Yinghui; Mitchell, Susan L; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L; Grande, Laura J; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A

    2015-07-01

    We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless.

  5. Health Outcomes of Obtaining Housing Among Older Homeless Adults

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    Miao, Yinghui; Mitchell, Susan L.; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L.; Grande, Laura J.; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A.

    2015-01-01

    Objectives. We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. Methods. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. Results. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Conclusions. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless. PMID:25973822

  6. A quantitative review of cognitive functioning in homeless adults.

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    Depp, Colin A; Vella, Lea; Orff, Henry J; Twamley, Elizabeth W

    2015-02-01

    Homeless people experience elevated rates of risk factors for cognitive impairment. We reviewed available peer-reviewed studies reporting data from objective measures of cognition in samples identified as homeless. Pooled sample-weighted estimates of global cognitive screening measures, full-scale intelligence quotient (IQ), and premorbid IQ were calculated, in addition to pooled sample characteristics, to understand the representativeness of available studies. A total of 24 unique studies were identified, with 2969 subjects. The pooled estimate for the frequency of cognitive impairment was 25%, and the mean full-scale IQ score was 85, 1 standard deviation below the mean of the normal population. Cognitive impairment was found to be common among homeless adults and may be a transdiagnostic problem that impedes rehabilitative efforts in this population. Comparatively little data are available about cognition in homeless women and unsheltered persons.

  7. Subjective health status of single homeless people in Sheffield.

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    Westlake, L; George, S L

    1994-03-01

    A census of single homeless people was carried out over a single 12-hour period in Sheffield. Places of residence of homeless people were identified by local workers with homeless people. Participants completed a questionnaire designed to provide data relating to their demography, employment history, contact with welfare agencies, social status, prison history, past and family medical history, contact with health services, perceived health status as measured by the Nottingham Health Profile, and anxiety and depression measured using the Foulds Delusions Symptoms States Inventory/State of Anxiety and Depression DSSI/sAD. Three hundred and seventy-nine single homeless individuals were contacted. Reliable data were available on 340. The population was heterogeneous with respect to perceived health status, but it was significantly worse than a standard London population on all dimensions. Those with a self-reported history of psychiatric illness had a significantly worse perceived health status on all dimensions than those without such a history. Those reporting a history of admission to psychiatric hospital had a significantly worse status in two dimensions: mobility, reflecting greater age, and more significantly social isolation, consistent with findings in other de-institutionalised populations. Anxiety and depression, measured using the Foulds sAD scale, was raised in all groups in the study, but did not differentiate between those with and without a self-reported psychiatric history, or between those with and without a self-reported history of psychiatric admission. This suggests that these symptoms are a result rather than a cause of homelessness, and that a broad social solution to mental illness in homeless people is needed in addition to specific medical interventions.

  8. Does housing chronically homeless adults lead to social integration?

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    Tsai, Jack; Mares, Alvin S; Rosenheck, Robert A

    2012-01-01

    Supported housing programs have been successful in helping homeless adults obtain housing. This study examined whether improvements in social integration occur after clients obtain supported housing. Measures of social integration were examined for 550 chronically homeless adults with mental illness who participated in the 11-site Collaborative Initiative to Help End Chronic Homelessness. Social integration was conceptualized as a multidimensional construct of variables in six domains: housing, work, social support, community participation, civic activity, and religious faith. Changes in baseline measures related to the six domains and their interrelationships were examined at six and 12 months after entry into the supported housing program. Chronically homeless adults showed substantial improvements in housing but remained socially isolated and showed limited improvement in other domains of social integration, which were only weakly correlated with one another. More attention is needed to develop rehabilitation interventions in supported housing programs to improve social integration of chronically homeless adults. Because improvements in some domains of social integration were only weakly related, it may be necessary to intervene in multiple domains simultaneously.

  9. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study

    OpenAIRE

    To, Matthew J.; Palepu, Anita; Aubry, Tim; Nisenbaum, Rosane; Gogosis, Evie; Gadermann, Anne; Cherner, Rebecca; Farrell, Susan; Misir, Vachan; Hwang, Stephen W.

    2016-01-01

    Abstract Background Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness. Methods Vulnerably ho...

  10. Physical and Mental Health Issues among Homeless Youth in British Columbia, Canada: Are they Different from Older Homeless Adults?

    Science.gov (United States)

    Saddichha, Sahoo; Linden, Isabelle; Krausz, Michael Reinhardt

    2014-09-01

    Youth homelessness is on the rise in North America, yet this vulnerable population is rarely studied and compared with adults. This paper aimed to study the homeless youth and identify specific vulnerabilities, which rendered them different from the adult homeless population. It also aimed to describe the youth homeless population and their significant co-morbidities. DATA WAS DERIVED FROM THE BC HEALTH OF THE HOMELESS STUDY (BCHOHS), CARRIED OUT IN THREE CITIES IN BRITISH COLUMBIA, CANADA: the large urban centre Vancouver (n=250); the mid-sized city and capital of the province Victoria (n=150). Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ) and the Mini International Neuropsychiatric Interview (MINI) Plus. Youth constituted 16.5% (n=82) of the homeless population. Compared to the adult homeless, the homeless youth were more often female (55%), were Aboriginal (47.6%), had greater substance abuse of alcohol (70.7%), amphetamines (8.5%) and cannabis (75.6%). A lower prevalence of sexually transmitted diseases (0.2%) and psychotic disorders (13.4%) was also observed. The prevalence of traumatic experiences, other psychiatric disorders and physical illnesses were similar between the adult and homeless youth. Homeless youth have high rates of physical and psychiatric comorbidity, similar to the adult homeless, despite being 20 years younger. An urgent need for interventions that go beyond the standardized ones being offered to homeless populations as a whole, and to derive specific strategies that target this vulnerable population is required.

  11. Barriers and facilitators to shelter utilization among homeless young adults.

    Science.gov (United States)

    Ha, Yoonsook; Narendorf, Sarah C; Santa Maria, Diane; Bezette-Flores, Noel

    2015-12-01

    Rates of shelter use among homeless youth are low compared to use of other supportive services, yet research on barriers to shelter use has been conducted in limited regions, specifically in West Coast or Midwest cities. Additionally, while studies have generally focused on barriers to shelter use, studies on what might facilitate shelter use are lacking. This study explores barriers and facilitators to shelter use among homeless young adults from a large city in the Southwest region. Focus groups were conducted with a diverse sample of 49 homeless young adults ages 18-24. Drawing on models of health service use, findings were categorized into two domains--attitudinal and access. Themes related to attitudinal barriers include stigma/shame and self-reliance/pride. Attitudinal facilitators include the desire to extricate themselves from street life and turn their lives in a new direction. Access-related themes include barriers such as a lack of shelters and services available to meet the needs of youth, adverse shelter conditions, staff attitudes that are not acceptable to youth, restrictive shelter rules, restrictive definitions of homelessness, and a desire to differentiate themselves from older homeless individuals. Certain characteristics or circumstances (e.g., being pregnant), having supportive others, and shelters' ability to connect them to other services emerged as access facilitators to shelter use. Implications for policymakers, service providers, and future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Providing Homeless Adults with Advantage: A Sustainable University Degree Program

    Science.gov (United States)

    Sinatra, Richard; Lanctot, Melissa Kim

    2016-01-01

    A university partnered with the New York City Department of Homeless Services (NYC DHS) to provide cohorts of adults a 60-credit Associate Degree Program in Business Administration over a 2-year period. Results of two cohorts of 30 Advantage Academy Program graduates revealed significant improvement in College Board AccuPlacer (ACPL) Arithmetic…

  13. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders

    Science.gov (United States)

    Brown, Rebecca T.; Thomas, M. Lori; Cutler, Deborah F.; Hinderlie, Mark

    2014-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population. PMID:24729832

  14. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders.

    Science.gov (United States)

    Brown, Rebecca T; Thomas, M Lori; Cutler, Deborah F; Hinderlie, Mark

    2013-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population.

  15. Predicting Homelessness among Emerging Adults Aging Out of Foster Care.

    Science.gov (United States)

    Shah, Melissa Ford; Liu, Qinghua; Mark Eddy, J; Barkan, Susan; Marshall, David; Mancuso, David; Lucenko, Barbara; Huber, Alice

    2017-09-01

    This study examines risk and protective factors associated with experiencing homelessness in the year after "aging out" of foster care. Using a state-level integrated administrative database, we identified 1,202 emerging adults in Washington State who exited foster care between July 2010 and June 2012. Initial bivariate analyses were conducted to assess the association between candidate predictive factors and an indicator of homelessness in a 12-month follow-up period. After deploying a stepwise regression process, the final logistic regression model included 15 predictive factors. Youth who were parents, who had recently experienced housing instability, or who were African American had approximately twice the odds of experiencing homelessness in the year after exiting foster care. In addition, youth who had experienced disrupted adoptions, had multiple foster care placements (especially in congregate care settings), or had been involved with the juvenile justice system were more likely to become homeless. In contrast, youth were less likely to experience homelessness if they had ever been placed with a relative while in foster care or had a high cumulative grade point average relative to their peers. © Society for Community Research and Action 2016.

  16. Dental health of homeless adults in Toronto, Canada.

    Science.gov (United States)

    Figueiredo, Rafael L F; Hwang, Stephen W; Quiñonez, Carlos

    2013-01-01

    This study aimed to assess the oral health status of the Toronto adult homeless population; to learn how they perceive their own oral health; and to correlate the presence of oral disease with length of homelessness and unemployment. This cross-sectional descriptive study collected data from 191 homeless adults who were randomly selected using a stratified cluster sample at 18 shelters. A questionnaire and clinical oral examination were conducted with participants. The mean Decayed/Missing/Filled Teeth (DMFT) score of the subjects was 14.4 (SD = 8.1). Only 32% of them had visited a dentist during the last year, 75% believed that they had untreated dental conditions, and 40% had their last dental visit for emergency care. The clinical oral examination observed that 88% needed fillings, 70% periodontal, 60% prosthodontic, and 40% emergency treatment. Homeless adults in Toronto have poor oral health, significant oral health treatment needs, and a lack of access to dental care. © 2012 American Association of Public Health Dentistry.

  17. The effects of the therapeutic workplace and heavy alcohol use on homelessness among homeless alcohol-dependent adults.

    Science.gov (United States)

    Carlson, Emily; Holtyn, August F; Fingerhood, Michael; Friedman-Wheeler, Dara; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

    2016-11-01

    A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial. In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness. Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94)=1.732, p=0.183). However, participants with more heavy drinking days (b=0.350, phomeless. Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. A Review of the Literature on LGBTQ Adults Who Experience Homelessness.

    Science.gov (United States)

    Ecker, John; Aubry, Tim; Sylvestre, John

    2017-12-05

    Little is known about lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults who experience homelessness. The current review critically analyzes the scant literature on LGBTQ adults who experience homelessness, with a particular focus on: (1) pathways into homelessness; (2) support needs; (3) targeted programming; and (4) exits out of homelessness. A total of 143 articles were identified, and 16 articles met the criteria of appropriate age range, article quality, and relevance of topic. Results from this review demonstrate that homeless LGBTQ adults have unique physical and mental health challenges, largely concerning HIV and substance use. Transgender and gender non-conforming adults who experience homelessness encounter several challenges in the homelessness system, particularly in regard to safety and gender-affirming supports. Recommendations focus on practical implications for support and suggestions for future research.

  19. Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

    NARCIS (Netherlands)

    van Laere, I.; de Wit, M.; Klazinga, N.

    2009-01-01

    ABSTRACT: BACKGROUND: Adequate support for homeless populations includes shelter and care to recuperate from illness and/or injury. This is a descriptive analysis of diagnoses and use of shelter-based convalescence in a cohort of homeless adults in Amsterdam. METHODS: Demographics of ill homeless

  20. Long-term and chronic homelessness in homeless women and women with children.

    Science.gov (United States)

    Zlotnick, Cheryl; Tam, Tammy; Bradley, Kimberly

    2010-09-01

    The Chronic Homelessness initiative has directed millions of federal dollars to services for single "unaccompanied homeless" individuals, specifically excluding women living with their children. Using a data set with a nationally representative sample of homeless adults, we calculated the prevalence rates and profiles of long-term homelessness in homeless women (n = 849). With the exception of the criterion of being a single "unaccompanied individual," many women, including women with children, met the criteria for chronic homelessness including having a disability of mental health or substance abuse problems. Our findings suggest that the federal definition of chronic homelessness needs to be revised.

  1. Family Histories and Multiple Transitions Among Homeless Young Adults: Pathways to Homelessness.

    Science.gov (United States)

    Tyler, Kimberly A; Schmitz, Rachel M

    2013-10-01

    This study explored the early family histories of homeless young adults, the types and number of transitions they experienced, and their pathways to the street. Intensive qualitative interviews were audio taped and transcribed with 40 homeless young adults 19 to 21 years of age in the Midwest. Findings show that family backgrounds were generally characterized by substance use, child maltreatment, and witnessing violence, all of which provide social context for understanding why so many of these young people opted to leave home in search of an alternative living situation. The current findings also reveal that while some young adults ran away from home as adolescents, others were "pushed out" (i.e., told to leave), or removed by state agencies. Current study findings illustrate that young adults' trajectories are marked by multiple living arrangements such as home, foster care, detention facility, and drug rehabilitation. Overall, study results show that young adults' family histories place them on trajectories for early independence marked by multiple transitions and numerous living situations, culminating in a lack of a permanent residence to call home.

  2. Measuring Food Security in Canadian Homeless Adult Men.

    Science.gov (United States)

    D'andreamatteo, Carla; Slater, Joyce

    2018-03-01

    To assess whether the current food security measurement tool used in Canada, the Canadian Community Health Survey, is appropriate for use with homeless adults. The Household Food Security Survey Module (HFSSM), a validated measurement tool utilized for determining the food security status of Canadian households, was used with a group of homeless men (n = 40). In-depth interviews were also conducted with participants to obtain particulars about their food acquisition strategies. Data were analyzed by comparing the results of the HFSSM with qualitative data. The HFSSM measurement tool found that 90% (n = 36) of the study participants experienced food insecurity with 67.5% (n = 27) experiencing severe food insecurity and 22.5% (n = 9) experiencing moderate food insecurity. The qualitative data, however, suggested that all participants (n = 40) were food insecure based on food acquisition practices, food accessibility, and diet quality. The HFSSM has validity concerns when applied to homeless populations. Nutrition professionals and other key stakeholders should work to develop valid tools for measuring the food security status of homeless individuals who are highly vulnerable to food insecurity.

  3. Trauma and post-traumatic stress disorder among homeless adults in Sydney.

    Science.gov (United States)

    Taylor, Kathryn M; Sharpe, Louise

    2008-03-01

    International studies indicate high prevalence rates of post-traumatic stress disorder within homeless populations. In Australia, studies indicate high rates of trauma among homeless adults, yet post-traumatic stress disorder has not been investigated in homeless Australian adults. The primary aim of this project was to determine the prevalence of post-traumatic stress disorder among homeless adults in Sydney. Further, another aim of the study was to determine whether the onset of post-traumatic stress disorder preceded the first episode of homelessness or was a consequence of homelessness. The sample consisted of 70 homeless men and women aged 18-73 years, who were randomly sampled through eight homeless services. A computer-assisted face-to-face structured clinical interview was conducted with each participant. Lifetime prevalence of post-traumatic stress disorder was determined via the Composite International Diagnostic Interview. The majority of the sample had experienced at least one traumatic event in their lifetime (98%). Indeed, the mean number of traumas per person was six. The 12 month prevalence of post-traumatic stress disorder was higher among homeless adults in Sydney in comparison to the Australian general population (41% vs 1.5%). But 79% of the sample had a lifetime prevalence of post-traumatic stress. In 59% of cases, the onset of post-traumatic stress disorder preceded the age of the first reported homeless episode. Homeless adults in Sydney frequently experience trauma and post-traumatic stress disorder. The study found that trauma and post-traumatic stress disorder more often precede homelessness, but re-victimization is common. These findings highlight the high mental health needs among homeless people and have implications for services for homeless people.

  4. Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

    Science.gov (United States)

    Hermes, Eric; Rosenheck, Robert

    2016-02-01

    Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.

  5. The relationship between victimization and mental health functioning in homeless youth and adults.

    Science.gov (United States)

    Rattelade, Stephanie; Farrell, Susan; Aubry, Tim; Klodawsky, Fran

    2014-06-01

    This study examined the relationship between victimization and mental health functioning in homeless individuals. Homeless populations experience higher levels of victimization than the general population, which in turn have a detrimental effect on their mental health. A sample of 304 homeless adults and youth completed one-on-one interviews, answering questions on mental health, past victimization, and recent victimization experiences. A hierarchical linear regression showed that experiences of childhood sexual abuse predicted lower mental health functioning after controlling for the sex and age of individuals. The study findings are applicable to current support programs for victims in the homeless population and are relevant to future research on homelessness and victimization.

  6. Gender, coping strategies, homelessness stressors, and income generation among homeless young adults in three cities.

    Science.gov (United States)

    Ferguson, Kristin M; Bender, Kimberly; Thompson, Sanna J

    2015-06-01

    This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder [ASPD], substance use disorder [SUD], and major depressive episode [MDE]) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Residential patterns in older homeless adults: Results of a cluster analysis.

    Science.gov (United States)

    Lee, Christopher Thomas; Guzman, David; Ponath, Claudia; Tieu, Lina; Riley, Elise; Kushel, Margot

    2016-03-01

    Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. They may have different life trajectories and reside in different environments than do younger homeless adults. Although the environmental risks associated with homelessness are substantial, the environments in which older homeless individuals live have not been well characterized. We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them. We generated four residential groups describing those who were unsheltered (n = 162), cohabited unstably with friends and family (n = 57), resided in multiple institutional settings (shelters, jails, transitional housing) (n = 88), or lived primarily in rental housing (recently homeless) (n = 43). Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing. Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after

  8. Adapting the Individual Placement and Support Model with Homeless Young Adults

    Science.gov (United States)

    Ferguson, Kristin M.; Xie, Bin; Glynn, Shirley

    2012-01-01

    Background: Prior research reveals high unemployment rates among homeless young adults. The literature offers many examples of using evidence-based supported employment models with vulnerable populations to assist them in obtaining and maintaining competitive employment; yet few examples exist to date with homeless young adults with mental…

  9. Health insurance coverage and healthcare utilization among homeless young adults in Venice, CA.

    Science.gov (United States)

    Winetrobe, H; Rice, E; Rhoades, H; Milburn, N

    2016-03-01

    Homeless young adults are a vulnerable population with great healthcare needs. Under the Affordable Care Act, homeless young adults are eligible for Medicaid, in some states, including California. This study assesses homeless young adults' health insurance coverage and healthcare utilization prior to Medicaid expansion. All homeless young adults accessing services at a drop-in center in Venice, CA, were invited to complete a self-administered questionnaire; 70% of eligible clients participated (n = 125). Within this majority White, heterosexual, male sample, 70% of homeless young adults did not have health insurance in the prior year, and 39% reported their last healthcare visit was at an emergency room. Past year unmet healthcare needs were reported by 31%, and financial cost was the main reported barrier to receiving care. Multivariable logistic regression found that homeless young adults with health insurance were almost 11 times more likely to report past year healthcare utilization. Health insurance coverage is the sole variable significantly associated with healthcare utilization among homeless young adults, underlining the importance of insurance coverage within this vulnerable population. Service providers can play an important role by assisting homeless young adults with insurance applications and facilitating connections with regular sources of health care. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Exploring the Psychosocial and Behavioral Adjustment Outcomes of Multi-Type Abuse among Homeless Young Adults

    Science.gov (United States)

    Ferguson, Kristin M.

    2009-01-01

    This article explores the psychosocial and behavioral adjustment outcomes associated with verbal, emotional, physical, and sexual abuse among homeless young adults as well as the associations among abuse types. Convenience sampling was used to select 28 homeless young adults (ages 18 to 24) from one drop-in center. Overall, subjects experienced…

  11. The working alliance between homeless young adults and workers: A dyadic approach

    NARCIS (Netherlands)

    Altena, A.M; Krabbenborg, M.A.M.; Boersma, S.N.; Beijersbergen, M.D.; Berg, Y.H.M. van den; Vollebergh, W.A.M.; Wolf, J.R.L.M.

    2017-01-01

    The development of a strong working alliance between homeless young adults and their social workers is seen as a critical component in the recovery process. The purpose of this study was to examine the composition of the working alliance between homeless young adults and their social workers, and

  12. The working alliance between homeless young adults and workers : A dyadic approach

    NARCIS (Netherlands)

    Altena, Astrid M.; Krabbenborg, Manon A M; Boersma, Sandra N.; Beijersbergen, Mariëlle D.; van den Berg, Yvonne H. M.; Vollebergh, Wilma A.M.; Wolf, Judith R.L.M.

    2017-01-01

    The development of a strong working alliance between homeless young adults and their social workers is seen as a critical component in the recovery process. The purpose of this study was to examine the composition of the working alliance between homeless young adults and their social workers, and

  13. Conceptualizing Social Integration among Formerly Homeless Adults with Severe Mental Illness

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2012-01-01

    The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well-studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors…

  14. Homelessness Pathways for Australian Single Mothers and Their Children: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Wayne Warburton

    2018-03-01

    Full Text Available There is increasing concern about family homelessness. Homeless mothers and their children are one of society’s most disadvantaged and at-risk populations. However, very little Australian research exploring mothers’ views on their homelessness experiences exists. Using semi-structured interviews with 14 mothers and four agency staff, this study explored homeless Australian mothers’ pathways into and out of homelessness, their specific needs and the services and supports that were (or would have been most helpful. In this sample of single mothers and their children, early experiences of homelessness and domestic violence contributed most commonly to homelessness episodes. Almost immediate engagement with welfare agencies seemed to be protective against re-experiencing homelessness, however Australian restrictions on length of program involvement and limited housing options for mothers exiting homelessness programs, may place such mothers and their children at high risk of re-entering homelessness. Younger mothers had greater needs and benefited most from personalised one-on-one support that addressed key parenting and life skills. The implications of these findings are considered in relation to service delivery to this vulnerable group and avenues for future research are noted.

  15. Self-transcendence and well-being in homeless adults.

    Science.gov (United States)

    Runquist, Jennifer J; Reed, Pamela G

    2007-03-01

    This study examines the relationships of spiritually and physically related variables to well-being among homeless adults. A convenience sample of 61 sheltered homeless persons completed the Spiritual Perspective Scale, the Self-Transcendence Scale, the Index of Well-Being, and items measuring fatigue and health status. The data were subjected to correlational and multiple regression analysis. Positive, significant correlations were found among spiritual perspective, self-transcendence, health status, and well-being. Fatigue was inversely correlated with health status and well-being. Self-transcendence and health status together explained 59% of the variance in well-being. The findings support Reed's theory of self-transcendence, in which there is the basic assumption that human beings have the potential to integrate difficult life situations. This study contributes to the growing body of evidence that conceptualizes homeless persons as having spiritual, emotional, and physical capacities that can be used by health care professionals to promote well-being in this vulnerable population.

  16. Florida's Adult Homeless Literacy Training & Basic Skills Assistance Project.

    Science.gov (United States)

    Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

    Some facts about the homeless population in Florida are the following: (1) 40,000 persons in Florida are homeless on any given day, with 40 percent of the total being families; (2) 65 percent are new homeless (not chronic); (3) 30 percent of the homeless are addicted to drugs or alcohol and 20 percent are mentally ill; (4) causes of homelessness…

  17. Perceived racial, sexual identity, and homeless status-related discrimination among Black adolescents and young adults experiencing homelessness: Relations with depressive symptoms and suicidality.

    Science.gov (United States)

    Gattis, Maurice N; Larson, Andrea

    2016-01-01

    There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16-24) experiencing homelessness. Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness. (c) 2016 APA, all rights reserved).

  18. Childhood risk factors in dually diagnosed homeless adults.

    Science.gov (United States)

    Blankertz, L E; Cnaan, R A; Freedman, E

    1993-09-01

    Although the negative long-term effects of specific childhood risk factors--sexual and physical abuse, parental mental illness and substance abuse, and out-of-home placement--have been recognized, most studies have focused on just one of these risks. This article examines the prevalence of these five childhood risk factors among dually diagnosed (mentally ill and substance abusing) homeless adults in rehabilitation programs. It further assesses the impact of each risk factor individually and in combinations of two on the social functioning skills and rehabilitation progress of these multiply disadvantaged clients.

  19. Exiting homelessness: perceived changes, barriers, and facilitators among formerly homeless adults with mental disorders.

    Science.gov (United States)

    Patterson, Michelle L; Currie, Lauren; Rezansoff, Stefanie; Somers, Julian M

    2015-03-01

    This study examines key themes from narrative interviews conducted with 43 homeless adults with mental disorders 18 months after random assignment to Housing First with intensive supports or to treatment as usual (no housing or supports through the study). Coding and thematic analysis of semistructured interviews was based on 2 research questions from participants' perspectives: (a) What changes were perceived over time? (b) What factors facilitated or hindered change? The majority of participants assigned to Housing First reported positive change across multiple domains as a result of stable housing; whereas the majority of treatment as usual participants reported negative or neutral change. Key themes included feelings of security and pride; adjusting to living alone; housing as a learning process; and developing meaningful activity. The sense of security associated with stable housing was the most influential factor that supported change. Factors that helped or hindered change clustered into 4 key themes: the type and quality of services; the cumulative effects of trauma; social ties; and concurrent substance use. Our findings provide important context to the emerging body of quantitative research on Housing First and recovery from homelessness. Participants' experiences of recovery, particularly as it relates to housing and supports, shifts in identity, and meaningful activity must be acknowledged and incorporated into the design and evaluation of public services, and policy and service reforms. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  20. Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

    Science.gov (United States)

    2009-01-01

    Background Adequate support for homeless populations includes shelter and care to recuperate from illness and/or injury. This is a descriptive analysis of diagnoses and use of shelter-based convalescence in a cohort of homeless adults in Amsterdam. Methods Demographics of ill homeless adults, diagnoses, referral pattern, length of stay, discharge locations, and mortality, were collected by treating physicians during outreach care provision in a shelter-based convalescence care facility in Amsterdam, from January 2001 through October 2007. Results 629 individuals accounted for 889 admissions to the convalescence care facility. 83% were male and 53% were born in the Netherlands. The mean age was 45 years (SD 10 years). The primary physical problems were skin disorders (37%), respiratory disorders (33%), digestive disorders (24%) and musculoskeletal disorders (21%). Common chronic conditions included addictions 78%, mental health disorders 20%, HIV/AIDS 11% and liver cirrhosis 5%. Referral sources were self-referred (18%), general hospitals (21%) and drug clinics (27%). The median length of stay was 20 days. After (self)discharge, 63% went back to the previous circumstances, 10% obtained housing, and 23% went to a medical or nursing setting. By March 2008, one in seven users (n = 83; 13%) were known to have died, the Standard Mortality Ratio was 7.5 (95% CI: 4.1-13.5). Over the years, fewer men were admitted, with significantly more self neglect, personality disorders and cocaine use. Lengths of stay increased significantly during the study period. Conclusion Over the last years, the shelter-based convalescence care facility users were mainly homeless single males, around 45 years of age, with chronic problems due to substance use, mental health disorders and a frail physical condition, many of whom died a premature death. The facility has been flexible and responsive to the needs of the users and services available. PMID:19922617

  1. Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

    Directory of Open Access Journals (Sweden)

    Klazinga Niek

    2009-11-01

    Full Text Available Abstract Background Adequate support for homeless populations includes shelter and care to recuperate from illness and/or injury. This is a descriptive analysis of diagnoses and use of shelter-based convalescence in a cohort of homeless adults in Amsterdam. Methods Demographics of ill homeless adults, diagnoses, referral pattern, length of stay, discharge locations, and mortality, were collected by treating physicians during outreach care provision in a shelter-based convalescence care facility in Amsterdam, from January 2001 through October 2007. Results 629 individuals accounted for 889 admissions to the convalescence care facility. 83% were male and 53% were born in the Netherlands. The mean age was 45 years (SD 10 years. The primary physical problems were skin disorders (37%, respiratory disorders (33%, digestive disorders (24% and musculoskeletal disorders (21%. Common chronic conditions included addictions 78%, mental health disorders 20%, HIV/AIDS 11% and liver cirrhosis 5%. Referral sources were self-referred (18%, general hospitals (21% and drug clinics (27%. The median length of stay was 20 days. After (selfdischarge, 63% went back to the previous circumstances, 10% obtained housing, and 23% went to a medical or nursing setting. By March 2008, one in seven users (n = 83; 13% were known to have died, the Standard Mortality Ratio was 7.5 (95% CI: 4.1-13.5. Over the years, fewer men were admitted, with significantly more self neglect, personality disorders and cocaine use. Lengths of stay increased significantly during the study period. Conclusion Over the last years, the shelter-based convalescence care facility users were mainly homeless single males, around 45 years of age, with chronic problems due to substance use, mental health disorders and a frail physical condition, many of whom died a premature death. The facility has been flexible and responsive to the needs of the users and services available.

  2. Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study.

    Science.gov (United States)

    van Laere, Igor; de Wit, Matty; Klazinga, Niek

    2009-11-18

    Adequate support for homeless populations includes shelter and care to recuperate from illness and/or injury. This is a descriptive analysis of diagnoses and use of shelter-based convalescence in a cohort of homeless adults in Amsterdam. Demographics of ill homeless adults, diagnoses, referral pattern, length of stay, discharge locations, and mortality, were collected by treating physicians during outreach care provision in a shelter-based convalescence care facility in Amsterdam, from January 2001 through October 2007. 629 individuals accounted for 889 admissions to the convalescence care facility. 83% were male and 53% were born in the Netherlands. The mean age was 45 years (SD 10 years). The primary physical problems were skin disorders (37%), respiratory disorders (33%), digestive disorders (24%) and musculoskeletal disorders (21%). Common chronic conditions included addictions 78%, mental health disorders 20%, HIV/AIDS 11% and liver cirrhosis 5%. Referral sources were self-referred (18%), general hospitals (21%) and drug clinics (27%). The median length of stay was 20 days. After (self)discharge, 63% went back to the previous circumstances, 10% obtained housing, and 23% went to a medical or nursing setting. By March 2008, one in seven users (n = 83; 13%) were known to have died, the Standard Mortality Ratio was 7.5 (95% CI: 4.1-13.5). Over the years, fewer men were admitted, with significantly more self neglect, personality disorders and cocaine use. Lengths of stay increased significantly during the study period. Over the last years, the shelter-based convalescence care facility users were mainly homeless single males, around 45 years of age, with chronic problems due to substance use, mental health disorders and a frail physical condition, many of whom died a premature death. The facility has been flexible and responsive to the needs of the users and services available.

  3. Characteristics of Emergency Department Visits by Older Versus Younger Homeless Adults in the United States

    Science.gov (United States)

    Steinman, Michael A.

    2013-01-01

    Objectives. We compared the characteristics of emergency department (ED) visits of older versus younger homeless adults. Methods. We analyzed 2005–2009 data from the National Hospital Ambulatory Medical Care Survey, a nationally representative survey of visits to hospitals and EDs, and used sampling weights, strata, and clustering variables to obtain nationally representative estimates. Results. The ED visits of homeless adults aged 50 years and older accounted for 36% of annual visits by homeless patients. Although demographic characteristics of ED visits were similar in older and younger homeless adults, clinical and health services characteristics differed. Older homeless adults had fewer discharge diagnoses related to psychiatric conditions (10% vs 20%; P = .002) and drug abuse (7% vs 15%; P = .003) but more diagnoses related to alcohol abuse (31% vs 23%; P = .03) and were more likely to arrive by ambulance (48% vs 36%; P = .02) and to be admitted to the hospital (20% vs 11%; P = .003). Conclusions. Older homeless adults’ patterns of ED care differ from those of younger homeless adults. Health care systems need to account for these differences to meet the needs of the aging homeless population. PMID:23597348

  4. [Health status and medical care accessibility of single, homeless persons].

    Science.gov (United States)

    Trabert, G

    1997-06-01

    The homeless population in Germany is continually increasing. Featuring prominently among those on the increase are women, young persons and homeless people from East Germany. Studies of the health of homeless individuals in recent years show that indices of illness are far higher for many disorders than for comparable groups who are housed. One result from a recent study by the University of Mainz (1994) was that more than 90% of homeless people urgently need medical treatment. According this research, the main health problems of the homeless are: cardiac disease (hypertension, CAD) (52.5%), skin disease (scabies, lice, leg ulcers, abscesses, pyodermias) and acute infections (50%), lower respiratory tract (COAD) (47.5%) and trauma victims (50%), followed by liver (30%), kidney (25%) and gastrointestinal diseases (GU) (20%). The problems of alcoholism and mental disorders of various sorts are added to this picture. Violence to homeless people is increasing. A lot of homeless people are multi-morbid. The relationship between the time of homelessness and the state of illness was not linear. It was found that in the beginning of homelessness most of the homeless people were in a poor physical condition. The poor physical condition of homeless people does not stem from only one cause, but results from a combination of different factors: individual social conditions (social class; social relations; sedentary lifestyle), personal or family life crisis (life events and coping behaviour), the individual risk behaviour (for instance the bizarre sleeping accommodations, alcohol and cigarette consumption unemployment in a depressed economy, structure of the society (cutbacks in government welfare and social service programmes). As a result of bad experiences with existing medical institutions, homeless persons do not consult the doctor or too late. Many are afraid of large institutions; most are not members of a health insurance scheme (uninsured); and many are perceived in

  5. Adults Experiencing Homelessness in the US-Mexico Border Region: A Photovoice Project.

    Science.gov (United States)

    Moya, Eva Margarita; Chavez-Baray, Silvia M; Loweree, Jacqueline; Mattera, Brian; Martinez, Nahomi

    2017-01-01

    Homelessness is a social, economic, and political crisis in the United States. In particular, the US-Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, "The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region." The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants' life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university.

  6. Survival Outside Home: Sexual Behaviour of Homeless and Runaway Young Adults in Ghana

    Directory of Open Access Journals (Sweden)

    William Wilberforce Amoah

    2014-10-01

    Full Text Available Although homeless young adults are often seen on the streets of Ghana, little research had examined the nature of sexual behaviour among these homeless and runaway young adults. Due to the culturally sensitive nature of such studies in the Ghanaian setting, only fifty (50 respondents agreed to participate in the study. A thirty–five (35 item questionnaire, comprising of twenty-eight (28 closed-ended and seven (7 open-ended questions was used for data collection. The findings indicated poverty, inability of parents to cater for the young adult’s needs, peer pressure and lack of parental acceptance as the main causes of homelessness. Consequently, the findings also showed a trend of school dropout, teenage pregnancy and use of illicit drugs as effects of homelessness. These findings have implications for future studies, policy reform and care for homeless young adult.

  7. The impact of psychosocial factors on subjective well-being among homeless young adults.

    Science.gov (United States)

    Barczyk, Amanda N; Thompson, Sanna J; Rew, Lynn

    2014-08-01

    Homeless young adults are one of this country's most vulnerable populations, and information surrounding issues of subjective well-being among this particularly diverse population is scarce. The purpose of this study was to examine the impact social support, future expectations, and homeless cultural factors have on subjective well-being among homeless young adults. A purposive sample of 185 homeless young people, ages 18 to 23, and known to use alcohol or drugs, participated in the study. Multiple regression analyses showed that participants who had a higher level of subjective well-being reported significantly higher levels of social support, more optimistic expectations of the future, and a better perception of the flow of time. More fatalistic views of the future significantly predicted lower levels of subjective well-being. Findings suggest that service providers should focus on understanding the strengths of individuals and, specifically, gain a deeper understanding of homeless young adults' support networks and views of the future.

  8. Health Services Utilization between Older and Younger Homeless Adults.(author Abstract)

    Science.gov (United States)

    Nakonezny, Paul A.; Ojeda, Michael

    2005-01-01

    Purpose: Our purpose in the current study was to examine the relationship between health services utilization delivered by means of the Homeless Outreach Medical Services (HOMES) program and health services utilization delivered by means of the Parkland emergency room and inpatient units among a sample of older and younger homeless adults being…

  9. Prevalence, distribution, and correlates of hepatitis C virus infection among homeless adults in Los Angeles.

    Science.gov (United States)

    Gelberg, Lillian; Robertson, Marjorie J; Arangua, Lisa; Leake, Barbara D; Sumner, Gerald; Moe, Ardis; Andersen, Ronald M; Morgenstern, Hal; Nyamathi, Adeline

    2012-01-01

    We documented the prevalence, distribution, and correlates of hepatitis C virus (HCV) infection among urban homeless adults. We sampled a community-based probability sample of 534 homeless adults from 41 shelters and meal programs in the Skid Row area of downtown Los Angeles, California. Participants were interviewed and tested for HCV, hepatitis B, and HIV. Outcomes included prevalence, distribution, and correlates of HCV infection; awareness of HCV positivity; and HCV counseling and treatment history. Overall, 26.7% of the sample tested HCV-positive and 4.0% tested HIV-positive. In logistic regression analysis, independent predictors of HCV infection for the total sample included older age, less education, prison history, and single- and multiple-drug injection. Among lifetime drug injectors, independent predictors of HCV infection included older age, prison history, and no history of intranasal cocaine use. Among reported non-injectors, predictors of HCV infection included older age, less education, use of non-injection drugs, and three or more tattoos. Sexual behaviors and snorting or smoking drugs had no independent relationship with HCV infection. Among HCV-infected adults, nearly half (46.1%) were unaware of their infection. Despite the high prevalence of HCV infection, nearly half of the cases were hidden and few had ever received any HCV-related treatment. While injection drug use was the strongest independent predictor, patterns of injection drug use, non-injection drug use, prison stays, and multiple tattoos were also independent predictors of HCV. Findings suggest that urgent interventions are needed to screen, counsel, and treat urban homeless adults for HCV infection.

  10. Changes in subjective quality of life among homeless adults who obtain housing: a prospective examination.

    Science.gov (United States)

    Wolf, J; Burnam, A; Koegel, P; Sullivan, G; Morton, S

    2001-08-01

    The aim of this present study is to examine whether overall subjective quality of life and specific domains of quality of life change among homeless adults after they become housed, and if so, what factors predict changes in satisfaction. The data analysed here were collected through face-to-face interviews with a sample of 485 homeless adults who were interviewed as often as bi-monthly over a 16-month period. Bivariate analyses examined initial differences between three groups: homeless people who did not exit from homelessness; those with an exit from homelessness to dependent housing; and those with an exit to independent housing. Bivariate analyses also examined differences in subjective quality of life before and after an exit from homelessness among the three groups. Multivariate analyses identified predictors of changes in quality of life before and after exit. This study has three main findings. First, homeless people who obtained independent housing had the largest positive and significant improvements in satisfaction with overall quality of life, and in satisfaction with housing, leisure and money. Second, becoming housed was not a predictor of changes in overall quality of life perceived by homeless people, nor in their satisfaction with leisure, clothing, food, and social life. Furthermore, a positive change in housing satisfaction was not associated with all types of exits from homelessness; only a move into independent housing predicted such a change, but a move into dependent housing did not. Finally, of all the covariates included as predictors at baseline, only two variables seemed to consistently predict changes in satisfaction; namely, self-assessed general health and self-assessed self-help skills. This study suggested that becoming independently housed may improve some aspects of quality of life for homeless people, but not others. The results suggest that homeless people prefer to be independently housed relative to remaining homeless or

  11. Parenting adults who become homeless: variations in stress and social support.

    Science.gov (United States)

    Polgar, Michael F; North, Carol S; Pollio, David E

    2009-07-01

    This article focuses on the stressors of parenting an adult child who experiences homelessness. Parents whose adult children become homeless may provide support to this child, but they may also subsequently experience stress and require social support themselves. Findings from this study support the hypothesis that parents who spend more time or money helping their homeless adult offspring experience higher levels of stress. Results also show higher levels of stress among parents who helped with activities of daily living and among parents who worked to prevent harm involving their adult homeless offspring. Among 37 respondents, a majority of whom were African American mothers parenting homeless sons, parents who engaged in activities to prevent harm and parents who experienced stress from harm prevention received more extensive social support. Health and social service providers should recognize and respond to the financial, emotional, and temporal burdens of parenting an adult who becomes homeless. Service providers can both support people who become homeless and reinforce larger family systems, particularly in circumstances that involve more extensive parental support or more harmful situations.

  12. Examining mortality among formerly homeless adults enrolled in Housing First: An observational study.

    Science.gov (United States)

    Henwood, Benjamin F; Byrne, Thomas; Scriber, Brynn

    2015-12-04

    Adults who experience prolonged homelessness have mortality rates 3 to 4 times that of the general population. Housing First (HF) is an evidence-based practice that effectively ends chronic homelessness, yet there has been virtually no research on premature mortality among HF enrollees. In the United States, this gap in the literature exists despite research that has suggested chronically homeless adults constitute an aging cohort, with nearly half aged 50 years old or older. This observational study examined mortality among formerly homeless adults in an HF program. We examined death rates and causes of death among HF participants and assessed the timing and predictors of death among HF participants following entry into housing. We also compared mortality rates between HF participants and (a) members of the general population and (b) individuals experiencing homelessness. We supplemented these analyses with a comparison of the causes of death and characteristics of decedents in the HF program with a sample of adults identified as homeless in the same city at the time of death through a formal review process. The majority of decedents in both groups were between the ages of 45 and 64 at their time of death; the average age at death for HF participants was 57, compared to 53 for individuals in the homeless sample. Among those in the HF group, 72% died from natural causes, compared to 49% from the homeless group. This included 21% of HF participants and 7% from the homeless group who died from cancer. Among homeless adults, 40% died from an accident, which was significantly more than the 14% of HF participants who died from an accident. HIV or other infectious diseases contributed to 13% of homeless deaths compared to only 2% of HF participants. Hypothermia contributed to 6% of homeless deaths, which was not a cause of death for HF participants. Results suggest HF participants face excess mortality in comparison to members of the general population and that mortality

  13. A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance

    Science.gov (United States)

    Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

    2013-01-01

    Objectives. We comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. Methods. We assessed health care utilization by 1165 homeless single men and women and adults in families and their age- and gender-matched low-income controls in Toronto, Ontario, from 2005 to 2009, using repeated-measures general linear models to calculate risk ratios and 95% confidence intervals (CIs). Results. Homeless participants had mean rates of 9.1 ambulatory care encounters (maximum = 141.1), 2.0 emergency department (ED) encounters (maximum = 104.9), 0.2 medical–surgical hospitalizations (maximum = 14.9), and 0.1 psychiatric hospitalizations per person-year (maximum = 4.8). Rate ratios for homeless participants compared with matched controls were 1.76 (95% CI = 1.58, 1.96) for ambulatory care encounters, 8.48 (95% CI = 6.72, 10.70) for ED encounters, 4.22 (95% CI = 2.99, 5.94) for medical–surgical hospitalizations, and 9.27 (95% CI = 4.42, 19.43) for psychiatric hospitalizations. Conclusions. In a universal health insurance system, homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services. PMID:24148051

  14. Food Insecurity among Homeless Adults with Mental Illness.

    Directory of Open Access Journals (Sweden)

    Milad Parpouchi

    Full Text Available The prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada.Data collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421. A modified version of the U.S. Department of Agriculture's Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity.The prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95-0.99, less than high school completion (aOR = 0.57; 95% CI: 0.35-0.93, needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00-2.72, subjective mental health (aOR = 0.97; 95% CI: 0.96-0.99, having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16-4.36, HIV/AIDS (aOR = 4.20; 95% CI: 1.36-12.96, heart disease (aOR = 0.39; 95% CI: 0.16-0.97 and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01-2.68.The prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed.

  15. Food Insecurity among Homeless Adults with Mental Illness.

    Science.gov (United States)

    Parpouchi, Milad; Moniruzzaman, Akm; Russolillo, Angela; Somers, Julian M

    2016-01-01

    The prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada. Data collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421). A modified version of the U.S. Department of Agriculture's Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity. The prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95-0.99), less than high school completion (aOR = 0.57; 95% CI: 0.35-0.93), needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00-2.72), subjective mental health (aOR = 0.97; 95% CI: 0.96-0.99), having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16-4.36), HIV/AIDS (aOR = 4.20; 95% CI: 1.36-12.96), heart disease (aOR = 0.39; 95% CI: 0.16-0.97) and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01-2.68). The prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed.

  16. Influence of Jail Incarceration and Homelessness Patterns on Engagement in HIV Care and HIV Viral Suppression among New York City Adults Living with HIV/AIDS.

    Directory of Open Access Journals (Sweden)

    Sungwoo Lim

    Full Text Available Both homelessness and incarceration are associated with housing instability, which in turn can disrupt continuity of HIV medical care. Yet, their impacts have not been systematically assessed among people living with HIV/AIDS (PLWHA.We studied a retrospective cohort of 1,698 New York City PLWHA with both jail incarceration and homelessness during 2001-05 to evaluate whether frequent transitions between jail incarceration and homelessness were associated with a lower likelihood of continuity of HIV care during a subsequent one-year follow-up period. Using matched jail, single-adult homeless shelter, and HIV registry data, we performed sequence analysis to identify trajectories of these events and assessed their influence on engagement in HIV care and HIV viral suppression via marginal structural modeling.Sequence analysis identified four trajectories; 72% of the cohort had sporadic experiences of both brief incarceration and homelessness, whereas others experienced more consistent incarceration or homelessness during early or late months. Trajectories were not associated with differential engagement in HIV care during follow-up. However, compared with PLWHA experiencing early bouts of homelessness and later minimal incarceration/homelessness events, we observed a lower prevalence of viral suppression among PLWHA with two other trajectories: those with sporadic, brief occurrences of incarceration/homelessness (0.67, 95% CI = 0.50,0.90 and those with extensive incarceration experiences (0.62, 95% CI = 0.43,0.88.Housing instability due to frequent jail incarceration and homelessness or extensive incarceration may exert negative influences on viral suppression. Policies and services that support housing stability should be strengthened among incarcerated and sheltered PLWHA to reduce risk of adverse health conditions.

  17. Survival Outside Home: Sexual Behaviour of Homeless and Runaway Young Adults in Ghana

    OpenAIRE

    William Wilberforce Amoah; Augustina Amoah; Alexander Atiogbe; Jacob Owusu Sarfo

    2014-01-01

    Although homeless young adults are often seen on the streets of Ghana, little research had examined the nature of sexual behaviour among these homeless and runaway young adults. Due to the culturally sensitive nature of such studies in the Ghanaian setting, only fifty (50) respondents agreed to participate in the study. A thirty–five (35) item questionnaire, comprising of twenty-eight (28) closed-ended and seven (7) open-ended questions was used for data collection. The findings indicated pov...

  18. A web-based personal health information system for homeless youth and young adults.

    Science.gov (United States)

    Dang, Michelle T; Whitney, Kimberley D; Virata, Maria Catrina D; Binger, Melissa M; Miller, Elizabeth

    2012-01-01

    Runaway and homeless youth face multiple challenges to their health and experience inadequate access to health care services. This article describes a web-based personal health information system (PHIS) called Healthshack that was specifically designed to improve health care access and health outcomes for runaway and homeless youth at a community-based agency that served homeless youth and young adults up to age 24. The program was developed in partnership with homeless youth and piloted by public health nurses. Preliminary findings from the program indicate that a PHIS is acceptable to runaway and homeless youth and feasible to incorporate into the flow of a youth agency. Thus, a PHIS may be an innovative model of service delivery for other marginalized populations. © 2011 Wiley Periodicals, Inc.

  19. Exploring the occupations of homeless adults living with mental illnesses in Toronto.

    Science.gov (United States)

    Illman, Sarah C; Spence, Sandy; O'Campo, Patricia J; Kirsh, Bonnie H

    2013-10-01

    The nature of occupational engagement for homeless people living with mental illnesses is not well understood, and there are few studies to date that examine the occupational lives of these individuals. This research study seeks to understand how this group of individuals engages in occupations. The central question is "What is the nature of occupational engagement by homeless adults living with mental illnesses in Toronto?" A constant comparative method of analysis was used in a secondary analysis of 60 interviews with homeless adults experiencing mental illness. Four themes emerged that describe the nature of occupational engagement for this group: occupations as enjoyment, occupations as survival/risk, occupations as passing time, and occupations as self-management. Implications. This research informs occupational therapy interventions aimed at optimizing engagement, health, and well-being for homeless adults living with mental illnesses.

  20. Characteristics of adherence to methadone maintenance treatment over a 15-year period among homeless adults experiencing mental illness

    Directory of Open Access Journals (Sweden)

    Milad Parpouchi

    2017-12-01

    Full Text Available Background: Methadone maintenance treatment (MMT has important protective effects related to reduced illicit opioid use, infectious disease transmission, and overdose mortality. Adherence to MMT has not been examined among homeless people. We measured MMT adherence and reported relevant characteristics among homeless adults experiencing mental illness in Vancouver, British Columbia, Canada. Material and methods: Homeless adults living with mental illness who had received MMT prior to the baseline interview of the Vancouver At Home study (n=78 were included in analyses. The medication possession ratio (MPR was used to estimate MMT adherence from retrospective administrative pharmacy and public health insurance data collected across 15years. Independent sample t tests and one-way ANOVA were used to test for significant differences in MMT MPR by participant characteristics. Results: Mean MMT MPR was 0.47. A large proportion of participants reported blood-borne infectious disease, three or more chronic physical health conditions, and substance use. Being single and never married was associated with significantly lower MMT MPR (0.40 vs. 0.55, p=0.036, while living with schizophrenia, bipolar disorder, or a mood disorder with psychotic features was associated with significantly higher MMT MPR (0.54 vs. 0.37, p=0.022. Daily drug use (excluding alcohol was associated with significantly lower MMT MPR (0.39 vs. 0.54, p=0.051. Conclusions: The level of adherence to MMT was very low among homeless adults experiencing mental illness. Efforts are needed to improve adherence to MMT as a means of reducing illicit substance use, preventing overdose deaths, and attenuating infectious disease transmission. Keywords: Adherence, Medication possession ratio, Methadone, Opioid dependence, Homeless, Mental illness

  1. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study.

    Science.gov (United States)

    To, Matthew J; Palepu, Anita; Aubry, Tim; Nisenbaum, Rosane; Gogosis, Evie; Gadermann, Anne; Cherner, Rebecca; Farrell, Susan; Misir, Vachan; Hwang, Stephen W

    2016-10-03

    Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness. Vulnerably housed adults were recruited in three Canadian cities. Data on demographic characteristics, chronic health conditions, and drug use problems were collected through structured interviews. Housing history was obtained at baseline and annual follow-up interviews. Generalized estimating equations were used to characterize associations between candidate predictors and subsequent experiences of homelessness during each follow-up year. Among 561 participants, the prevalence of homelessness was 29.2 % over three years. Male gender (AOR = 1.59, 95 % CI: 1.14-2.21) and severe drug use problems (AOR = 1.98, 95 % CI: 1.22-3.20) were independently associated with experiencing homelessness during the follow-up period. Having ≥3 chronic conditions (AOR = 0.55, 95 % CI: 0.33-0.94) and reporting higher housing quality (AOR = 0.99, 95 % CI: 0.97-1.00) were protective against homelessness. Vulnerably housed individuals are at high risk for experiencing homelessness. The study has public health implications, highlighting the need for enhanced access to addiction treatment and improved housing quality for this population.

  2. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Matthew J. To

    2016-10-01

    Full Text Available Abstract Background Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness. Methods Vulnerably housed adults were recruited in three Canadian cities. Data on demographic characteristics, chronic health conditions, and drug use problems were collected through structured interviews. Housing history was obtained at baseline and annual follow-up interviews. Generalized estimating equations were used to characterize associations between candidate predictors and subsequent experiences of homelessness during each follow-up year. Results Among 561 participants, the prevalence of homelessness was 29.2 % over three years. Male gender (AOR = 1.59, 95 % CI: 1.14–2.21 and severe drug use problems (AOR = 1.98, 95 % CI: 1.22–3.20 were independently associated with experiencing homelessness during the follow-up period. Having ≥3 chronic conditions (AOR = 0.55, 95 % CI: 0.33–0.94 and reporting higher housing quality (AOR = 0.99, 95 % CI: 0.97–1.00 were protective against homelessness. Conclusions Vulnerably housed individuals are at high risk for experiencing homelessness. The study has public health implications, highlighting the need for enhanced access to addiction treatment and improved housing quality for this population.

  3. Assessment of the nutritional status of urban homeless adults.

    OpenAIRE

    Luder, E; Boey, E; Buchalter, B; Martinez-Weber, C

    1989-01-01

    Homeless people eat foods at municipal and charity run shelters, fast-food restaurants, delicatessens, and from garbage bins. Data on the adequacy of the diets and the nutritional status of homeless persons are sparse. Therefore, nutritional indicators of 55 urban homeless subjects were assessed, and a high prevalence of risk factors was identified. Although 93 percent of subjects reported that they obtained enough to eat, a low dietary adequacy score of 10.1 (norm = 16) indicated that the qu...

  4. Homelessness in Rural Areas: Causes, Patterns, and Trends.

    Science.gov (United States)

    First, Richard J.; And Others

    1994-01-01

    Conducted study of rural homelessness in Ohio. Of 919 homeless adults interviewed, 247 were heading family units; 480 children were in these families. More than two-thirds of families were headed by single parents. Found differences in demographic characteristics of rural homeless population as compared to urban counterparts. Findings have…

  5. Alcoholism among homeless adults in the inner city of Los Angeles.

    Science.gov (United States)

    Koegel, P; Burnam, M A

    1988-11-01

    The prevalence, course, and severity of alcoholism were examined in a probability sample of homeless adults in Los Angeles' inner city and in a household sample (drawn from two communities in Los Angeles), matched to the demographic characteristics of the homeless sample. Both lifetime and current prevalence of alcoholism (as measured by the National Institute of Mental Health's Diagnostic Interview Schedule) was substantially higher among homeless individuals. Moreover, compared with household alcoholics, homeless alcoholics were characterized by (1) a substantially higher prevalence of other psychiatric disorders, particularly the major mental illnesses; (2) more severe patterns of drinking, which spanned longer periods of time; and (3) more profoundly affected levels of social and vocational functioning. Homeless alcoholics were also more likely to have entered treatment programs and to have engaged in problem behaviors as children and adults. Emphasis was placed on the complicated etiologic relationship between alcoholism and homelessness, and on the need for alcohol rehabilitation services that are sensitive to the unique situations in which homeless alcoholics find themselves.

  6. Betrayal trauma among homeless adults: associations with revictimization, psychological well-being, and health.

    Science.gov (United States)

    Mackelprang, Jessica L; Klest, Bridget; Najmabadi, Shadae J; Valley-Gray, Sarah; Gonzalez, Efrain A; Cash, Ralph E Gene

    2014-04-01

    Betrayal trauma theory postulates that traumas perpetrated by a caregiver or close other are more detrimental to mental health functioning than are traumatic experiences in which the victim is not affiliated closely with the perpetrator. This study is the first to examine the concept of betrayal among a sample of individuals with a history of homelessness. A total of 95 homeless or formerly homeless adults completed the Brief Betrayal Trauma Survey, the Posttraumatic Stress Disorder Checklist-Civilian Version, the Center for Epidemiologic Studies Depression Scale the Perceived Stress Scale, and a demographics questionnaire assessing participants' histories of homelessness, health, and relationships with their families. Regression analyses were conducted to explore the associations between high betrayal (HB) and low betrayal (LB) trauma exposure, relationship with family, and physical and mental health symptoms. Exposure to HB traumas in childhood and poor family relationships predicted earlier age at first episode of homelessness, and participants who had been exposed to a greater number of traumas during childhood were more likely to be revictimized during adulthood. Trauma exposure as an adult and earlier age of first homeless episode predicted symptoms of posttraumatic stress disorder, while trauma exposure alone predicted symptoms of depression and perceived stress. Number of medical diagnoses was associated with trauma exposure and becoming homeless at an older age. These findings emphasize that even among the most marginalized and multiply victimized individuals in our society, traumas that are characterized by a higher degree of betrayal are associated with more adverse outcomes.

  7. A Retrospective Examination of Child Protection Involvement Among Young Adults Accessing Homelessness Services.

    Science.gov (United States)

    Putnam-Hornstein, Emily; Lery, Bridgette; Hoonhout, Jonathan; Curry, Susanna

    2017-09-01

    Childhood maltreatment is associated with a variety of young adult adversities including homelessness. This study used linked administrative records to develop a population-level, epidemiological characterization of the child protection histories of young adults accessing homelessness services. The records of all 17- to 24-year-olds receiving homeless services between 2011 and 2014 in San Francisco County, California (n = 2241) were probabilistically linked to statewide child protective service (CPS) records. Findings document that 50.0% of young adults had been reported for maltreatment at least once during childhood, yet the prevalence of past CPS involvement varied across demographic and child welfare characteristics. Homeless female youth were significantly more likely to have a CPS history than male youth (58.1% vs. 41.5%). Nearly twice as many Black clients accessing homelessness services had a CPS history as did White clients (59.8% vs. 31.8%). Roughly half (47.3%) of those with a childhood history of reported maltreatment had been last reported for maltreatment in another California county. Targeting services that address past trauma and instability among homeless young adults may be justified given the prevalence of CPS history in this population. © Society for Community Research and Action 2017.

  8. An ethnonursing research study: adults residing in a midwestern Christian philosophy urban homeless shelter.

    Science.gov (United States)

    Hubbert, Ann O

    2005-07-01

    The ethnonursing study's purpose was to explore the subculture of homeless adults residing in one shelter, with discovery of their meanings and experiences of care, or lack of care. Leininger's theory of culture care was used to identify, analyze, and discuss the cultural care patterns. The findings included themes that were identified in two categories: two themes before shelter residence (no caring practices in their lives) and two themes during shelter residence (acceptance and hope). Ethnonursing discovery contributes to nurses' knowledge about who the homeless people are and why they are homeless and develops culturally congruent care practices.

  9. Acute Alcohol Use, History of Homelessness, and Intent of Injury Among a Sample of Adult Emergency Department Patients.

    Science.gov (United States)

    Jetelina, Katelyn K; Reingle Gonzalez, Jennifer M; Brown, Carlos V R; Foreman, Michael L; Field, Craig

    2017-08-01

    The literature is clear that adults who are currently homeless also have higher rates of intentional injuries, such as assault and suicide attempts. No study has assessed whether intentional injuries are exacerbated because of substance use among adults with a history of homelessness. Data were obtained from a cohort of adults admitted to 3 urban emergency departments (EDs) in Texas from 2007 to 2010 (N = 596). Logistic regression analyses were used to determine whether a history of homelessness was associated with alcohol use at time of injury in intentional violent injuries (gunshot, stabbing, or injury consistent with assault). 39% adults with a history of homelessness who were treated at trauma centers for a violent injury. Bivariate analyses indicated that adults who had ever experienced homelessness have 1.67 increased odds, 95% confidence interval (CI) [1.11, 2.50], of any intentional violent injury and 1.95 increased odds (95% CI [1.12, 3.40]) of a stabbing injury than adults with no history of homelessness. Adults who experienced homelessness in their lifetime were more likely to visit EDs for violencerelated injuries. Given our limited knowledge of the injuries that prompt ED use by currently homeless populations, future studies are needed to understand the etiology of injuries, and substance-related injuries specifically, among adults with a history of homelessness.

  10. Adults Experiencing Homelessness in the US–Mexico Border Region: A Photovoice Project

    Science.gov (United States)

    Moya, Eva Margarita; Chavez-Baray, Silvia M.; Loweree, Jacqueline; Mattera, Brian; Martinez, Nahomi

    2017-01-01

    Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university. PMID:28580355

  11. Adults Experiencing Homelessness in the US–Mexico Border Region: A Photovoice Project

    Directory of Open Access Journals (Sweden)

    Eva Margarita Moya

    2017-05-01

    Full Text Available Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university.

  12. Determinants of regular source of care among homeless adults in Los Angeles.

    Science.gov (United States)

    Gallagher, T C; Andersen, R M; Koegel, P; Gelberg, L

    1997-08-01

    The authors explore the determinants of having a regular source of care in a community-based probability sample of homeless adults in Los Angeles. Results from this study should be more representative than those from previous studies of the homeless that are clinic- or shelter-based. In addition to those factors found to be barriers to regular sources of care in the general population, we hypothesized that psychosocial characteristics of the homeless and the homeless lifestyle would negatively impact their likelihood of having a regular source of care. The authors conducted a multiple logistic regression to predict regular source of care among the homeless, using an adaptation of the Behavioral Model of health services utilization as an analytic framework. Fifty-seven percent of the sample reported that they had a regular source of care. Of those with a source of care, 30% reported a hospital outpatient department; 25% reported a community or homeless clinic; 23% reported a hospital emergency room; 14% reported a government clinic; and 9% reported a private physician's office as their source of care. Some factors found to be barriers to having a regular source of care in the general population (male, Hispanic, young age) also were barriers among homeless adults. Additional barriers in this sample included homelessness-related characteristics such as competing needs, long-term homelessness, and social isolation. Chronic mental illness and chronic substance dependence were not related to having a source of care among the homeless. Characteristics that increased the likelihood of having a regular source of care in the general population (poor health status, Medicaid) were not related to having a regular source of care among the homeless. In a context of limited resources, the distribution of regular source of care among the homeless appears to be highly inequitable. Although some of the characteristics identifying those with a regular source of care suggest

  13. Dietary intake, nutritional status and mental wellbeing of homeless adults in Reading, UK.

    Science.gov (United States)

    Fallaize, Rosalind; Seale, Josephine V; Mortin, Charlotte; Armstrong, Lisha; Lovegrove, Julie A

    2017-11-01

    Malnutrition has been reported in the homeless, yet the specific nutritional issues faced by each homeless community are unclear. This is in part due to nutrient intake often being compared with dietary reference values as opposed to a comparative housed population. In addition, the complex interplay between nutrient intake, reward mediated behaviour and mental illness is frequently overlooked. This study aimed to compare the dietary intake, nutritional status and mental wellbeing of homeless and housed adults. Homeless (n 75) and matched housed (n 75) adults were recruited from Reading (UK). Nutrient intake was determined using the European Prospective Investigation into Cancer and Nutrition Norfolk FFQ. The Patient Health Questionnaire: Somatic Anxiety Depressive Symptoms (PHQ-SADS) assessed for signs of mental illness. Demographic, behavioural and physiological information was collected using closed-ended questions and anthropometric measurements. Overall, dietary intake was poorer in homeless adults who reported higher intakes of salt (8·0 v. 6·4 g, P=0·017), SFA (14·6 v. 13·0 %, P=0·002) and alcohol (5·3 v. 1·9 %, Phomeless (Phomeless population, street homeless (n 24) had lower SFA (13·7 v.15·0 %, P=0·010), Ca (858 v. 1032 mg, P=0·027) and milk intakes (295 v. 449 g, P=0·001) than hostel residents (n 51), which may reflect the issues with food storage. This study highlights the disparity between nutritional status in homeless and housed populations and the need for dietary intervention in the homeless community.

  14. Housing retention in single-site housing first for chronically homeless individuals with severe alcohol problems.

    Science.gov (United States)

    Collins, Susan E; Malone, Daniel K; Clifasefi, Seema L

    2013-12-01

    We studied housing retention and its predictors in the single-site Housing First model. Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005-2008) conducted in Seattle, Washington. At baseline, participants responded to self-report questionnaires assessing demographic, illness burden, alcohol and other drug use, and psychiatric variables. Housing status was recorded over 2 years. Participants were interested in housing, although a sizable minority did not believe they would be able to maintain abstinence-based housing. Only 23% of participants returned to homelessness during the 2-year follow-up. Commonly cited risk factors--alcohol and other drug use, illness burden, psychiatric symptoms, and homelessness history--did not predict resumed homelessness. Active drinkers were more likely to stay in this housing project than nondrinkers. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems.

  15. Housing Retention in Single-Site Housing First for Chronically Homeless Individuals With Severe Alcohol Problems

    Science.gov (United States)

    Malone, Daniel K.; Clifasefi, Seema L.

    2013-01-01

    Objectives. We studied housing retention and its predictors in the single-site Housing First model. Methods. Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005–2008) conducted in Seattle, Washington. At baseline, participants responded to self-report questionnaires assessing demographic, illness burden, alcohol and other drug use, and psychiatric variables. Housing status was recorded over 2 years. Results. Participants were interested in housing, although a sizable minority did not believe they would be able to maintain abstinence-based housing. Only 23% of participants returned to homelessness during the 2-year follow-up. Commonly cited risk factors—alcohol and other drug use, illness burden, psychiatric symptoms, and homelessness history—did not predict resumed homelessness. Active drinkers were more likely to stay in this housing project than nondrinkers. Conclusions. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems. PMID:24148063

  16. Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults.

    Science.gov (United States)

    Santa Maria, Diane; Hernandez, Daphne C; Arlinghaus, Katherine R; Gallardo, Kathryn R; Maness, Sarah B; Kendzor, Darla E; Reitzel, Lorraine R; Businelle, Michael S

    2018-01-26

    While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis ( n = 460) on sexually active homeless adults from a cross-sectional study of participants ( n = 610) recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s), and multiple sexual partners (≥4 sexual partners) in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness.

  17. Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

    Directory of Open Access Journals (Sweden)

    Diane Santa Maria

    2018-01-01

    Full Text Available While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460 on sexually active homeless adults from a cross-sectional study of participants (n = 610 recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s, and multiple sexual partners (≥4 sexual partners in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness.

  18. Factors associated with violent victimisation among homeless adults in Sydney, Australia.

    Science.gov (United States)

    Larney, Sarah; Conroy, Elizabeth; Mills, Katherine L; Burns, Lucy; Teesson, Maree

    2009-08-01

    To determine the prevalence and correlates of violent victimisation among homeless people in inner-Sydney. Cross-sectional design. Clients of a shelter for homeless, substance-using adults were interviewed about their drug use, mental health and violent victimisation in the previous 12 months. Logistic regression was used to identify factors associated with victimisation. Participants reported complex drug use histories and high levels of depression, post-traumatic stress disorder (PTSD) and schizophrenia or other psychotic disorders. Forty-eight per cent of participants reported past year victimisation. In univariate analyses, being female, schizophrenia/psychotic disorder, PTSD, depression and regular use of psychostimulants were associated with increased risk of victimisation. In multivariate analyses, regular use of psychostimulants (odds ratio [95% CI] 5.07 [1.53-16.84]), schizophrenia or other psychotic disorder (3.13 [1.24-7.9], and depression (2.65 [1.07-6.59]) were associated with increased risk of victimisation. This sample of homeless, substance-using adults experienced high levels of violence. People with poor mental health and regular psychostimulant users were at greater risk of victimisation. A longitudinal study to determine whether victimisation prolongs homelessness is warranted. Clinical staff working with homeless populations need to be aware of the likelihood of past and future victimisation and its effects on mental health. Homeless persons may benefit from learning to identify risk situations for victimisation and how to de-escalate potentially violent situations.

  19. Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless.

    Science.gov (United States)

    Poremski, Daniel; Woodhall-Melnik, Julia; Lemieux, Ashley J; Stergiopoulos, Vicky

    2016-02-01

    Adults with mental illness who are homeless experience multiple barriers to employment, contributing to difficulties securing and maintaining housing. Housing First programs provide quick, low-barrier access to housing and support services for this population, but their success in improving employment outcomes has been limited. Supported employment interventions may augment Housing First programs and address barriers to employment for homeless adults with mental illness. The present paper presents data from qualitative interviews to shed light on the persisting barriers to employment among people formerly homeless. Once housed, barriers to employment persisted, including the following: (1) worries about disclosing sensitive information, (2) fluctuating motivation, (3) continued substance use, and (4) fears about re-experiencing homelessness-related trauma. Nevertheless, participants reported that their experiences of homelessness helped them develop interpersonal strength and resilience. Discussing barriers with an employment specialist helps participants develop strategies to overcome them, but employment specialists must be sensitive to specific homelessness-related experiences that may not be immediately evident. Supported housing was insufficient to help people return to employment. Supported employment may help people return to work by addressing persisting barriers.

  20. Influenza Vaccination Rates Among Homeless Adults With Mental Illness in Toronto.

    Science.gov (United States)

    Young, Samantha; Dosani, Naheed; Whisler, Adam; Hwang, Stephen

    2015-07-01

    To determine the incidence of influenza vaccination among homeless individuals with mental illness in Toronto. A retrospective chart review was carried out using a random sample of homeless individuals with mental illness who were participants of the At Home/Chez Soi Study. Primary care charts were obtained and reviewed for the incidence influenza vaccination within a 1-year period. Of the 75 participants for whom charts were reviewed, 5 (6.7%) had documentation indicating receipt of the influenza vaccination in the year prior to study recruitment. This study raises awareness of the low incidence of homeless adults receiving the influenza vaccination in Toronto. The data are concerning given the high risk of morbidity from communicable respiratory illnesses in this group. Further research into the causes of low influenza vaccination rates among homeless Canadians is needed to develop strategies for increased delivery of the vaccination. © The Author(s) 2014.

  1. Health and social adjustment of homeless older adults with a mental illness.

    Science.gov (United States)

    Gordon, Rebecca J; Rosenheck, Robert A; Zweig, Richard A; Harpaz-Rotem, Ilan

    2012-06-01

    To better inform treatment strategies, this study compared mental health, substance use, physical health, and social support among young, middle-aged, and older homeless adults before and after participation in intensive case management services. Data were obtained from the Access to Community Care and Effective Services and Supports (ACCESS) public database. Young (age 18 to 34; N=2,469), middle-aged (age 35 to 54; N=4,358), and older (age 55 or older; N=408) homeless adults with a mental illness were compared on the basis of demographic characteristics and measures of substance use, mental and general medical health, and social support at baseline by using Kruskal-Wallis and chi square tests and at three-month and 12-month follow-ups by using mixed-model analysis. Older adults had fewer severe mental health and substance abuse problems than the two groups of younger adults at baseline. At 12-month follow-up, all age groups had improvements in housing, substance use, and psychiatric symptoms, but rates of psychiatric symptoms had improved the most among young adults, and their scores for psychiatric symptoms were the lowest on average of any group. Compared with older adults, adults in the younger groups showed greater decreases in substance use. Older homeless adults appeared to follow a different treatment trajectory than their younger counterparts, possibly because of lower severity of mental illness at baseline, and may need specific interventions to address their unique pathways to homelessness.

  2. Population-based surveillance for invasive pneumococcal disease in homeless adults in Toronto.

    Science.gov (United States)

    Plevneshi, Agron; Svoboda, Tomislav; Armstrong, Irene; Tyrrell, Gregory J; Miranda, Anna; Green, Karen; Low, Donald; McGeer, Allison

    2009-09-29

    Identification of high-risk populations for serious infection due to S. pneumoniae will permit appropriately targeted prevention programs. We conducted prospective, population-based surveillance for invasive pneumococcal disease and laboratory confirmed pneumococcal pneumonia in homeless adults in Toronto, a Canadian city with a total population of 2.5 M, from January 1, 2002 to December 31, 2006. We identified 69 cases of invasive pneumococcal disease and 27 cases of laboratory confirmed pneumococcal pneumonia in an estimated population of 5050 homeless adults. The incidence of invasive pneumococcal disease in homeless adults was 273 infections per 100,000 persons per year, compared to 9 per 100,000 persons per year in the general adult population. Homeless persons with invasive pneumococcal disease were younger than other adults (median age 46 years vs 67 years, Pdrugs (42% vs 4%, Phomeless than other adults (7/58, 12% vs. 24/943, 2.5%, Phomeless adults, 28 (32%) of pneumococcal isolates were of serotypes included in the 7-valent conjugate vaccine, 42 (48%) of serotypes included in the 13-valent conjugate vaccine, and 72 (83%) of serotypes included in the 23-valent polysaccharide vaccine. Although no outbreaks of disease were identified in shelters, there was evidence of clustering of serotypes suggestive of transmission of pathogenic strains within the homeless population. Homeless persons are at high risk of serious pneumococcal infection. Vaccination, physical structure changes or other program to reduce transmission in shelters, harm reduction programs to reduce rates of smoking, alcohol abuse and infection with bloodborne pathogens, and improved treatment programs for HIV infection may all be effective in reducing the risk.

  3. Mortality Among Homeless Adults in Boston: Shifts in Causes of Death Over a 15-year Period

    Science.gov (United States)

    Baggett, Travis P.; Hwang, Stephen W.; O'Connell, James J.; Porneala, Bianca C.; Stringfellow, Erin J.; Orav, E. John; Singer, Daniel E.; Rigotti, Nancy A.

    2013-01-01

    Background Homeless persons experience excess mortality, but U.S.-based studies on this topic are outdated or lack information about causes of death. No studies have examined shifts in causes of death for this population over time. Methods We assessed all-cause and cause-specific mortality rates in a cohort of 28,033 adults aged 18 years or older who were seen at Boston Health Care for the Homeless Program between January 1, 2003, and December 31, 2008. Deaths were identified through probabilistic linkage to the Massachusetts death occurrence files. We compared mortality rates in this cohort to rates in the 2003–08 Massachusetts population and a 1988–93 cohort of homeless adults in Boston using standardized rate ratios with 95% confidence intervals. Results 1,302 deaths occurred during 90,450 person-years of observation. Drug overdose (n=219), cancer (n=206), and heart disease (n=203) were the major causes of death. Drug overdose accounted for one-third of deaths among adults homeless adults in Boston remains high and unchanged since 1988–93 despite a major interim expansion in clinical services. Drug overdose has replaced HIV as the emerging epidemic. Interventions to reduce mortality in this population should include behavioral health integration into primary medical care, public health initiatives to prevent and reverse drug overdose, and social policy measures to end homelessness. PMID:23318302

  4. Cigarette smoking and advice to quit in a national sample of homeless adults.

    Science.gov (United States)

    Baggett, Travis P; Rigotti, Nancy A

    2010-08-01

    Cigarette smoking is common among homeless people, but its characteristics in this vulnerable population have not been studied at a national level. Whether homeless smokers receive advice to quit from healthcare providers is also unknown. To determine the prevalence and predictors of current cigarette smoking, smoking cessation, and receipt of clinician advice to quit in a national sample of homeless adults. This study analyzed data from 966 adult respondents to the 2003 Health Care for the Homeless User Survey, representing more than 436,000 people nationally. Using multivariable logistic regression, the independent predictors of smoking, quitting, and receiving advice to quit were identified. Analyses were conducted in 2008-2009. The prevalence of current smoking was 73%. The lifetime quit rate among ever smokers was 9%. Among past-year smokers, 54% reported receiving clinician advice to quit. Factors independently associated with current smoking included out-of-home placement in childhood (AOR=2.79, 95% CI=1.03, 7.52); victimization while homeless (AOR=2.36, 95% CI=1.15, 4.83); past-year employment (AOR=2.52, 95% CI=1.13, 5.58); and prior illicit drug use (AOR=7.21, 95% CI=3.11, 16.7) or problem alcohol use (AOR=7.42, 95% CI=2.51, 21.9). Respondents with multiple homeless episodes had higher odds of receiving quit advice (AOR=2.51, 95% CI=1.30, 4.83) but lower odds of quitting (AOR=0.47, 95% CI=0.29, 0.78). Compared to the general population, homeless people are far more likely to smoke and much less likely to quit, even though more than half of smokers received quit advice in the past year. Interventions for homeless smokers should address the unique comorbidities and vulnerabilities of this population. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Characteristics of adherence to methadone maintenance treatment over a 15-year period among homeless adults experiencing mental illness.

    Science.gov (United States)

    Parpouchi, Milad; Moniruzzaman, Akm; Rezansoff, Stefanie N; Russolillo, Angela; Somers, Julian M

    2017-12-01

    Methadone maintenance treatment (MMT) has important protective effects related to reduced illicit opioid use, infectious disease transmission, and overdose mortality. Adherence to MMT has not been examined among homeless people. We measured MMT adherence and reported relevant characteristics among homeless adults experiencing mental illness in Vancouver, British Columbia, Canada. Homeless adults living with mental illness who had received MMT prior to the baseline interview of the Vancouver At Home study ( n  = 78) were included in analyses. The medication possession ratio (MPR) was used to estimate MMT adherence from retrospective administrative pharmacy and public health insurance data collected across 15 years. Independent sample t tests and one-way ANOVA were used to test for significant differences in MMT MPR by participant characteristics. Mean MMT MPR was 0.47. A large proportion of participants reported blood-borne infectious disease, three or more chronic physical health conditions, and substance use. Being single and never married was associated with significantly lower MMT MPR (0.40 vs. 0.55, p  = 0.036), while living with schizophrenia, bipolar disorder, or a mood disorder with psychotic features was associated with significantly higher MMT MPR (0.54 vs. 0.37, p  = 0.022). Daily drug use (excluding alcohol) was associated with significantly lower MMT MPR (0.39 vs. 0.54, p  = 0.051). The level of adherence to MMT was very low among homeless adults experiencing mental illness. Efforts are needed to improve adherence to MMT as a means of reducing illicit substance use, preventing overdose deaths, and attenuating infectious disease transmission.

  6. Psychiatric disorders and treatment among newly homeless young adults with histories of foster care

    Science.gov (United States)

    Thompson, Ronald G.; Hasin, Deborah S.

    2013-01-01

    Objective While foster care placement is often preceded by stressful events such as childhood abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. However, whether a history of foster care elevates the likelihood of psychiatric disorders and treatment among homeless young adults, after adjustment for childhood abuse, is unknown. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults, controlling for childhood abuse and other covariates. Methods Among a consecutive sample of 424 newly homeless young adults (18 to 21 years) in a crisis shelter, logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, psychotic) and psychiatric treatment, adjusted for demographics, childhood abuse, substance abuse, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Results Homeless young adults with histories of foster care were 70% more likely to report any psychiatric disorder (AOR=1.70) and twice as likely to have received mental health counseling for a psychiatric disorder (AOR=2.17), been prescribed psychiatric medication (AOR=2.26), and been hospitalized for psychiatric problems (AOR=2.15) than those without such histories. Conclusions Histories of foster care should trigger screening for psychiatric disorders among homeless young adults to aid in the provision of treatment (counseling, medication, hospitalization) tailored to their psychiatric needs. PMID:22706986

  7. Population-based surveillance for invasive pneumococcal disease in homeless adults in Toronto.

    Directory of Open Access Journals (Sweden)

    Agron Plevneshi

    Full Text Available BACKGROUND: Identification of high-risk populations for serious infection due to S. pneumoniae will permit appropriately targeted prevention programs. METHODS: We conducted prospective, population-based surveillance for invasive pneumococcal disease and laboratory confirmed pneumococcal pneumonia in homeless adults in Toronto, a Canadian city with a total population of 2.5 M, from January 1, 2002 to December 31, 2006. RESULTS: We identified 69 cases of invasive pneumococcal disease and 27 cases of laboratory confirmed pneumococcal pneumonia in an estimated population of 5050 homeless adults. The incidence of invasive pneumococcal disease in homeless adults was 273 infections per 100,000 persons per year, compared to 9 per 100,000 persons per year in the general adult population. Homeless persons with invasive pneumococcal disease were younger than other adults (median age 46 years vs 67 years, P<.001, and more likely than other adults to be smokers (95% vs. 31%, P<.001, to abuse alcohol (62% vs 15%, P<.001, and to use intravenous drugs (42% vs 4%, P<.001. Relative to age matched controls, they were more likely to have underlying lung disease (12/69, 17% vs 17/272, 6%, P = .006, but not more likely to be HIV infected (17/69, 25% vs 58/282, 21%, P = .73. The proportion of patients with recurrent disease was five fold higher for homeless than other adults (7/58, 12% vs. 24/943, 2.5%, P<.001. In homeless adults, 28 (32% of pneumococcal isolates were of serotypes included in the 7-valent conjugate vaccine, 42 (48% of serotypes included in the 13-valent conjugate vaccine, and 72 (83% of serotypes included in the 23-valent polysaccharide vaccine. Although no outbreaks of disease were identified in shelters, there was evidence of clustering of serotypes suggestive of transmission of pathogenic strains within the homeless population. CONCLUSIONS: Homeless persons are at high risk of serious pneumococcal infection. Vaccination, physical structure changes

  8. Mental and nonmental health hospital admissions among chronically homeless adults before and after supportive housing placement.

    Science.gov (United States)

    Rieke, Katherine; Smolsky, Ann; Bock, Erin; Erkes, Laura Peet; Porterfield, Erin; Watanabe-Galloway, Shinobu

    2015-01-01

    Individuals experiencing chronic homelessness may utilize hospital services more frequently than the general population. Understanding the benefits of providing permanent supportive housing to these individuals can lead to improved services for this population. This study examined the effect of supportive housing placement on hospital admissions of adults who were homeless. Admissions were examined for a period of one-year pre- and postsupportive housing placement for 23 adults. Results showed a reduction in the number of emergency department admissions and an increase in outpatient admissions during the year following housing placement, indicating that supportive housing may encourage more appropriate use of health care services.

  9. Gentrification and Homelessness: The Single Room Occupant and the Inner City Revival.

    Science.gov (United States)

    Philip, Kasinitz

    1984-01-01

    Discusses how gentrification, described as due to both a shift in middle class values and to government policy, has forced out the single room occupancy hotels, rooming houses, and shelters that serve marginal populations and thus contributed to the growing numbers of homeless people. (CMG)

  10. Nutrition and health services needs among the homeless.

    Science.gov (United States)

    Wiecha, J L; Dwyer, J T; Dunn-Strohecker, M

    1991-01-01

    This review discusses nutrition and related health problems among homeless Americans, summarizes recent information, and identifies needs for services and future research. The nature of homelessness today provides a context for the discussion. Many homeless persons eat fewer meals per day, lack food more often, and are more likely to have inadequate diets and poorer nutritional status than housed U.S. populations. Yet many homeless people eligible for food stamps do not receive them. While public and private agencies provide nutritious food and meals for homeless persons, availability of the services to homeless persons is limited. Many homeless people lack appropriate health care, and certain nutrition-related health problems are prevalent among them. Compared with housed populations, alcoholism, anemia, and growth problems are more common among homeless persons, and pregnancy rates are higher. The risks vary among homeless persons for malnutrition, nutrition-related health problems, drug and alcohol abuse, and mental illness. For example, among homeless persons, fewer heads of families than single adults are substance abusers, and mental illness varies in prevalence among single men, single women, and parents in homeless families. Homeless persons need improved access to food, nutrition, and health services. More nutrition education needs to be available to them and to service providers. Use of representative samples and validation of self-reported nutrition and health data will help future investigators to clarify the relationships between the characteristics of the homeless and their nutritional status.

  11. Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

    Science.gov (United States)

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2014-04-12

    It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n=364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

  12. A systematic review of cognitive deficits in homeless adults: implications for service delivery.

    Science.gov (United States)

    Burra, Tara A; Stergiopoulos, Vicky; Rourke, Sean B

    2009-02-01

    The primary goals of this systematic review were to assess studies of homeless adults and cognitive functioning, and to explore the clinical implications and potential impacts on social functioning of these cognitive deficits. The MEDLINE, CINAHL, EMBASE, PsycINFO, Applied Social Sciences Index and Abstracts, ERIC, Social Sciences Abstracts, Social Sciences Citation Index, Social Services Abstracts, and Sociological Abstracts databases were searched from 1970 (or their inception) to October 2007. Abstracts from 582 studies were screened and 22 studies were found to meet inclusion criteria (published in the English language, reported results of neuropsychological tests, or screening tests for cognitive dysfunction in homeless people aged 18 years or older). Two investigators independently reviewed each study and rated its quality based on well-defined criteria. Ten studies were of good or fair quality. Studies that administered the Mini Mental State Examination indicate about 4% to 7% of homeless people exhibit global cognitive deficits. Focal deficits in verbal and visual memory, attention, speed of cognitive processing, and executive function were also apparent. No studies of the functional implications of cognitive deficits were found. Cognitive deficits in homeless people likely have a significant mediating impact on the effectiveness of skills training and rehabilitation programs. Clinicians should be cognizant that cognitive deficits probably impair homeless patients' ability to maintain housing stability and follow treatment recommendations. Implications for housing options and health service delivery should also be considered. Research is lacking on interventions to improve cognitive functioning in the homeless.

  13. Homeless adults engagement in art: first steps towards identity, recovery and social inclusion.

    Science.gov (United States)

    Thomas, Yvonne; Gray, Marion; McGinty, Sue; Ebringer, Sally

    2011-12-01

    The Australian policy on homelessness identifies participation in structured activities as the first step towards social inclusion and increasing the likelihood of permanently leaving a homeless lifestyle. Art interventions increase interpersonal function and social participation and provide a means of expression and transformation with people who are homeless. This study explores the value of an art programme provided by a non-government agency for homeless adults. Qualitative methods including participant observation and purposive interviews were analysed inductively and thematically to gain an understanding of the participants' experience of art and its value. Interviews with stakeholders provided additional information and triangulation of the data. The study demonstrates that art occupations provide a starting point for participation in community and a positive experience that encourages the construction of new identities, routines and roles. Furthermore, art provides an alternative from the problems associated with homelessness, mental health and substance abuse and allows for public recognition and social inclusion. Health professionals should work towards the social inclusion of homeless people through providing occupational opportunities for participation in safe settings as a first step to community engagement. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

  14. Effects of psychosocial and situational variables on substance abuse among homeless adults.

    Science.gov (United States)

    Stein, Judith A; Dixon, Elizabeth L; Nyamathi, Adeline M

    2008-09-01

    Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing. (c) 2008 APA, all rights reserved.

  15. Bidirectional partner violence among homeless young adults: risk factors and outcomes.

    Science.gov (United States)

    Tyler, Kimberly A; Melander, Lisa A; Noel, Harmonijoie

    2009-06-01

    One of the most prevalent forms of violence in contemporary society is the victimization of intimate partners. Although it has been established that homeless young people experience high levels of victimization on the street, little is known about partner violence (PV) experiences among this group, especially bidirectional violence. As such, the purpose of this study is to examine the prevalence of PV and bidirectional violence and to investigate risk factors and outcomes of this form of violence using a sample of homeless young adults. Overall, 59% of the sample experienced bidirectional violence. Multivariate results reveal that sexual abuse and neglect are significant correlates of PV. In addition, being either a victim or perpetrator of PV is associated with more severe substance use and higher levels of posttraumatic stress disorder (PTSD). Finally, there is support for bidirectional violence among homeless young adults even after controlling for early histories of maltreatment.

  16. Does end-of-life decision making matter? Perspectives of older homeless adults.

    Science.gov (United States)

    Ko, Eunjeong; Nelson-Becker, Holly

    2014-03-01

    This qualitative pilot study explored perspectives, needs, and concerns relating to advance care planning among older homeless adults. Twenty-one older adults residing at a transitional housing facility in an urban area of the West coast were interviewed in person. Key emergent themes included discomfort with the topic, trust in God's decisions, physicians preferred as decision makers, and planning is important but not an immediate concern. Further, people who are homeless want to be approached with sensitivity. Instead of simply eliciting life-sustaining treatment preferences of homeless people, health care professionals should assess their unique concerns and needs regarding death and dying, prepare them to consider their possible end-of-life situation, and assist them to plan in accordance with their needs.

  17. Social and physical health of homeless adults previously treated for mental health problems.

    Science.gov (United States)

    Gelberg, L; Linn, L S

    1988-05-01

    A total of 529 homeless adults in Los Angeles County were surveyed to determine the relationship between their previous use of mental health services and their physical health status, utilization of medical services, personal habits affecting health, experience of injury and victimization, and perceived needs. Homeless adults with a previous psychiatric hospitalization were more likely to have experienced serious physical symptoms during the previous month than those who had used only outpatient mental health services or who had never used mental health services. They reported more reasons for not obtaining needed medical care, were more likely to obtained food from garbage cans, and had the least adequate personal hygiene. However, they did not differ from the other groups on most measures of nutrition, social relations, and financial status. The most frequently expressed needs of the homeless were for improved social relations, employment, shelter, and money.

  18. Psychiatric disorders and treatment among newly homeless young adults with histories of foster care.

    Science.gov (United States)

    Thompson, Ronald G; Hasin, Deborah

    2012-09-01

    Although foster care placement is often preceded by stressful events such as child abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults. A consecutive sample of 423 adults aged 18 to 21 years who sought emergency shelter for the first time between October 1, 2007, and February 29, 2008, were assessed at intake. Logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, and psychotic) and psychiatric treatment. The analyses adjusted for demographic characteristics, childhood abuse, substance use, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Homeless young adults with histories of foster care were 70% more likely than those without such histories to report any psychiatric disorder. They were more than twice as likely to have received mental health counseling for a psychiatric disorder, to have been prescribed psychiatric medication, and to have been hospitalized for psychiatric problems. Histories of foster care among homeless young adults should trigger screening for psychiatric disorders to aid in the provision of treatment (counseling, medication, and hospitalization) tailored to the psychiatric needs of this highly vulnerable population.

  19. Comprehensive services delivery and emergency department use among chronically homeless adults.

    Science.gov (United States)

    Moore, David T; Rosenheck, Robert A

    2017-05-01

    Homeless adults use emergency department (ED) services more frequently than other adults, but the relationships between homelessness, health status, outpatient service use, and ED utilization are poorly understood. Data from the Collaborative Initiative to Help End Chronic Homelessness (CICH) were used to compare ED use among chronically homeless adults receiving comprehensive housing, case management, mental health, addiction, and primary care services through CICH at 5 U.S. sites (n = 274) and ED use among comparison group clients receiving generally available community services (n = 116) at the same sites. Multiple imputation was used to account for missing data and differential rates of attrition between the cohorts. Longitudinal models were constructed to compare ED use between the 2 groups during the first year after initiation of CICH services. A mediation analysis was performed to determine the relative contributions of being housed, the receipt of outpatient services, and health status to group differences in ED utilization. Participants receiving CICH services were significantly less likely to report ED use (odds ratio = 0.78, 95% confidence interval [0.65, 0.93]) in the year after program entry. Decreased ED use was primarily mediated by decreased homelessness-not by increased access to other services or health status. This suggests that becoming housed is a key driver of reduced ED utilization and that efforts to provide housing for homeless adults may result in significantly decreased ED use. Further research is needed to determine the long-term effects of housing on health status and to develop services to improve health outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Diabetes and Hypertension Prevalence in Homeless Adults in the United States: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Meurer, Linda N.; Plumb, Ellen J.; Jackson, Jeffrey L.

    2015-01-01

    We estimated hypertension and diabetes prevalence among US homeless adults compared with the general population, and investigated prevalence trends. We systematically searched 5 databases for published studies (1980–2014) that included hypertension or diabetes prevalence for US homeless adults, pooled disease prevalence, and explored heterogeneity sources. We used the National Health Interview Survey for comparison. We included data from 97 366 homeless adults. The pooled prevalence of self-reported hypertension was 27.0% (95% confidence interval = 23.8%, 29.9%; n = 43 studies) and of diabetes was 8.0% (95% confidence interval = 6.8%, 9.2%; n = 39 studies). We found no difference in hypertension or diabetes prevalence between the homeless and general population. Additional health care and housing resources are needed to meet the significant, growing burden of chronic disease in the homeless population. PMID:25521899

  1. The nutritional status and dietary adequacy of single homeless women and their children in shelters.

    OpenAIRE

    Drake, M A

    1992-01-01

    Data were collected on the nutrient intake and nutritional status of 96 single mothers and their 192 dependent children who had been displaced from their homes. The objective of the study was to provide information on the dietary adequacy of a newly identified subgroup of homeless persons, single women and their dependent children. Once situated in temporary housing, those participating in the study indicated that they believed that they were receiving sufficient food. However, a nutrient ana...

  2. Assessment of the nutritional status of urban homeless adults.

    Science.gov (United States)

    Luder, E; Boey, E; Buchalter, B; Martinez-Weber, C

    1989-01-01

    Homeless people eat foods at municipal and charity run shelters, fast-food restaurants, delicatessens, and from garbage bins. Data on the adequacy of the diets and the nutritional status of homeless persons are sparse. Therefore, nutritional indicators of 55 urban homeless subjects were assessed, and a high prevalence of risk factors was identified. Although 93 percent of subjects reported that they obtained enough to eat, a low dietary adequacy score of 10.1 (norm = 16) indicated that the quality of the diet was inadequate. Diet records showed a high intake of sodium, saturated fat, and cholesterol. Serum cholesterol levels above the desirable limit of 200 mg per dl were prevalent. Anthropometric measurements were significantly different from percentile distributions of the U.S. population (P less than .001). Triceps skinfold measurement was above the 95th percentile in 25 percent of subjects. Upper arm muscle area, which reflects lean body mass, was below the 5th percentile in 23.3 percent of women and 44 percent of the men. These decreased levels of lean body mass and increased levels of body fat, together with the elevated serum cholesterol levels and the shortages of essential nutrients in the diet, may place the homeless at risk of developing nutrition-related disorders.

  3. Rates and Predictors of Uncontrolled Hypertension Among Hypertensive Homeless Adults Using New York City Shelter-Based Clinics.

    Science.gov (United States)

    Asgary, Ramin; Sckell, Blanca; Alcabes, Analena; Naderi, Ramesh; Schoenthaler, Antoinette; Ogedegbe, Gbenga

    2016-01-01

    We undertook a study to determine the rates, predictors, and barriers to blood pressure control among homeless and nonhomeless hypertensive adult patients from 10 New York City shelter-based clinics. The study was a retrospective chart review of blood pressure measurements, sociodemographic characteristics, and factors associated with homelessness and hypertension extracted from the medical records of a random sample of hypertensive patients (N = 210) in 2014. Most patients were African American or Hispanic; 24.8% were female, and 84.3% were homeless for a mean duration of 3.07 years (SD = 5.04 years). Homeless adult patients were younger, had less insurance, and were more likely to be a current smoker and alcohol abuser. Of the 210 hypertensive patients, 40.1% of homeless and 33.3% of nonhomeless patients had uncontrolled blood pressure (P = .29) when compared with US rates for hypertensive adults, which range between 19.6% and 24.8%, respectively; 15.8% of homeless patients had stage 2 hypertension (P = .27). Homeless hypertensive patients with diabetes or multiple chronic diseases had better blood pressure control (P lack of insurance was associated with inadequate blood pressure control (P homeless adults is alarming. We propose comprehensive approaches to improve social support, access to medical insurance, and medication adherence, the lack of which complicate blood pressure control, targeted health education, and life style modifications using mobile health strategies for this mobile population. © 2016 Annals of Family Medicine, Inc.

  4. Employment Status and Income Generation among Homeless Young Adults: Results from a Five-City, Mixed-Methods Study

    Science.gov (United States)

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.; Maccio, Elaine M.; Pollio, David

    2012-01-01

    This mixed-methods study identified correlates of unemployment among homeless young adults in five cities. Two hundred thirty-eight homeless young people from Los Angeles (n = 50), Austin (n = 50), Denver (n = 50), New Orleans (n = 50), and St. Louis (n = 38) were recruited using comparable sampling strategies. Multivariate logistic regression…

  5. On the Road: Examining Self-Representation and Discourses of Homelessness in Young Adult Texts

    Science.gov (United States)

    Rogers, Theresa; Marshall, Elizabeth

    2012-01-01

    In this article, the authors analyze representations of social issues within contemporary memoirs written for and marketed to a young adult audience and multimodal zines produced by homeless youth. To read across these distinctly different texts (mass marketed and do-it-yourself cultural productions) and genres (memoir and zines), the authors…

  6. Hepatitis A seroprevalence and risk factors among homeless adults in San Francisco: should homelessness be included in the risk-based strategy for vaccination?

    Science.gov (United States)

    Hennessey, Karen A; Bangsberg, David R; Weinbaum, Cindy; Hahn, Judith A

    2009-01-01

    Homeless adults have an increased risk of infectious diseases due to sexual and drug-related behaviors and substandard living conditions. We investigated the prevalence and risk factors for presence of hepatitis A virus (HAV) antibodies among homeless and marginally housed adults. We analyzed serologic and questionnaire data from a study of marginally housed and homeless adults in San Francisco from April 1999 to March 2000. We tested seroprevalance for total antibodies to HAV (anti-HAV) and analyzed data using Chi-square tests and logistic regression. Of the 1,138 adults in the study, 52% were anti-HAV positive. The anti-HAV prevalence in this study population was 58% higher than the expected prevalence based on age-specific prevalence rates from the general population. Number of years of homelessness ( or =5 years) was associated with anti-HAV prevalence (46%, 50%, and 61%, respectively, p drugs (63% vs. 42% for non-injectors), being foreign-born (75% vs. 51% among U.S.-born), race/ethnicity (72%, 53%, and 45% for Hispanic, white, and black people, respectively), and increasing age (38%, 49%, and 62% among those aged 45 years, respectively). These variables all remained significant in a multivariate model. We found overall anti-HAV prevalence elevated in this San Francisco homeless population compared with the general U.S. population. These data show that anti-HAV was associated with homelessness independent of other known risk factors, such as being foreign-born, race/ethnicity, and injection drug use. This increase indicates an excess risk of HAV infection and the potential need to offer hepatitis A vaccination as part of homeless services.

  7. [Homeless adults' most frequent cause of death is suicide or murder].

    Science.gov (United States)

    Slockers, M T; Nusselder, W J; Rietjens, J; van Beeck, E F

    2018-01-01

    Get insight into excess mortality in the Rotterdam homeless population according to cause of death and changes in this mortality after introduction of social policies in Rotterdam, the Netherlands, in 2006. Uncontrolled before-and-after study. We included homeless adults who visited the Rotterdam shelter in 2001 and followed them for 10 years (2001-2010). We then linked the data of this cohort to Statistics Netherlands mortality figures. We calculated the shares of specific mortality causes in total mortality for the entire study period. We used the 'standardised mortality ratio' (SMR) to compare mortality in the homeless cohort of this period with mortality figures of the general Rotterdam population. In order to be able to compare the homeless death rates according to cause of death in the period before (2001-2005) and after introduction of social policy measures (2006-2010), the hazard ratio (HR) was calculated. Our cohort consisted of 2130 homeless persons with a mean age of 40.3 years. The most important causes of death were unnatural death (26%; 95% CI: 21-32), cardiovascular diseases (22%; 17-27) and cancer (17%; 13-22). Suicide and murder together were responsible for 50% of the unnatural deaths. The largest differences in mortality in comparison with the Rotterdam population were those for unnatural death (SMR: 14.8; 95% CI: 11.5-18.7), infectious diseases (SMR: 10.0; 5.2-17.5) and psychiatric conditions (SMR: 7.7; 4.0-13.5). Mortality due to suicide or murder was significantly different for both study periods (HR: 0.45; 0.20-0.97). Prevention of unnatural deaths among the homeless should be one of the priorities in homeless policy. Improvement of their living conditions may reduce the number of murders and suicides in this vulnerable group.

  8. Adherence to antipsychotic medication among homeless adults in Vancouver, Canada: a 15-year retrospective cohort study.

    Science.gov (United States)

    Rezansoff, Stefanie N; Moniruzzaman, A; Fazel, S; Procyshyn, R; Somers, J M

    2016-12-01

    The purpose of this study was to investigate the level of adherence to antipsychotic prescription medication in a well-defined homeless cohort over a 15-year period. We hypothesized that adherence would be well below the recommended threshold for clinical effectiveness (80 %), and that it would be strongly associated with modifiable risk factors in the social environment in which homeless people live. Linked baseline data (including comprehensive population-level administrative prescription records) were examined in a subpopulation of participants from two pragmatic-randomized trials that investigated Housing First for homeless and mentally ill adults. Adherence to antipsychotic medication was operationalized using the medication possession ratio. Multivariable logistic regression was used to estimate effect sizes between socio-demographic, homelessness-related and illness factors, and medication possession ratio. Among the 290 participants who met inclusion criteria for the current analysis, adherence to antipsychotic prescription was significantly associated with: history of psychiatric hospitalization; receipt of primary medical services; long-acting injectable antipsychotic formulations; and duration of homelessness. Mean medication possession ratio in the pre-randomization period was 0.41. Socio-demographic characteristics previously correlated with antipsychotic non-adherence were not significantly related to medication possession ratio. This is the first study to quantify the very low level of adherence to antipsychotic medication among homeless people over an extended observation period of 15 years. Each of the four factors found to be significantly associated with adherence presents opportunities for intervention. Strategies to end homelessness for this population may represent the greatest opportunity to improve adherence to antipsychotic medication.

  9. The nutritional status and dietary adequacy of single homeless women and their children in shelters.

    Science.gov (United States)

    Drake, M A

    1992-01-01

    Data were collected on the nutrient intake and nutritional status of 96 single mothers and their 192 dependent children who had been displaced from their homes. The objective of the study was to provide information on the dietary adequacy of a newly identified subgroup of homeless persons, single women and their dependent children. Once situated in temporary housing, those participating in the study indicated that they believed that they were receiving sufficient food. However, a nutrient analysis found that the study subjects in all age groups were consuming less than 50 percent of the 1989 Recommended Dietary Allowances (RDA) for iron, magnesium, zinc, and folic acid. Adults were consuming less than 50 percent of the RDA for calcium. The type and amounts of fats consumed were in higher than desirable quantities for a significant number of subjects of all ages. The health risk factors of iron deficiency anemia, obesity, and hypercholesterolemia were prevalent. The findings indicate a need to examine and remedy nutrient intake deficiencies among single women who are heads of household and their dependent children in temporary housing situations. Diet-related conditions found included low nutrient intakes that may affect child growth and development, risk factors associated with chronic disease, and lack of appropriate foods and knowledge of food preparation methods in shelter situations. Applicable, understandable nutrition education should be offered mothers in shelter situations to help them make food choices at the shelter and when they become self-sufficient. Assistance programs such as the Special Supplemental Food Program for Women, Infants, and Children, and food stamps, should be available to this group.

  10. Mastery matters: consumer choice, psychiatric symptoms and problematic substance use among adults with histories of homelessness.

    Science.gov (United States)

    Greenwood, Ronni Michelle; Manning, Rachel M

    2017-05-01

    Previous research demonstrated the importance of consumer choice and mastery to residential stability and psychiatric functioning for adults with histories of homelessness. In the present study, we investigated whether these relationships hold, even in the context of problem-related substance misuse. Questionnaire data were collected in Ireland from 101 residents of long-term homeless accommodation in 2010. Hayes' PROCESS macro for mediation and moderation analysis in SPSS was employed to test our hypotheses. Findings demonstrated that the indirect effect of choice through mastery on psychiatric functioning was stronger for individuals with more recent problem-related substance use than for those with no or distant histories of problem-related substance use. Our findings confirm that consumer choice in housing and services is important to homeless services users' recovery experiences. Because of its relationship with mastery, consumer choice in housing and services protects homeless services users' psychiatric functioning, especially when substance use-related choices have had negative consequences. Our findings suggest that if homeless services take away consumer choice when substance use causes problems, they may actually undermine, rather than foster, service users' psychiatric functioning. © 2016 John Wiley & Sons Ltd.

  11. A Qualitative Examination of Smoke-Free Policies and Electronic Cigarettes Among Sheltered Homeless Adults.

    Science.gov (United States)

    Vijayaraghavan, Maya; Hurst, Samantha; Pierce, John P

    2017-05-01

    To examine attitudes toward smoke-free policies and perceptions of e-cigarette use among homeless adults. A cross-sectional qualitative study was conducted. Study setting comprised seven transitional homeless shelters with indoor smoke-free policies in San Diego County; facilities differed in outdoor restrictions on smoking. Sixty-six current or former smokers were the study participants. Participants completed a questionnaire on smoking behaviors, perceived antitobacco norms, and attitudes toward smoke-free policies, and attended a focus group interview that explored these topics. We used a directed content analysis approach to analyze the focus group transcripts. Clients in facilities with outdoor restrictions on smoking had stronger perceived antitobacco norms than those in facilities without such restrictions. We identified the following major themes: attitudes toward smoke-free policies, the use of e-cigarettes, the addictive potential of cigarettes, vulnerability to tobacco industry marketing, and interest in smoking cessation. The consensus was that smoke-free policies were important because they limited secondhand smoke exposure to nonsmokers and children. All were curious about e-cigarettes, particularly if they could be smoked in areas where smoking was prohibited and/or used as a cessation aid. In this study of homeless adults, there was strong support for indoor and outdoor smoke-free policies. However, misperceptions that e-cigarettes could be used indoors could threaten antitobacco norms, highlighting opportunities to educate about the potential risks of e-cigarette use among homeless individuals.

  12. Life Goals Over Time Among Homeless Adults in Permanent Supportive Housing.

    Science.gov (United States)

    Wenzel, S L; Rhoades, H; Moore, H; Lahey, J; Henwood, B; La Motte-Kerr, W; Bird, M

    2018-03-14

    Permanent supportive housing (PSH) is a widely-accepted solution to the challenge of chronic homelessness. While housing support and retention, physical health, and healthcare continue to be important for formerly homeless persons in PSH, "higher-order" and humanistic needs such as thriving have received less attention and as a result are less well understood in this population. One important indicator of thriving is the ability to establish and articulate life goals. This study utilizes longitudinal data from 421 formerly homeless adults prior to their move into PSH, and at 3-, 6- and 12-months after move-in (369 respondents completed all four interviews), to examine what life goals are articulated by this population and how those goals change over time. Prior to housing, most respondents articulated housing attainment as their primary life goal, whereas at follow-up interviews health goals, housing relocation, and financial goals became more prevalent. Aspirational goals (e.g., independence, self-improvement, artistic pursuits) were also common, but demonstrated a decrease over time in housing. Relationship goals remained common and consistent over time. Findings indicate that housing is a necessary, but perhaps not sufficient, step for improving thriving among formerly homeless adults. Implications for practice and future research are discussed. © Society for Community Research and Action 2018.

  13. Youth Homelessness 2006

    Science.gov (United States)

    MacKenzie, David; Chamberlain, Chris

    2008-01-01

    The third national census of homeless school students, conducted in 2006, found that the number of homeless students had decreased since 2001. There were 9,389 homeless students in 2006 compared with 12,227 in 2001. Three groups were over-represented in the homeless population: Indigenous students, young people from single parent and blended…

  14. History of foster care among homeless adults with mental illness in Vancouver, British Columbia: a precursor to trajectories of risk.

    Science.gov (United States)

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2015-02-26

    It is well documented that a disproportionate number of homeless adults have childhood histories of foster care placement(s). This study examines the relationship between foster care placement as a predictor of adult substance use disorders (including frequency, severity and type), mental illness, vocational functioning, service use and duration of homelessness among a sample of homeless adults with mental illness. We hypothesize that a history of foster care predicts earlier, more severe and more frequent substance use, multiple mental disorder diagnoses, discontinuous work history, and longer durations of homelessness. This study was conducted using baseline data from two randomized controlled trials in Vancouver, British Columbia for participants who responded to a series of questions pertaining to out-of-home care at 12 months follow-up (n = 442). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; vocational functioning; and service use. In multivariable regression models, a history of foster care placement independently predicted incomplete high school, duration of homelessness, discontinuous work history, less severe types of mental illness, multiple mental disorders, early initiation of drug and/or alcohol use, and daily drug use. This is the first Canadian study to investigate the relationship between a history of foster care and current substance use among homeless adults with mental illness, controlling for several other potential confounding factors. It is important to screen homeless youth who exit foster care for substance use, and to provide integrated treatment for concurrent disorders to homeless youth and adults who have both psychiatric and substance use problems. Both trials are registered with the International Standard Randomized Control Trial Number Register and were assigned ISRCTN57595077 (Vancouver At Home Study: Housing First plus

  15. Caries and oral health related behaviours among homeless adults from Porto, Portugal.

    Science.gov (United States)

    de Pereira, Maria; Oliveira, Luís; Lunet, Nuno

    2014-01-01

    To describe caries prevalence and oral-health-related behaviours in a sample of homeless adults from the city of Porto, Portugal. Subjects attending any of two temporary shelters or two institutions that provide meal programmes were consecutively invited (n = 196); 42 (21.4%) refused to participate. Trained interviewers applied a structured questionnaire to obtain sociodemographic, behavioural, health and oral health status data. An oral examination was conducted to evaluate the past and present history of caries (Decayed Missing Filled Teeth [DMFT] index) and the presence of oral lesions. Those classified as houseless were considered for the present analysis (n = 141). The association between homelessness, sociodemographic and behavioural characteristics and oral health indexes was quantified through crude β coefficients and β coefficients adjusted for age, gender, education, nationality and duration of homelessness, as well as the respective 95% confidence intervals (CI). The median age of the participants was 45 years, most were male (86.3%), reported having less than a 9th grade education (80.1%) and were unemployed (82.1%). The median duration of homelessness was 24 months. The mean (SD) DMFT index, number of decayed, lost and filled teeth were 12.8 (7.9), 4.2 (4.4), 8.0 (7.6) and 0.6 (1.9), respectively. Older subjects and those homeless for longer periods presented higher DMFT index scores (β = 3.4, 95% CI: 0.0 to 6.8) and higher number of decayed teeth (β = 2.8, 95% CI: 0.4 to 5.2). Filled teeth were more frequent among the more educated (>9 vs ≤4 years: β = 1.6, 95% CI: 0.7 to 2.6). This population of homeless subjects showed poor oral health, particularly with respect to caries and missing teeth, resulting in high oral treatment needs.

  16. Neurobehavioural and cognitive function is linked to childhood trauma in homeless adults.

    Science.gov (United States)

    Pluck, Graham; Lee, Kwang-Hyuk; David, Rajan; Macleod, Diana C; Spence, Sean A; Parks, Randolph W

    2011-03-01

    To describe levels of traumatic childhood events in a sample of homeless individuals and to assess the contribution of traumatic events to neurobehavioural traits (measured with the Frontal Systems Behaviour Scale, FrSBe) and general cognitive function (IQ). A sample of 55 homeless adults was recruited from homeless services in the city of Sheffield, UK. All were interviewed to acquire substance misuse information, record experiences of childhood trauma, and assess cognitive and neurobehavioural traits. Experiences of abuse and neglect were assessed with the Childhood Trauma Questionnaire. Participants also completed the Wechsler Abbreviated Scale of Intelligence and the FrSBe, which was completed with respect to current behaviour and conduct prior to homelessness. Around three-quarters of the sample scored in the clinically significant range for current neurobehavioural impairment. They also reported high levels of impairment when rating retrospectively for the period before they were homeless. The mean group IQ was below average at 88. Abuse or neglect during their upbringing was reported by 89% of the sample. Emotional abuse, emotional neglect, and physical neglect were all positively correlated with total FrSBe scores. Sexual abuse, emotional neglect, and physical neglect were all negatively correlated with IQ. The associations between trauma and IQ and neurobehavioural traits appear generally unrelated to the presence of substance misuse in the sample. Our homeless sample displayed relatively low IQ with high levels of neurobehavioural impairment. Our evidence suggests that these neuropsychological factors may, in part, constitute a long-term consequence of childhood trauma. ©2010 The British Psychological Society.

  17. Visual impairment and unmet eye care needs among homeless adults in a Canadian city.

    Science.gov (United States)

    Noel, Christopher W; Fung, Henry; Srivastava, Raman; Lebovic, Gerald; Hwang, Stephen W; Berger, Alan; Lichter, Myrna

    2015-04-01

    The ocular status of homeless populations remains largely unknown. Given that visual acuity has been shown to be heavily correlated with reduced well-being and decreased earning potential, findings of poor vision could have important health implications for people experiencing homelessness. To assess the prevalence of visual impairment and to identify unmet eye care needs in an adult homeless population. For this cross-sectional study, we recruited 100 homeless persons using a stratified random sampling technique from January to March 2014. Recruitment took place at 10 randomly selected adult shelters in Toronto, Ontario, Canada. All English-speaking persons older than 18 years of age were eligible to participate. Information was obtained on sociodemographic characteristics, ocular history, and subjective visual acuity. A comprehensive vision screening and an undilated retinal examination were performed for each participant. Rates of functional visual impairment and prevalence of nonrefractive eye pathology. The median age of participants was 48 years (interquartile range, 36-56 years), and 62% were men. The median lifetime duration of homelessness was 12 months (interquartile range, 5-36 months). Based on the participants' presenting visual acuity, the age-standardized rate of visual impairment was 25.2% (95% CI, 16.7%-33.7%). After pinhole occlusion, this number decreased to 15.2% (95% CI, 7.7%-22.7%). In total, 13.0% (95% CI, 7.8%-20.0%) of participants experienced visual impairment secondary to a correctable refractive error. Although the major problem for this demographic was limited access to refractive correction, a large degree of nonrefractive pathology was also observed. Of all the participants, 34.0% (95% CI, 24.7%-43.3%) had 1 or more abnormal findings during the vision screening, and 8% (95% CI, 2.7%-13.3%) required urgent referral to an ophthalmologist. A large majority of participants (89.0%) indicated interest in accessing free eye examinations

  18. Missed opportunities: childhood learning disabilities as early indicators of risk among homeless adults with mental illness in Vancouver, British Columbia.

    Science.gov (United States)

    Patterson, Michelle Louise; Moniruzzaman, Akm; Frankish, Charles James; Somers, Julian M

    2012-01-01

    It is well documented that early-learning problems and poor academic achievement adversely impact child development and a wide range of adult outcomes; however, these indicators have received scant attention among homeless adults. This study examines self-reported learning disabilities (LD) in childhood as predictors of duration of homelessness, mental and substance use disorders, physical health, and service utilisation in a sample of homeless adults with current mental illness. This study was conducted using the baseline sample from a randomised controlled trial (RCT). Participants were sampled from the community in Vancouver, British Columbia. The total sample included 497 adult participants who met criteria for absolute homelessness or precarious housing and a current mental disorder based on a structured diagnostic interview. Learning disabilities in childhood were assessed by asking adult participants whether they thought they had an LD in childhood and if anyone had told them they had an LD. Only participants who responded positively to both questions (n=133) were included in the analyses. Primary outcomes include current mental disorders, substance use disorders, physical health, service utilisation and duration of homelessness. In multivariable regression models, self-reported LD during childhood independently predicted self-reported educational attainment and lifetime duration of homelessness as well as a range of mental health, physical health and substance use problems, but did not predict reported health or justice service utilisation. Childhood learning problems are overrepresented among homeless adults with complex comorbidities and long histories of homelessness. Our findings are consistent with a growing body of literature indicating that adverse childhood events are potent risk factors for a number of adult health and psychiatric problems, including substance abuse. TRIALS REGISTRATION NUMBER: This trial has been registered with the International

  19. Perspectives of cancer and cancer screening among homeless adults of New York City shelter-based clinics: a qualitative approach.

    Science.gov (United States)

    Asgary, Ramin; Sckell, Blanca; Alcabes, Analena; Naderi, Ramesh; Ogedegbe, Gbenga

    2015-10-01

    Millions of homeless Americans have lower cancer screening and higher cancer mortality rates. We explored perspectives and perceptions regarding cancer and cancer screening among homeless. Using random and criteria sampling, we conducted in-depth semi-structured interviews with 50 homeless adults from New York City's (NYC) shelters and shelter-based clinics. Mean age was 51.66 years with average 2.03 years of homelessness; 33/50 were older than 50. Only a small number of participants had their recommended cancer screening. Contrary to general assumptions and despite significant barriers, the homeless were concerned about cancer, believed their risk of cancer is higher compared to the general population, and generally considered screening a high priority during homelessness. While they acknowledged several individual- and systems-level barriers, they welcomed targeted measures to address their multi-level barriers. Suggested strategies included active counseling by providers, health education or reminders via mHealth strategies or face-to-face in shelters, addressing potential providers' prejudice and biases regarding their priorities, incentives, and patient navigators or coach to help navigating the complex cancer screening process. There are gaps in effective cancer screening despite adequate attitude and perceptions among homeless. The health system needs to shift from addressing only basic care to a more equitable approach with accessible and acceptable opportunities for preventive cancer care for the homeless.

  20. Healthcare Barriers and Utilization Among Adolescents and Young Adults Accessing Services for Homeless and Runaway Youth.

    Science.gov (United States)

    Chelvakumar, Gayathri; Ford, Nancy; Kapa, Hillary M; Lange, Hannah L H; McRee, Annie-Laurie; Bonny, Andrea E

    2017-06-01

    Homeless and runaway youth are at disproportionate risk for adverse health outcomes. Many barriers to accessing healthcare have been documented; however, the relative impact of discrete barriers on homeless youth healthcare utilization behavior is not firmly established. We administered a survey examining reported barriers and healthcare utilization among adolescents and young adults accessing services at three community centers for homeless and runaway youth. Of 180 respondents, 57 % were male, 80 % non-White, and 21 % identified as a sexual minority. Stepwise logistic regression models, controlling for age and study site, explored associations between barriers and 3 healthcare utilization outcomes (doctor visit in past 12 months; regular care provider; frequent emergency department (ED) visits). The most commonly reported barriers were "don't have a ride" (27.2 %), "no insurance" (23.3 %), and "costs too much" (22.8 %). All fear-based barriers (e.g., "I don't trust the doctors") were reported by homeless and runaway youth as the impact of discrete barriers varies depending on outcome of focus.

  1. Neurocognitive impairment in a large sample of homeless adults with mental illness.

    Science.gov (United States)

    Stergiopoulos, V; Cusi, A; Bekele, T; Skosireva, A; Latimer, E; Schütz, C; Fernando, I; Rourke, S B

    2015-04-01

    This study examines neurocognitive functioning in a large, well-characterized sample of homeless adults with mental illness and assesses demographic and clinical factors associated with neurocognitive performance. A total of 1500 homeless adults with mental illness enrolled in the At Home Chez Soi study completed neuropsychological measures assessing speed of information processing, memory, and executive functioning. Sociodemographic and clinical data were also collected. Linear regression analyses were conducted to examine factors associated with neurocognitive performance. Approximately half of our sample met criteria for psychosis, major depressive disorder, and alcohol or substance use disorder, and nearly half had experienced severe traumatic brain injury. Overall, 72% of participants demonstrated cognitive impairment, including deficits in processing speed (48%), verbal learning (71%) and recall (67%), and executive functioning (38%). The overall statistical model explained 19.8% of the variance in the neurocognitive summary score, with reduced neurocognitive performance associated with older age, lower education, first language other than English or French, Black or Other ethnicity, and the presence of psychosis. Homeless adults with mental illness experience impairment in multiple neuropsychological domains. Much of the variance in our sample's cognitive performance remains unexplained, highlighting the need for further research in the mechanisms underlying cognitive impairment in this population. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Self injurious behavior among homeless young adults: a social stress analysis.

    Science.gov (United States)

    Tyler, Kimberly; Melander, Lisa; Almazan, Elbert

    2010-01-01

    Although self-mutilation has been studied from medical and individual perspectives, it has rarely been examined within a social stress context. As such, we use a social stress framework to examine risk factors for self-mutilation to determine whether status strains that are often associated with poorer health outcomes in the general population are also associated with self-mutilation among a sample of young adults in the United States who have a history of homelessness. Data are drawn from the Homeless Young Adult Project which involved interviews with 199 young adults in 3 Midwestern United States cities. The results of our path analyses revealed that numerous stressors including running away, substance use, sexual victimization, and illegal subsistence strategies were associated with more self-mutilation. In addition, we found that certain social statuses exacerbate the risk for self-mutilation beyond the respondents' current situation of homelessness. We discuss the implications of our findings for the social stress framework and offer suggestions for studying this unique population within this context. Copyright 2009 Elsevier Ltd. All rights reserved.

  3. Fidelity of a strengths-based intervention used by dutch shelters for homeless young adults.

    Science.gov (United States)

    Krabbenborg, Manon A M; Boersma, Sandra N; Beijersbergen, Mariëlle D; Goscha, Richard J; Wolf, Judith R L M

    2015-05-01

    In a cluster randomized controlled trial, this study aimed to investigate the effectiveness of and fidelity to Houvast (Dutch for "grip"), a strengths-based intervention to improve the quality of life for homeless young adults. Fidelity was measured six months after professionals and team leaders at five Dutch shelters for homeless young adults finished their training in Houvast. Fidelity was measured with the Dutch version of the strengths model fidelity scale, which consists of ten indicators distributed across three subscales: structure, supervision, and clinical practice. A total fidelity score was composed by averaging the ten indicator scores for each facility. During one-day audits by two trained assessors visiting each facility, a file analysis (N=46), a focus group with homeless young adults (N=19), and interviews with the team leader and supervisor (N=9) were conducted. Professionals, supervisors, and team leaders completed questionnaires two weeks before the audit (N=43). In addition, an evaluation of the audit was conducted six months later. Although none of the five shelters achieved a sufficient total model fidelity score, median scores on caseload, group supervision, and strengths assessment were satisfactory. Each facility received a report with a set of recommendations to improve model fidelity. The evaluation showed improvements in use of the strengths assessment and personal recovery plans and in supervision. Facilities face several challenges when implementing a new intervention, and implementing Houvast was no exception. Learning experiences and possible explanations for the insufficient total fidelity scores are reported.

  4. Family Homelessness in Europe : 7 EOH Comparative Studies in Homeless

    OpenAIRE

    Baptista, Isabel; Benjaminsen, Lars; Pleace, Nicholas; Busch-Geertsema, Volker

    2017-01-01

    This comparative report critically assesses the evidence on the nature and extent of family homelessness in Europe and also explores the provision of preventative, support and rehousing services. Family homelessness is disproportionately experienced by lone women parents whose homelessness is frequently triggered by domestic violence. Homeless families tend to be in situations of poverty or low income, but unlike lone homeless adults experiencing recurrent or sustained homelessness, families ...

  5. Homeless Outreach Projects for Single Parent Families: What Happens to the Children?

    OpenAIRE

    Kasting, Colleen; Artz, Sibylle

    2005-01-01

    This article provides an overview of the changing nature of family homelessness in the US and Canada, the current literature on homeless families and their children, and reports on a Canadian example of community-based research on family homelessness. This research shows that poverty, family violence, a history of abuse and problems with mental health and substance misuse are the dominant factors that contribute to family homelessness. The research also shows that the children of homeless fam...

  6. Homelessness Pathways for Australian Single Mothers and Their Children: An Exploratory Study

    OpenAIRE

    Wayne Warburton; Elizabeth Whittaker; Marina Papic

    2018-01-01

    There is increasing concern about family homelessness. Homeless mothers and their children are one of society’s most disadvantaged and at-risk populations. However, very little Australian research exploring mothers’ views on their homelessness experiences exists. Using semi-structured interviews with 14 mothers and four agency staff, this study explored homeless Australian mothers’ pathways into and out of homelessness, their specific needs and the services and supports that were (or would ha...

  7. Prevalence and Correlates of Substance Use in Homeless Youth and Young Adults.

    Science.gov (United States)

    Santa Maria, Diane M; Narendorf, Sarah C; Cross, Matthew B

    Substance use is higher among homeless youth than among the general population. Although substance use has been well studied, little is known about the risk factors associated with specific substances used by homeless youth, particularly in the Houston, Texas, area. Therefore, we conducted this study to examine the rates of lifetime and past-month substance use in a sample of homeless youth in Harris County, Texas, and examine the relations between substance type and race/ethnicity, age, gender identity, sexual orientation, shelter status, stress, and trauma history. Participants were recruited during October and November 2014 as part of the study YouthCount 2.0! and completed a survey to assess demographics, stress, abuse, substance use, and risk behaviors. The sample (N = 416) was predominantly young adult (13-17 years old: 55 and 18-24 years old: 361), African American (54.5%), and male (55.9%). Nearly one quarter identified as lesbian, gay, bisexual, or questioning (n = 102). Over a third of youth had used alcohol (38%) or marijuana (36%) in the past month, and 36% had ever used synthetic marijuana. Bivariate analyses showed that substance use was significantly associated with race/ethnicity, age, gender identity, sexual orientation, shelter status, stress, and trauma scores. Youth in this study had lower rates of alcohol and some substance use than other samples of homeless youth, although use still exceeded national rates for housed youth. Substance use prevention interventions for homeless youth should be trauma informed and include housing navigation and stress management strategies. The most at-risk subgroups included street-dwelling and lesbian, gay, bisexual, or questioning youth.

  8. Mortality among homeless adults in Boston: shifts in causes of death over a 15-year period.

    Science.gov (United States)

    Baggett, Travis P; Hwang, Stephen W; O'Connell, James J; Porneala, Bianca C; Stringfellow, Erin J; Orav, E John; Singer, Daniel E; Rigotti, Nancy A

    2013-02-11

    Homeless persons experience excess mortality, but US-based studies on this topic are outdated or lack information about causes of death. To our knowledge, no studies have examined shifts in causes of death for this population over time. We assessed all-cause and cause-specific mortality rates in a cohort of 28 033 adults 18 years or older who were seen at Boston Health Care for the Homeless Program from January 1, 2003, through December 31, 2008. Deaths were identified through probabilistic linkage to the Massachusetts death occurrence files. We compared mortality rates in this cohort with rates in the 2003-2008 Massachusetts population and a 1988-1993 cohort of homeless adults in Boston using standardized rate ratios with 95% confidence intervals. A total of 1302 deaths occurred during 90 450 person-years of observation. Drug overdose (n = 219), cancer (n = 206), and heart disease (n = 203) were the major causes of death. Drug overdose accounted for one-third of deaths among adults younger than 45 years. Opioids were implicated in 81% of overdose deaths. Mortality rates were higher among whites than nonwhites. Compared with Massachusetts adults, mortality disparities were most pronounced among younger individuals, with rates about 9-fold higher in 25- to 44-year-olds and 4.5-fold higher in 45- to 64-year-olds. In comparison with 1988-1993 rates, reductions in deaths from human immunodeficiency virus (HIV) were offset by 3- and 2-fold increases in deaths owing to drug overdose and psychoactive substance use disorders, resulting in no significant difference in overall mortality. The all-cause mortality rate among homeless adults in Boston remains high and unchanged since 1988 to 1993 despite a major interim expansion in clinical services. Drug overdose has replaced HIV as the emerging epidemic. Interventions to reduce mortality in this population should include behavioral health integration into primary medical care, public health initiatives to prevent and reverse

  9. Emergency department use and hospitalizations among homeless adults with substance dependence and mental disorders.

    Science.gov (United States)

    Cheung, Adrienne; Somers, Julian M; Moniruzzaman, Akm; Patterson, Michelle; Frankish, Charles J; Krausz, Michael; Palepu, Anita

    2015-08-05

    Homelessness, substance use, and mental disorders each have been associated with higher rates of emergency department (ED) use and hospitalization. We sought to understand the correlation between ED use, hospital admission, and substance dependence among homeless individuals with concurrent mental illness who participated in a 'Housing First' (HF) intervention trial. The Vancouver At Home study consisted of two randomized controlled trials addressing homeless individuals with mental disorders who have "high" or "moderate" levels of need. Substance dependence was determined at baseline prior to randomization, using the Mini International Neuropsychiatric Interview diagnostic tool, version 6.0. To assess health service use, we reviewed the number of ED visits and the number of hospital admissions based on administrative data for six urban hospitals. Negative binomial regression modeling was used to test the independent association between substance dependence and health service use (ED use and hospitalization), adjusting for HF intervention, age, gender, ethnicity, education, duration of lifetime homelessness, mental disorders, chronic health conditions, and other variables that were selected a priori to be potentially associated with use of ED services and hospital admission. Of the 497 homeless adults with mental disorders who were recruited, we included 381 participants in our analyses who had at least 1 year of follow-up and had a personal health number that could be linked to administrative health data. Of this group, 59% (n = 223) met criteria for substance dependence. We found no independent association between substance dependence and ED visits or hospital admissions [rate ratio (RR) = 0.85; 95% CI 0.62-1.17 and RR = 1.21; 95% CI 0.83-1.77, respectively]. The most responsible diagnoses (defined as the diagnosis that accounts for the length of stay) for hospital admissions were schizo-affective disorder, schizophrenia-related disorder, or bipolar affective

  10. The high-risk environment of homeless young adults: consequences for physical and sexual victimization.

    Science.gov (United States)

    Tyler, Kimberly A; Beal, Morgan R

    2010-01-01

    Little is known about how the social environment of homeless youth contributes to their risk and how it varies for different types of victimization. As such, the current study examines the constructs of victimization theories in order to investigate the potential risk for physical and sexual victimization among homeless young adults. Results revealed that running at an earlier age, running more often, sleeping on the street, panhandling, deviant peers associations, and not having a family member in one's network are associated with more physical victimization. Being female, a sexual minority, having an unkempt physical appearance, panhandling, and having friends who traded sex are associated with more sexual victimization. Overall, we find that the constructs differed in their ability to explain sexual versus physical victimization.

  11. Different faces of discrimination: perceived discrimination among homeless adults with mental illness in healthcare settings.

    Science.gov (United States)

    Skosireva, Anna; O'Campo, Patricia; Zerger, Suzanne; Chambers, Catharine; Gapka, Susan; Stergiopoulos, Vicky

    2014-09-07

    Research on discrimination in healthcare settings has primarily focused on health implications of race-based discrimination among ethno-racial minority groups. Little is known about discrimination experiences of other marginalized populations, particularly groups facing multiple disadvantages who may be subjected to other/multiple forms of discrimination. (1) To examine the prevalence of perceived discrimination due to homelessness/poverty, mental illness/alcohol/drug related problems, and race/ethnicity/skin color while seeking healthcare in the past year among racially diverse homeless adults with mental illness; (2) To identify whether perceiving certain types of discrimination is associated with increased likelihood of perceiving other kinds of discrimination; and (3) To examine association of these perceived discrimination experiences with socio-demographic characteristics, self-reported measures of psychiatric symptomatology and substance use, and Emergency Department utilization. We used baseline data from the Toronto site of the At Home/Chez Soi randomized controlled trial of Housing First for homeless adults with mental illness (n = 550). Bivariate statistics and multivariable logistic regression models were used for the analysis. Perceived discrimination related to homelessness/poverty (30.4%) and mental illness/alcohol/substance use (32.5%) is prevalent among ethnically diverse homeless adults with mental illness in healthcare settings. Only 15% of the total participants reported discrimination due to race/ethnicity/skin color. After controlling for relevant confounders and presence of psychosis, all types of discrimination in healthcare settings were associated with more frequent ED use, a greater - 3 - severity of lifetime substance abuse, and mental health problems. Perceiving discrimination of one type was associated with increased likelihood of perceiving other kinds of discrimination. Understanding the experience of discrimination in healthcare

  12. New Frontiers in Literacy: Education and Mental Health of the Homeless. Southeast Florida Training Center for Adult Literacy Educators Conference Proceedings (Miami, Florida, May 5-6, 1990).

    Science.gov (United States)

    Miami-Dade Community Coll., FL. Southeast Florida Training Center for Adult Literacy Educators.

    This document is a transcript of a tape of a conference on homelessness and mental illness conducted by adult literacy educators in Florida. Persons whose remarks are transcribed include Blanca Polo, Director of the Southeast Florida Training Center for Adult Literacy Educators; David K. Fike, author of a study on homelessness in southern Florida;…

  13. Promoting continuity of care for homeless adults with unmet health needs: The role of brief interventions.

    Science.gov (United States)

    Lamanna, Denise; Stergiopoulos, Vicky; Durbin, Janet; O'Campo, Patricia; Poremski, Daniel; Tepper, Joshua

    2018-01-01

    Promoting timely and continuous care for people experiencing homelessness has been a challenge in many jurisdictions, plagued by access barriers and service fragmentation. As part of a larger programme evaluation, this study used qualitative methods to examine the role of a brief interdisciplinary intervention in supporting continuity of care for this population in a large Canadian urban centre. The intervention provides time-limited case management, primary and psychiatric care, and peer accompaniment to homeless adults with unmet health needs discharged from hospital. Data were collected from 52 study participants between July 2013 and December 2014. Three focus groups were conducted with service providers and people with lived experience of homelessness, and 29 individual, semi-structured interviews were conducted with service users and other key informants. Transcripts were analysed using thematic analysis. Analysis was informed by existing frameworks for continuity of care, while remaining open to additional or unexpected findings. Findings suggest that brief interdisciplinary interventions can promote continuity of care by offering low-barrier access, timely and responsive service provision, including timely connection to long-term services and supports, appropriate individualised services and effective co-ordination of services. Although brief interdisciplinary interventions were perceived to promote access, timeliness and co-ordination of care for this population with complex health and social needs, gaps in the local service delivery context can present persisting barriers to care comprehensiveness and continuity. © 2017 John Wiley & Sons Ltd.

  14. Unmet need for medical care among homeless adults with serious mental illness.

    Science.gov (United States)

    Desai, Mayur M; Rosenheck, Robert A

    2005-01-01

    The objective of this study was to determine the rates and predictors of unmet medical needs among homeless adults with serious mental illness entering a community-based case management program and those of receipt of medical care in the subsequent 3-month period. We analyzed baseline and follow-up data for 7213 homeless clients in the multisite Access to Community Care and Effective Services and Supports program. Overall, 43.6% of the sample reported having an unmet need for medical care at baseline; of these subjects, only 36.1% received medical services during the 3 months following program entry. Using multivariate logistic regression modeling, we found that, at baseline, independent correlates of an unmet medical need included lower educational level, increased depressive and psychotic symptoms and greater number of potentially competing needs. None of these variables, however, adversely affected the likelihood of receiving medical care during follow-up. Factors associated with receiving medical services in the 3 months following program entry included receiving outpatient psychiatric services and reporting stronger therapeutic alliance with one's case manager. Collaborative case management may play an important role in meeting mentally ill homeless persons' medical needs. Greater efforts are needed to identify and link at-risk clients with appropriate medical services.

  15. Housing first improves residential stability in homeless adults with concurrent substance dependence and mental disorders.

    Science.gov (United States)

    Palepu, Anita; Patterson, Michelle L; Moniruzzaman, Akm; Frankish, C James; Somers, Julian

    2013-12-01

    We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study). The Vancouver At Home study in Canada included 2 randomized controlled trials of Housing First interventions. Eligible participants met the criteria for homelessness or precarious housing, as well as a current mental disorder. Residential stability was defined as the number of days in stable residences 12 months after randomization. We used negative binomial regression modeling to examine the independent association between residential stability and substance dependence. We recruited 497 participants, and 58% (n = 288) met the criteria for substance dependence. We found no significant association between substance dependence and residential stability (adjusted incidence rate ratio = 0.97; 95% confidence interval = 0.69, 1.35) after adjusting for housing intervention, employment, sociodemographics, chronic health conditions, mental disorder severity, psychiatric symptoms, and lifetime duration of homelessness. People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence.

  16. The effect of early maltreatment, victimization, and partner violence on HIV risk behavior among homeless young adults.

    Science.gov (United States)

    Melander, Lisa A; Tyler, Kimberly A

    2010-12-01

    The purpose of our study was to examine the relationship between child maltreatment, physical and sexual victimization, and partner violence victimization with human immunodeficiency virus (HIV) risk behaviors among a sample of homeless young adults from the midwestern United States. Data are from the Homeless Young Adult Project. A total of 199 young adults aged 19-26 years were interviewed over 14 months using a systematic sampling strategy. The final sample included 172 young adults who were homeless or had a history of running away and being homeless. Results from the path analysis revealed that sexual abuse is directly linked with street sexual victimization which was positively associated with a greater number of HIV risk behaviors. Experiencing more types of physical abuse and neglect were positively correlated with partner violence victimization, which was, in turn, associated with more HIV risk behaviors. Those who suffered from more types of neglect also experienced more forms of sexual and physical victimization. These findings have implications for service providers. Clinicians who serve homeless youth should recognize the potential effect that experiencing a variety of forms of victimization may have on health risk behaviors. Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Medicaid expansion: chronically homeless adults will need targeted enrollment and access to a broad range of services.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Culhane, Dennis P; Artiga, Samantha

    2013-09-01

    Homeless adults may gain access to health services under the Affordable Care Act's Medicaid expansion, which takes effect in 2014. This study analyzed the health coverage, health status, and health services use of 725 chronically homeless adults with disabilities in eleven cities in the United States. Nearly three-quarters of the chronically homeless adults in this study with incomes below the threshold for the Medicaid expansion were not enrolled in Medicaid. Fifty-three percent were uninsured or relied solely on state or local assistance, and 21 percent had other coverage that included Department of Veterans Affairs health care. The findings on differences in health status and service use across groups suggest that the Medicaid expansion offers important opportunities to increase coverage and access to care for chronically homeless adults. There may be potential savings for states that expand Medicaid, as people transition from state and local assistance to more comprehensive services under Medicaid. Targeted outreach and assistance to enroll eligible homeless people will be necessary. A broad range of physical and mental health services will be required, including case management to coordinate services.

  18. Building Adult Parenting Skills in a Homeless Population Through a Problem Solving Approach.

    Science.gov (United States)

    Price, Jonaphine P.

    The experience of homelessness places great stress on families. Homeless parents in a shelter deal with various stressors in addition to homelessness, causing difficulties in dealing with their children and in developing parenting skills. This report describes a program designed for homeless parents of preschool children temporarily living in a…

  19. The Relationship between Literacy and Depression and Anxiety in Homeless Adults

    Science.gov (United States)

    Holland, Mark Edward

    2014-01-01

    Homelessness is a problem that has correlating social, psychological, and health problems. The pathways that lead to homelessness are plentiful and varied, as are the risk factors that are associated with chronic homelessness. Much of the research that has been completed with homeless individuals has focused on substance use or psychological…

  20. Relationship among adverse childhood experiences, history of active military service, and adult outcomes: homelessness, mental health, and physical health.

    Science.gov (United States)

    Montgomery, Ann Elizabeth; Cutuli, J J; Evans-Chase, Michelle; Treglia, Dan; Culhane, Dennis P

    2013-12-01

    We determined whether a report of adverse childhood experiences predicts adult outcomes related to homelessness, mental health, and physical health and whether participation in active military service influences the relationship between childhood and adult adversity. Using data from the 2010 Washington State Behavioral Risk Factor Surveillance System, we tested by means of logistic regression the relationship between adverse childhood experiences and 3 adult outcomes--homelessness, mental health, and physical health--as well as differences among those with a history of active military service. Adverse childhood experiences separately predicted increased odds of experiencing homelessness as an adult and mental health and physical health problems. Childhood adversity increased the likelihood of adult homelessness and poor physical health among individuals with no history of active military service and the likelihood of mental health problems among individuals with a history of active military service. The relationship between childhood adversity and adult adversity changes in degree when history of active military service is controlled, which has implications for Armed Forces recruitment strategies and postmilitary service risk assessment.

  1. Adverse Childhood Experiences and the Risk of Criminal Justice Involvement and Victimization Among Homeless Adults With Mental Illness.

    Science.gov (United States)

    Edalati, Hanie; Nicholls, Tonia L; Crocker, Anne G; Roy, Laurence; Somers, Julian M; Patterson, Michelle L

    2017-12-01

    Exposure to adverse childhood experiences (ACEs) is highly prevalent among homeless individuals and is associated with negative consequences during homelessness. This study examined the effect of ACEs on the risk of criminal justice involvement and victimization among homeless individuals with mental illness. The study used baseline data from a demonstration project (At Home/Chez Soi) that provided Housing First and recovery-oriented services to homeless adults with mental illness. The sample was recruited from five Canadian cities and included participants who provided valid responses on an ACEs questionnaire (N=1,888). Fifty percent reported more than four types of ACE, 19% reported three or four types, 19% reported one or two, and 12% reported none. Rates of criminal justice involvement and victimization were significantly higher among those with a history of ACEs. For victimization, the association was significant for all ten types of ACE, and for justice involvement, it was significant for seven types. Logistic regression models indicated that the effect of cumulative childhood adversity on the two outcomes was significant regardless of sociodemographic factors, duration of homelessness, and psychiatric diagnosis, with one exception: the relationship between cumulative childhood adversity and criminal justice involvement did not remain significant when the analysis controlled for a diagnosis of posttraumatic stress disorder and substance dependence. Findings support the need for early interventions for at-risk youths and trauma-informed practice and violence prevention policies that specifically target homeless populations.

  2. Multiple types of childhood and adult violence among homeless and unstably housed women in San Francisco

    Science.gov (United States)

    Wong, Lauren H.; Shumway, Martha; Flentje, Annesa; Riley, Elise D.

    2017-01-01

    The present study examined the relationship between different forms of childhood violence (emotional, physical, and sexual) and these same forms of violence in adulthood, using a cross-sectional baseline survey of 298 homeless and unstably housed women in San Francisco, California. We also examined other related factors, including mental illnesses diagnosis, sex exchange, jail time, HIV status, and sociodemographic information. Regression analysis indicated that while several of these factors were associated with experiences of violence as an adult, specific types of child violence (e.g. sexual violence) predicted instances of that same type of violence as an adult, but not necessarily other types. Thus, risk of adult violence among low-income women may be better predicted and addressed through histories of same-type childhood violence, despite competing current stressors. PMID:27640925

  3. Multiple Types of Childhood and Adult Violence Among Homeless and Unstably Housed Women in San Francisco.

    Science.gov (United States)

    Wong, Lauren H; Shumway, Martha; Flentje, Annesa; Riley, Elise D

    2016-12-01

    This study examined the relationship between different forms of childhood violence (emotional, physical, and sexual) and these same forms of violence in adulthood, using a crosssectional baseline survey of 298 homeless and unstably housed women in San Francisco, California. We also examined other related factors, including mental illnesses diagnosis, sex exchange, jail time, HIV status, and sociodemographic information. Regression analysis indicated that although several of these factors were associated with experiences of violence as an adult, specific types of child violence (e.g., sexual violence) predicted instances of that same type of violence as an adult but not necessarily other types. Thus, risk of adult violence among low-income women may be better predicted and addressed through histories of same-type childhood violence, despite years of intervening exposures and stressors.

  4. Risk factors associated with recurrent homelessness after a first homeless episode.

    Science.gov (United States)

    McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

    2014-07-01

    Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

  5. Vancouver At Home: pragmatic randomized trials investigating Housing First for homeless and mentally ill adults.

    Science.gov (United States)

    Somers, Julian M; Patterson, Michelle L; Moniruzzaman, Akm; Currie, Lauren; Rezansoff, Stefanie N; Palepu, Anita; Fryer, Karen

    2013-11-01

    Individuals with mental illnesses are overrepresented among the homeless. Housing First (HF) has been shown to promote positive outcomes in this population. However, key questions remain unresolved, including: how to match support services to client needs, the benefits of housing in scattered sites versus single congregate building, and the effectiveness of HF with individuals actively using substances. The present study aimed to recruit two samples of homeless mentally ill participants who differed in the complexity of their needs. Study details, including recruitment, randomization, and follow-up, are presented. Eligibility was based on homeless status and current mental disorder. Participants were classified as either moderate needs (MN) or high needs (HN). Those with MN were randomized to HF with Intensive Case Management (HF-ICM) or usual care. Those with HN were randomized to HF with Assertive Community Treatment (HF-ACT), congregate housing with support, or usual care. Participants were interviewed every 3 months for 2 years. Separate consent was sought to access administrative data. Participants met eligibility for either MN (n = 200) or HN (n = 297) and were randomized accordingly. Both samples were primarily male and white. Compared to participants designated MN, HN participants had higher rates of hospitalization for psychiatric reasons prior to randomization, were younger at the time of recruitment, younger when first homeless, more likely to meet criteria for substance dependence, and less likely to have completed high school. Across all study arms, between 92% and 100% of participants were followed over 24 months post-randomization. Minimal significant differences were found between study arms following randomization. 438 participants (88%) provided consent to access administrative data. The study successfully recruited participants meeting criteria for homelessness and current mental disorder. Both MN and HN groups had high rates of substance

  6. 'Hello, you're not supposed to be here': homeless emerging adults' experiences negotiating food access.

    Science.gov (United States)

    Bowen, Elizabeth A; Irish, Andrew

    2018-03-05

    We aimed to examine the food-seeking experiences of homeless emerging adults (age 18-24 years) in a US urban context. The study used a qualitative descriptive design, combining semi-structured interviews with a standardized quantitative measure of food insecurity. Interview data were coded using constant comparative methods to identify patterns across and within interviews. Emerging themes were confirmed and refined through member checking. Buffalo, a mid-sized city in the Northeastern USA. A sample of thirty participants was recruited through community-based methods. Eligibility criteria specified that participants were aged 18-24 years and did not have a stable place to live. The sample was demographically diverse and included participants who were couch-surfing, staying on the streets and/or using shelters. Participants' food access strategies varied across their living circumstances. Common strategies included purchasing food with cash or benefits (reported by 77 %), using free meal programmes (70 %) and eating at friends' or relatives' homes (47 %). Although 70 % of participants received Supplemental Nutrition Assistance Program benefits, several reported access barriers, including initial denials of eligibility due to being listed on a parent's application even when the participant no longer resided in the household. Participants described a stigma associated with using food pantries and free meal programmes and expressed preference for less institutionalized programmes such as Food Not Bombs. Given endemic levels of food insecurity among homeless youth and young adults, policy modifications and service interventions are needed to improve food access for this population.

  7. Profiles of criminal justice system involvement of mentally ill homeless adults.

    Science.gov (United States)

    Roy, Laurence; Crocker, Anne G; Nicholls, Tonia L; Latimer, Eric; Gozdzik, Agnes; O'Campo, Patricia; Rae, Jennifer

    2016-01-01

    This study aims to examine the rates of self-reported contacts with the criminal justice system among homeless adults with mental illness, to identify the characteristics of participants who have had contacts with the criminal justice system, to report the dimensional structure of criminal justice system involvement in this sample, and to identify typologies of justice-involved participants. Self-report data on criminal justice system involvement of 2221 adults participating in a Canadian Housing First trial were analyzed using multiple correspondence and cluster analysis. Almost half of the participants had at least one contact with the criminal justice system in the 6months prior to study enrollment. Factors associated with justice involvement included age, gender, ethnic background, diagnosis, substance misuse, impulse control, compliance, victimization, service use, and duration of homelessness. A typology of criminal justice involvement was developed. Seven criminal justice system involvement profiles emerged; substance use and impulse control distinguished the clusters, whereas demographic and contextual variables did not. The large number of profiles indicates the need for a diverse and flexible range of interventions that could be integrated within or in addition to current support of housing services, including integrated substance use and mental health interventions, risk management strategies, and trauma-oriented services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Oscillating in and out of place: Experiences of older adults residing in homeless shelters in Montreal, Quebec.

    Science.gov (United States)

    Burns, Victoria F

    2016-12-01

    Aging in place is desirable from the perspective of older adults and policy makers alike. However, the meaning of 'place' for adults experiencing homelessness has been largely overlooked. Addressing this gap, this constructivist grounded theory study discusses the meaning of place for 15 older adults residing in emergency homeless shelters in Montreal, Quebec. Findings revealed that four interrelated dimensions of place-that is, control, comfort, privacy, and security were instrumental in supporting participants' ability to feel in place across housed-homeless trajectories. Many felt out of place well before they lost their housing and some felt more in place during homelessness when shelter conditions and interpersonal relations supported these four dimensions. The empirically-driven model oscillating in and out of place extends and nuances existing understandings of aging in place and provides insights into policy and practice solutions for older adults who may not have a stable place to call home. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Monetary Incentives to Reinforce Engagement and Achievement in a Job-Skills Training Program for Homeless, Unemployed Adults

    Science.gov (United States)

    Koffarnus, Mikhail N.; Wong, Conrad J.; Fingerhood, Michael; Svikis, Dace S.; Bigelow, George E.; Silverman, Kenneth

    2013-01-01

    The current study examined whether monetary incentives could increase engagement and achievement in a job-skills training program for unemployed, homeless, alcohol-dependent adults. Participants (n?=?124) were randomized to a no-reinforcement group (n?=?39), during which access to the training program was provided but no incentives were given; a…

  10. The effect of victimization, mental health, and protective factors on crime and illicit drug use among homeless young adults.

    Science.gov (United States)

    Tyler, Kimberly A; Kort-Butler, Lisa A; Swendener, Alexis

    2014-01-01

    Although research has found high rates of child maltreatment, widespread victimization, and other negative outcomes among homeless youth and young adults, resiliency among this population has largely been understudied. Specifically, a gap remains in terms of how protective factors such as self-efficacy, low deviant beliefs, and religiosity operate among homeless youth and young adults. The purpose of this study is to examine the relationship between various forms of victimization, mental health, and protective factors with property and violent crime and illicit drug use among homeless young adults. Results from regression analyses indicate that running away from home more frequently, experiencing more physical victimization on the street, higher levels of self-efficacy, and more deviant beliefs were associated with greater property crime. Significant correlates of violent crime included being male, running away from home more frequently, greater sexual and physical victimization on the street, higher levels of self-efficacy, and more deviant beliefs. Finally, being male, running away more frequently from home, greater child physical abuse and partner victimization, and more deviant beliefs were all associated with greater illicit drug use. Self-efficacy was positively related to both property and violent crime, suggesting that it may not operate for homeless young adults in the same manner as it does for normative populations.

  11. Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults.

    Science.gov (United States)

    Nyamathi, Adeline; Liu, Yihang; Marfisee, Mary; Shoptaw, Steven; Gregerson, Paul; Saab, Sammy; Leake, Barbara; Tyler, Darlene; Gelberg, Lillian

    2009-01-01

    Hepatitis B virus (HBV) infection constitutes a major health problem for homeless persons. Ability to complete an HBV vaccination series is complicated by the need to prioritize competing needs, such as addiction issues, safe places to sleep, and food, over health concerns. The objectives of this study were to evaluate the effectiveness of a nurse-case-managed intervention compared with that of two standard programs on completion of the combined hepatitis A virus (HAV) and HBV vaccine series among homeless adults and to assess sociodemographic factors and risk behaviors related to the vaccine completion. A randomized, three-group, prospective, quasi-experimental design was conducted with 865 homeless adults residing in homeless shelters, drug rehabilitation sites, and outdoor areas in the Skid Row area of Los Angeles. The programs included (a) nurse-case-managed sessions plus targeted hepatitis education, incentives, and tracking (NCMIT); (b) standard targeted hepatitis education plus incentives and tracking (SIT); and (c) standard targeted hepatitis education and incentives only (SI). Sixty-eight percent of the NCMIT participants completed the three-series vaccine at 6 months, compared with 61% of SIT participants and 54% of SI participants. NCMIT participants had almost 2 times greater odds of completing vaccination than those of participants in the SI program. Completers were more likely to be older, to be female, to report fair or poor health, and not to have participated in a self-help drug treatment program. Newly homeless White adults were significantly less likely than were African Americans to complete the vaccine series. The use of vaccination programs incorporating nurse case management and tracking is critical in supporting adherence to completion of a 6-month HAV/HBV vaccine. The finding that White homeless persons were the least likely to complete the vaccine series suggests that programs tailored to address their unique cultural issues are needed.

  12. Social Support and Housing Transitions Among Homeless Adults With Serious Mental Illness and Substance Use Disorders.

    Science.gov (United States)

    Gabrielian, Sonya; Young, Alexander S; Greenberg, Jared M; Bromley, Elizabeth

    2016-08-22

    Objective: Research suggests that social supports are associated with housing retention among adults who have experienced homelessness. Yet, we know very little about the social support context in consumers find and retain housing. We examined the ways and identified the junctures in which consumers' skills and deficits in accessing and mobilizing social supports influenced their longitudinal housing status. Method: We performed semi-structured qualitative interviews with VA Greater Los Angeles consumers ( n = 19) with serious mental illness, substance use disorders, and a history of homelessness; interviews explored associations between longitudinal housing status (categorized as: stable, independent housing; sheltered housing, continually engaged in structured housing programs; and unstable housing) and social supports. We compared data from consumers in these 3 mutually exclusive categories. Results: All participants described social support as important for finding and maintaining housing. However, participants used formal (provider/case managers) and informal (family/friends) supports in different ways. Participants in stable housing relied on formal and informal supports to obtain/maintain housing. Participants in sheltered housing primarily used formal supports, for example, case management staff. Unstably housed participants used formal and informal supports, but some of these relationships were superficial or of negative valence. Interpersonal problems were prevalent across longitudinal housing status categories. Conclusions and Implications for Practice: Social context, including patterns of formal and informal support, was associated with participants' longitudinal housing status. Within interventions to end homelessness, these findings suggest the value of future research to identify, tailor, and implement practices that can help consumers improve their social resources. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  13. Predictors of Retention in an Alcohol and Risky Sex Prevention Program for Homeless Young Adults.

    Science.gov (United States)

    Pedersen, Eric R; Ewing, Brett A; D'Amico, Elizabeth J; Miles, Jeremy N V; Haas, Ann C; Tucker, Joan S

    2018-05-01

    Homeless young adults are at risk for alcohol and other drug (AOD) use and risky sexual behavior. Interventions are needed to help these young people reduce their risky behavior, but this population is often difficult to engage and retain in services. We offered a four-session AOD and risky sex reduction program to 100 participants and examined if retention in the program was predicted by a number of factors: demographics, homelessness severity, other service use, AOD behaviors, mental health symptoms, sexual risk behaviors, and readiness to change AOD and condom use. Nearly half (48%) of participants completed all sessions. In bivariate analyses, participants were significantly less likely to be retained in the program if they had slept outdoors in the past month, engaged in more alcohol and marijuana use, experienced more alcohol-related consequences, and received the program in an urban drop-in center (as opposed to a drop-in center near the beach). When controlling for all significant bivariate relationships, only sleeping outdoors and receipt of the program in the urban setting predicted fewer sessions completed. The most endorsed reasons for program non-completion were being too busy to attend and inconvenient day/time of the program. Findings can help outreach staff and researchers better prepare methods to engage higher risk homeless youth and retain them in services. Finding unique ways to help youth overcome barriers related to location of services appears especially necessary, perhaps by bringing services to youth where they temporarily reside or offering meaningful incentives for program attendance.

  14. Healthcare barriers among severely mentally ill homeless adults: evidence from the five-site health and risk study.

    Science.gov (United States)

    Kim, Mimi M; Swanson, Jeffrey W; Swartz, Marvin S; Bradford, Daniel W; Mustillo, Sarah A; Elbogen, Eric B

    2007-07-01

    Few studies have examined barriers to physical and mental healthcare among homeless mentally adults. This study examined physical and mental healthcare barriers reported by 154 recently homeless mentally ill persons. Practical concerns (e.g. transportation and cost) were key components of barriers to accessing general medical care among uninsured men with poorer overall mental health, PTSD, and STD infections. Perceived stigma was an important component of mental healthcare barriers reported most frequently by those with greater psychiatric symptoms. Focusing on individual characteristics underlying barriers to healthcare may lead to better interventions for improving access to needed care.

  15. Is Shared Housing a Way to Reduce Homelessness? The Effect of Household Arrangements on Formerly Homeless People

    OpenAIRE

    He, Yinghua; O’Flaherty, Brendan; Rosenheck, Robert A.

    2010-01-01

    Most single adults share housing with other adults, and living alone is considerably more expensive than living with someone else. Yet policies that discourage shared housing for formerly homeless people or people at risk of becoming homeless are common, and those that encourage it are rare. This would be understandable if such housing adversely affected its users in some way. We ask whether shared housing produces adverse effects. Our provisional answer is no. For the most part, whether a pe...

  16. Does stimulant use impair housing outcomes in low-demand supportive housing for chronically homeless adults?

    Science.gov (United States)

    Edens, Ellen L; Tsai, Jack; Rosenheck, Robert A

    2014-01-01

    Recent research suggests low-demand housing (i.e., not contingent upon abstinence) is effective in helping people exit homelessness, even among recent active substance users. Whether active users of illicit drugs and stimulants have worse housing outcomes than primary alcohol users, however, is unknown. A total of 149 participants in a multisite supportive housing program who reported high levels of active substance use at program entry were classified as either (1) predominantly "Alcohol Use" (>10 of 30 days alcohol, but not >10 days of drug use) or (2) "Illicit Drug Use" (>10 of 30 days any single illicit drug use with or without alcohol use). Sub-analysis of the "Illicit Drug Use" group compared participants reporting high levels of "Stimulant Use" (>10 days cocaine, crack, or methamphetamine use) to those with high levels of "Non-stimulant Use" (>10 days marijuana or other non-stimulant drug use). Group differences in housing outcomes were examined with mixed model multivariate regression. During 24-month follow-up, days housed increased dramatically for both the "Alcohol Use" and the "Illicit Drug Use" groups without significant differences. Sub-analysis of illicit drug users showed stimulant use was associated with fewer days housed (p = .01) and more days homeless (p = .02) over time. Among illicit drug users, stimulant users have somewhat less successful housing outcomes than other active drug and alcohol users, though both groups maintained substantial housing improvements in low-demand housing. © American Academy of Addiction Psychiatry.

  17. Discrepancies in reporting of physical and sexual abuse among homeless young adults.

    Science.gov (United States)

    Tyler, Kimberly A; Melander, Lisa A

    2009-09-01

    This study investigated risk factors for discrepant reporting of physical and sexual abuse among 172 homeless young adults. Discrepant reporting includes situations in which a respondent denies experiencing abuse in general but reports being a victim of specific forms of maltreatment. The results revealed that discrepant reporting rates tended to be highest for minor physical assault and for noncontact sexual abuse. Multivariate results revealed that demographic characteristics were important correlates of both discrepant physical and sexual abuse reporters. Family background characteristics also played a role in discrepant reporting for physical abuse. Overall, some young people with abuse histories are not adequately labeling their maltreatment experiences and, as a result, may not be receiving the necessary treatment.

  18. Assessing criminal history as a predictor of future housing success for homeless adults with behavioral health disorders.

    Science.gov (United States)

    Malone, Daniel K

    2009-02-01

    Homeless adults with serious mental illnesses and chronic substance abuse problems have few housing options, a problem compounded when a criminal background is present. This study compared the criminal backgrounds and other characteristics of homeless individuals who succeeded in housing (retained housing continuously for two years) and those who failed in housing. The study population consisted of homeless adults with behavioral health disorders who moved into supportive housing between January 1, 2000, and June 30, 2004, regardless of criminal background. Data about criminal history and other characteristics were extracted from existing records and analyzed for associations with housing success. Chi square tests and logistic regression analysis were used to find characteristics predictive of subsequent housing success or failure. Data were available for 347 participants. Most (51%) had a criminal record, and 72% achieved housing success. The presence of a criminal background did not predict housing failure. Younger age at move-in, the presence of a substance abuse problem, and higher numbers of drug crimes and property crimes were separately associated with more housing failure; however, when they were adjusted for each of the other variables, only move-in age remained associated with the outcome. The finding that criminal history does not provide good predictive information about the potential for housing success is important because it contradicts the expectations of housing operators and policy makers. The findings suggest that policies and practices that keep homeless people with criminal records out of housing may be unnecessarily restrictive.

  19. Housing First for older homeless adults with mental illness: a subgroup analysis of the At Home/Chez Soi randomized controlled trial.

    Science.gov (United States)

    Chung, Timothy E; Gozdzik, Agnes; Palma Lazgare, Luis I; To, Matthew J; Aubry, Tim; Frankish, James; Hwang, Stephen W; Stergiopoulos, Vicky

    2018-01-01

    This study compares the effect of Housing First on older (≥50 years old) and younger (18-49 years old) homeless adults with mental illness participating in At Home/Chez Soi, a 24-month multisite randomized controlled trial of Housing First. At Home/Chez Soi, participants (n = 2148) were randomized to receive rent supplements with intensive case management or assertive community treatment, based on their need level for mental health services, or usual care in their respective communities. A subgroup analysis compared older (n = 470) and younger (n = 1678) homeless participants across baseline characteristics and 24-month outcomes including housing stability (primary outcome), generic and condition-specific quality of life, community functioning, physical and mental health status, mental health symptom severity, psychological community integration, recovery, and substance use (secondary outcomes). At 24 months, Housing First significantly improved the percentage of days stably housed among older (+43.9%, 95% confidence interval [CI]: 38.4% to 49.5%) and younger homeless adults (+39.7%, 95% CI: 36.8% to 42.6%), compared with usual care, with no significant differences between age groups (difference of differences = +4.2%, 95% CI: -2.1% to 10.5%, p = 0.188). Improvements from baseline to 24 months in mental health and condition-specific quality of life were significantly greater among older homeless adults than among younger homeless adults. Housing First significantly improved housing stability among older and younger homeless adults with mental illness, resulting in superior mental health and quality of life outcomes in older homeless adults compared with younger homeless adults at 24 months. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Childhood Adversities Associated with Poor Adult Mental Health Outcomes in Older Homeless Adults: Results From the HOPE HOME Study.

    Science.gov (United States)

    Lee, Chuan Mei; Mangurian, Christina; Tieu, Lina; Ponath, Claudia; Guzman, David; Kushel, Margot

    2017-02-01

    To examine whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization. History of seven childhood adversities (physical neglect, verbal abuse, physical abuse, sexual abuse, parental death, parental incarceration, and child welfare system placement) was gathered through in-person interviews. Multivariate models examined associations between history of childhood adversities and moderate to severe depressive symptoms, lifetime history of suicide attempt, or lifetime history of psychiatric hospitalization. The study enrolled 350 homeless adults, aged 50 and older, in Oakland, California, using population-based sampling methods. Moderate to severe depressive symptoms were measured on a Center for Epidemiologic Studies-Depression Scale (≥22), self-reported lifetime history of suicide attempt, and self-reported lifetime history of psychiatric hospitalization. Participants with exposure to one childhood adversity had elevated odds of reporting moderate to severe depressive symptoms (adjusted odds ratio [AOR]: 2.0; 95% confidence interval [CI]: 1.1-3.7) and lifetime history of suicide attempt (AOR: 4.6; 95% CI: 1.0-21.6) when compared with those who had none; the odds of these two outcomes increased with exposure to additional childhood adversities. Participants with four or more childhood adversities had higher odds of having a lifetime history of psychiatric hospitalization (AOR: 7.1; 95% CI: 2.8-18.0); no increase with fewer adversities was found. Childhood adversities are associated with poor mental health outcomes among older homeless adults. Clinicians should collect information about childhood adversities among this high-risk population to inform risk assessment and treatment recommendations. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  1. Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment.

    Science.gov (United States)

    Riley, Elise D; Cohen, Jennifer; Dilworth, Samantha E; Grimes, Barbara; Marquez, Carina; Chin-Hong, Peter; Philip, Susan S

    2016-06-01

    The social context of poverty is consistently linked to Trichomonas vaginalis infection, yet few studies regarding T. vaginalis have been conducted exclusively among low-income individuals. We identified social determinants of health associated with prevalent T. vaginalis infection among homeless and unstably housed adult women. Between April and October of 2010, we conducted cross-sectional T. vaginalis screening and behavioural interviews in an existing cohort of San Francisco homeless and unstably housed women. Data were analysed using multivariable logistical regression. Among 245 study participants, the median age was 47 years and 72% were of non-Caucasian race/ethnicity. T. vaginalis prevalence was 12%, compared to 3% in the general population, and 33% of infected individuals reported no gynaecological symptoms. In adjusted analysis, the odds of T. vaginalis infection were lower among persons older than 47 years, the population median (OR=0.14, 95% CI 0.04 to 0.38), and higher among those reporting recent short-term homeless shelter stays (OR=5.36, 95% CI 1.57 to 18.26). Race and income did not reach levels of significance. Sensitivity analyses indicated that testing all women who report recent unprotected sex would identify more infections than testing those who report gynaecological symptoms (20/30 vs 10/30; p=0.01). The prevalence of T. vaginalis is high among homeless and unstably housed adult women, over one-third of infected individuals have no gynaecological symptoms, and correlates of infection differ from those reported in the general population. Targeted screening and treatment among impoverished women reporting recent unprotected sex, particularly young impoverished women and all women experiencing short-term homelessness, may reduce complications related to this treatable infection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Dietary intake, nutritional status and mental wellbeing of homeless adults in Reading, UK

    OpenAIRE

    Fallaize, Rosalind; Seale, J. V.; Mortin, Charlotte; Armstrong, L.; Lovegrove, Julie A.

    2017-01-01

    Malnutrition has been reported in the homeless, yet the specific nutritional issues faced by each homeless community are unclear. This is in part due to nutrient intake often being compared with dietary reference values as opposed to a comparative housed population. In addition, the complex interplay between nutrient intake, reward mediated behaviour and mental illness is frequently overlooked. This study aimed to compare the dietary intake, nutritional status and mental wellbeing of homeless...

  3. One-year housing arrangements among homeless adults with serious mental illness in the ACCESS program.

    Science.gov (United States)

    Mares, Alvin S; Rosenheck, Robert A

    2004-05-01

    This study examined the various living arrangements among formerly homeless adults with mental illness 12 months after they entered case management. The study surveyed 5,325 clients who received intensive case management services in the Access to Community Care and Effective Services and Supports (ACCESS) program. Living arrangements 12 months after program entry were classified into six types on the basis of residential setting, the presence of others in the home, and stability (living in the same place for 60 days). Differences in perceived housing quality, unmet housing needs, and overall satisfaction were compared across living arrangements by using analysis of covariance. One year after entering case management, 37 percent of clients had been independently housed during the previous 60 days (29 percent lived alone in their own place and 8 percent lived with others in their own place), 52 percent had been dependently housed during the previous 60 days (11 percent lived in someone else's place, 10 percent lived in an institution, and 31 percent lived in multiple places), and 11 percent had literally been homeless during the previous 60 days. Clients with less severe mental health and addiction problems at baseline and those in communities that had higher social capital and more affordable housing were more likely to become independently housed, to show greater clinical improvement, and to have greater access to housing services. After the analysis adjusted for potentially confounding factors, independently housed clients were more satisfied with life overall. However, no significant association was found between specific living arrangements and either perceived housing quality or perceived unmet needs for housing. Living independently was positively associated with satisfaction of life overall, but it was not associated with the perception that the quality of housing was better or that there was less of a need for permanent housing.

  4. The New Vagabonds? Homelessness Outside the Megalopolis.

    Science.gov (United States)

    Huff, Dan; Johnson, David

    This paper reports results of a survey of 47 homeless adults, interviewed in Ada County, Idaho. Most respondents were male, white, currently single, with no religious preference. The mean number of years of formal education was 11.6. Seventeen percent of the sample were American Indians. Ninety-three percent were unemployed. Twenty-five percent of…

  5. Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review.

    Science.gov (United States)

    Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

    2016-09-01

    During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs.

  6. Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review

    Science.gov (United States)

    Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

    2016-01-01

    During the United States economic recession of 2008–2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs. PMID:28042394

  7. Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey.

    Science.gov (United States)

    Khandor, Erika; Mason, Kate; Chambers, Catharine; Rossiter, Kate; Cowan, Laura; Hwang, Stephen W

    2011-01-01

    Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of homeless adults in Toronto, Canada. Homeless adults were recruited from shelter and meal programs in downtown Toronto between November 2006 and February 2007. Cross-sectional data were collected on demographic characteristics, health status, health determinants and access to health care. We used multivariable logistic regression analysis to investigate the association between having a family doctor as the usual source of health care (an indicator of access to primary care) and health status, proof of health insurance, and substance use after adjustment for demographic characteristics. Of the 366 participants included in our study, 156 (43%) reported having a family doctor. After adjustment for potential confounders and covariates, we found that the odds of having a family doctor significantly decreased with every additional year spent homeless in the participant's lifetime (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.97). Having a family doctor was significantly associated with being lesbian, gay, bisexual or transgendered (adjusted OR 2.70, 95% CI 1.04-7.00), having a health card (proof of health insurance coverage in the province of Ontario) (adjusted OR 2.80, 95% CI 1.61-4.89) and having a chronic medical condition (adjusted OR 1.91, 95% CI 1.03-3.53). Less than half of the homeless people in Toronto who participated in our study reported having a family doctor. Not having a family doctor was associated with key indicators of health care access and health status, including increasing duration of

  8. Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study.

    Science.gov (United States)

    Hurstak, Emily; Johnson, Julene K; Tieu, Lina; Guzman, David; Ponath, Claudia; Lee, Christopher T; Jamora, Christina Weyer; Kushel, Margot

    2017-09-01

    We evaluated cognitive function and factors associated with cognitive impairment in a cohort of older homeless adults. We hypothesized that substance use and a history of traumatic brain injury would be associated with cognitive impairment. We recruited 350 homeless individuals aged ≥50 years using population-based sampling and conducted structured interviews and neuropsychological testing. We evaluated alcohol use with the Alcohol Use Disorder Identification Test, defining high-severity alcohol use as a total score ≥16 or ≥4 on the alcohol dependency sub-scale. We assessed global cognition with the Modified Mini-Mental State Test (3MS) and processing speed and executive function with the Trail Making Test (TMTB), defining impairment as performing 1.5 standard deviations below the standardized mean. We used multivariable logistic regression to examine the association between alcohol use and cognition. Participants had a median age of 58 years [IQR 54-61], 76.7% were men, and 79.9% were African American. A quarter (25.1%) of participants met criteria for impairment on the 3MS; 32.9% met criteria for impairment on TMTB. In models adjusted for sociodemographic variables and health conditions, high-severity alcohol use was associated with global cognitive impairment (AOR 2.39, CI 1.19-4.79) and executive dysfunction (AOR 3.09, CI 1.61-5.92). Older homeless adults displayed a prevalence of cognitive impairment 3-4 times higher than has been observed in general population adults aged 70 and older. Impaired cognition in older homeless adults could impact access to housing programs and the treatment of health conditions, including the treatment of alcohol use disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.

    Science.gov (United States)

    Chambers, Catharine; Katic, Marko; Chiu, Shirley; Redelmeier, Donald A; Levinson, Wendy; Kiss, Alex; Hwang, Stephen W

    2013-12-01

    We identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. We recruited participants from shelters and meal programs. We then linked them to administrative databases to capture hospital admissions during the study (2005-2009). We used logistic regression to identify predictors of medical or surgical and psychiatric hospitalizations. Among 1165 homeless adults, 20% had a medical or surgical hospitalization, and 12% had a psychiatric hospitalization during the study. These individuals had a total of 921 hospitalizations, of which 548 were medical or surgical and 373 were psychiatric. Independent predictors of medical or surgical hospitalization included birth in Canada, having a primary care provider, higher perceived external health locus of control, and lower health status. Independent predictors of psychiatric hospitalization included being a current smoker, having a recent mental health problem, and having a lower perceived internal health locus of control. Being accompanied by a partner or dependent children was protective for hospitalization. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.

  10. A group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among homeless young adults.

    Science.gov (United States)

    Tucker, Joan S; D'Amico, Elizabeth J; Ewing, Brett A; Miles, Jeremy N V; Pedersen, Eric R

    2017-05-01

    Homeless young adults ages 18-25 exhibit high rates of alcohol and other drug (AOD) use, and sexual risk behaviors such as unprotected sex. Yet few programs exist for this population that are both effective and can be easily incorporated into settings serving this population. This pilot cluster cross-over randomized controlled trial evaluates AWARE, a voluntary four session group-based motivational interviewing (MI) intervention to reduce AOD use and sexual risk behavior. We evaluated AWARE with 200 homeless young adults using drop-in center services in Los Angeles County (mean age=21.8years; 73% male; 79% heterosexual; 31% non-Hispanic White, 25% African American, 24% Hispanic, 21% multiracial/other). Surveys were completed at baseline and three months after program completion. Retention in the AWARE program was excellent (79% attended multiple sessions) and participants reported high levels of satisfaction with the program. AWARE participants self-reported positive change in their past 3month and past 30day alcohol use (ps≤0.05), motivation to change drug use (psintervention can be effective in helping homeless young adults make positive changes in their alcohol and condom use. Further work is needed to more fully evaluate the efficacy of AWARE on AOD behavior and sexual risk behavior outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Implementing nutrition guidelines that will benefit homeless people.

    Science.gov (United States)

    Kinder, Hazel

    The nutritional status of single adult homeless people is often overlooked, with many of the homeless population being malnourished due to a variety of reasons. This paper looks at the government's policies relating to nutrition and at the current research concerning home-lessness and diet. It also offers various strategies for improving the nutritional intake and status of this client group. It discusses the issues surrounding the use of dietary supplements, ways to minimise the risk of misuse, and highlights possible alternatives. A guideline has been devised with the specific aim of identifying people who are at risk of malnutrition within hostels.

  12. Homelessness and neuropsychological impairment: preliminary analysis of adults entering outpatient psychiatric treatment.

    Science.gov (United States)

    Bousman, Chad A; Twamley, Elizabeth W; Vella, Lea; Gale, Maiken; Norman, Sonya B; Judd, Patricia; Everall, Ian P; Heaton, Robert K

    2010-11-01

    Homelessness has been associated with neuropsychological (NP) impairment, but few studies have adequately controlled for factors known to affect NP performance. We performed brief NP testing examining learning, recall, processing speed, executive functioning, and verbal fluency in 50 ever- and 22 never-homeless persons entering outpatient psychiatric treatment. Groups were matched a priori on key demographic, substance use, psychiatric, and premorbid intelligence quotient characteristics. Rates of NP impairment were high among both groups (46%-54%). There were no significant differences in global NP impairment. There were trends toward better levels of processing speed and executive functioning among never-homeless relative to ever-homeless. Among the ever-homeless group, NP test performance was unrelated to number of homelessness episodes (median 3). Findings confirm high prevalence of NP impairment among homeless individuals but provide little evidence for broad NP differences between ever- and never-homeless persons matched for coexisting conditions that have confounded interpretation of previous results in the literature.

  13. Poor Parenting and Antisocial Behavior among Homeless Young Adults: Links to Dating Violence Perpetration and Victimization

    Science.gov (United States)

    Tyler, Kimberly A.; Melander, Lisa A.

    2012-01-01

    Though research has examined risk factors associated with street victimization among homeless young people, little is known about dating violence experiences among this group. Given homeless youths' elevated rates of child maltreatment, it is likely that they are at high risk for dating violence. As such, the current study examined the association…

  14. The high burden of traumatic brain injury and comorbidities amongst homeless adults with mental illness.

    Science.gov (United States)

    Topolovec-Vranic, Jane; Schuler, Andree; Gozdzik, Agnes; Somers, Julian; Bourque, Paul-Émile; Frankish, C James; Jbilou, Jalila; Pakzad, Sarah; Palma Lazgare, Luis Ivan; Hwang, Stephen W

    2017-04-01

    characterize the prevalence of self-reported head injury with loss of consciousness (LOC) and associated demographic, clinical and service use factors in a sample of homeless adults with mental illness. Participants in the At Home/Chez Soi study were interviewed at the time of study enrollment regarding their history of head injuries, mental and physical health diagnoses and justice system and healthcare interactions. Sociodemographic and clinical data were also collected. Over half of the 2088 study respondents (52.6%, n = 1098) reported a history of head injury with a LOC, which was associated with several demographic, clinical and service use variables in this population. With respect to specific mental health conditions, a history of head injury with LOC was associated with higher odds of current depression (OR = 2.18, CI: 1.83-2.60), manic episode or hypomanic episode (OR = 1.91, CI: 1.45-2.50), PTSD (OR = 2.98, CI: 2.44-3.65), panic disorder (OR = 2.37, CI:1.91-2.93), mood disorder (OR = 1.78, CI: 1.40-2.26) and alcohol (OR = 2.09, CI: 1.75-2.49) and drug (OR = 1.73, CI: 1.46-2.06) misuse disorders, but reduced odds of having diagnosis of a psychotic disorder (OR = 0.63, CI: 0.53-0.76). A history of head injury with LOC was also associated with increased use of variety of services, including family medicine (OR = 1.33, CI: 1.12-1.59), criminal justice system (OR = 1.50, CI: 1.25-1.80) and the emergency department (OR = 1.03, CI: 1.01-1.05). Amongst homeless adults with mental illness having a history of head injuries with LOC was independently associated with various adverse outcomes. These individuals constitute a high-risk group who may benefit from specialized services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Why does family homelessness occur? A case-control study.

    Science.gov (United States)

    Bassuk, E L; Rosenberg, L

    1988-07-01

    We compared 49 homeless female-headed families with 81 housed female-headed families in Boston. Most housed families were living in public or private subsidized housing. In both groups the mothers were poor, currently single, had little work experience, and had been on welfare for long periods. Many of their children had serious developmental and emotional problems. Homeless mothers had more frequently been abused as children and battered as adults and their support networks were fragmented; the housed mothers had female relatives and extended family living nearby whom they saw often. The frequency of drug, alcohol, and serious psychiatric problems was greater among the homeless mothers. The homeless mothers may have been more vulnerable to the current housing shortage because they lacked support in time of need. This, in turn, may have been due to their history of family violence. Psychiatric disabilities may have been another contributing factor in the minority of homeless women. The notion that a "culture of poverty" accounts for homelessness was not supported by the data since the homeless were less likely to have grown up in families on welfare. The data suggest that solutions to family homelessness in the current housing market require an increase in the supply of decent affordable housing, income maintenance, and assistance from social welfare agencies focused on rebuilding supportive relationships.

  16. How do Housing Subsidies Improve Quality of Life Among Homeless Adults? A Mediation Analysis.

    Science.gov (United States)

    O'Connell, Maria; Sint, Kyaw; Rosenheck, Robert

    2018-03-01

    Supported housing, combining rent subsidies with intensive case management, is associated with improvements in quality of life of homeless adults, but factors mediating their impact on quality of life have not been studied. Twelve-month outcome data from a randomized trial of the Housing and Urban Development- Veterans Affairs Supported Housing program (HUD-VASH) showed that access to a housing rent subsidy plus intensive case management (ICM) was associated with greater improvement in subjective quality of life than ICM alone. Multiple mediation analyses were applied to identify variables that significantly mediated the relationship between receipt of housing voucher and improvements in quality of life. Significant mediating covariates were those whose 95% bias-corrected confidence intervals, when added to the model predicting improvement in quality of life, did not overlap zero. Increases in the number of days housed, size of social network, and availability of emotional support appear to mediate improvement in quality of life and account for 71% of the benefit attributable to having a rent subsidy. Improvement in subjective quality of life though housing subsidies is mediated by gains in both material and psychosocial factors. Mediating factors deserve special attention in supported housing services. © Society for Community Research and Action 2018.

  17. Predictors of criminal justice system trajectories of homeless adults living with mental illness.

    Science.gov (United States)

    Roy, Laurence; Crocker, Anne G; Nicholls, Tonia L; Latimer, Eric; Isaak, Corinne A

    This study examines whether baseline profiles of criminal justice involvement are independently associated with 24-month trajectories of arrests in a sample of homeless adults living with mental illness. Interviews with justice-involved participants from the At Home/Chez soi project, a multisite trial of Housing First in Canada, yielded information related to arrests, as well as demographic, clinical, and contextual predictors of criminal justice system involvement. All potential predictors were entered into logistic and negative binomial regression models to assess their effect on re-arrest. Of the 584 individuals involved with the criminal justice system at baseline, and for whom follow-up data was obtained, 347 (59%) were re-arrested within two years. Of those, 283 (82%) had an episodic pattern of re-arrest and 64 (18%) had a continuous trajectory of re-arrest. Results indicate that participants involved with the legal system for minor (mostly theft and public order) offenses at baseline were most likely to be repeatedly arrested. Gender, Aboriginal status, and recent victimization were also independently associated with re-arrest. These findings have implications for the delivery of police and clinical services alike, as well as for policies that aim to divert vulnerable individuals who commit minor crimes from a long-term trajectory of justice involvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. The perceptions of homeless people regarding their healthcare needs and experiences of receiving health care.

    Science.gov (United States)

    Rae, Bernadette Emma; Rees, Sharon

    2015-09-01

    To understand the perspective of the homeless about their healthcare encounters and how their experiences of receiving healthcare influence their health-seeking behaviour. A phenomenological study was undertaken because of the increasing levels of homelessness in the United Kingdom. Most of the current literature is American or Canadian. An interpretive phenomenological inquiry. An opportunistic sample of fourteen single homeless adults was recruited from one male hostel and one non-residential day centre. Data collection was done in 2013. Semi-structured audio-recorded interviews were conducted one-to-one. Colaizzi's method for data analysis was used. Three major themes were identified. Expressed Health Need, Healthcare Experiences and Attitudes to health care. Health problems are recognized by the homeless but the need for intervention is not always prioritised. Obstacles in access to health care in the UK are both perceived (attitudes towards the homeless; previous bad experience) and actual (difficulty in registering with a general practitioner, difficulty travelling to services, being forced to move to new area). Some homeless people feel that they are treated with prejudice and receive substandard care. Positive healthcare experiences were also reported. Positive and negative healthcare encounters can profoundly affect the homeless. Address apparent inconsistency of care; promote greater interdisciplinary communication and referrals to homeless services from prisons and hospitals; increase the availability of intermediate services; reduce obligation of homeless to move area; research experiences of homeless families. © 2015 John Wiley & Sons Ltd.

  19. The individual and beyond: a socio-rational choice model of service participation among homeless adults with substance abuse problems.

    Science.gov (United States)

    Sosin, Michael R; Grossman, Susan F

    2003-01-01

    While substance user service programs can help homeless adults solve their substance use and housing problems, relatively few needy individuals use and complete these programs. The lack of participation is poorly explained by typical empirical studies, most of which consider the role in service participation of various personal traits and client problems. The current article instead seeks to explain service participation through the application of an alternative, "socio-rational choice" model. This model has three premises: Clients weigh the costs and benefits of participating in services against alternative uses of their time and resources. The clients' weighing procedures reflect their personal situations and perceptions of the treatment environment. The perceptions of their personal situations and perceptions of the treatment environment are affected by the manner in which clients react to representatives of service systems, members of their social network including both housed and homeless persons, and other individuals. Secondary evidence supports many of the model's hypotheses and generally suggests that homeless clients may be heavily affected by their experiences with individuals and systems with which they come into contact.

  20. The neighborhood context of homelessness.

    Science.gov (United States)

    Alexander-Eitzman, Ben; Pollio, David E; North, Carol S

    2013-04-01

    We examined and compared the changing neighborhood characteristics of a group of homeless adults over time. We collected the addresses of previous housing and sleep locations from a longitudinal study of 400 homeless adults in the St. Louis, Missouri, region and compared census measures of housing and economic opportunities at different points along individual pathways from housing to homelessness and at 1- and 2-year follow-up interviews. Sleep locations of homeless adults were much more concentrated in the urban core at baseline than were their previous housed and follow-up locations. These core areas had higher poverty, unemployment, and rent-to-income ratios and lower median incomes. The spatial concentration of homeless adults in areas with fewer opportunities and more economic and housing distress may present additional barriers to regaining stable housing and employment. A big-picture spatial and time-course viewpoint is critical for both policymakers and future homelessness researchers.

  1. Becoming and remaining homeless: a qualitative investigation.

    Science.gov (United States)

    Morrell-Bellai, T; Goering, P N; Boydell, K M

    2000-09-01

    This article reports the qualitative findings of a multimethod study of the homeless population in Toronto, Canada. The qualitative component sought to identify how people become homeless and why some individuals remain homeless for an extended period of time or cycle in and out of homelessness (the chronically homeless). In-depth, semistructured interviews were conducted with 29 homeless adults. The findings suggest that people both become and remain homeless due to a combination of macro level factors (poverty, lack of employment, low welfare wages, lack of affordable housing) and personal vulnerability (childhood abuse or neglect, mental health symptoms, impoverished support networks, substance abuse). Chronically homeless individuals often reported experiences of severe childhood trauma and tended to attribute their continued homelessness to a substance abuse problem. It is concluded that both macro and individual level factors must be considered in planning programs and services to address the issue of homelessness in Canada.

  2. Lung Cancer in Homeless People: Clinical Outcomes and Cost Analysis in a Single Institute

    Directory of Open Access Journals (Sweden)

    Koung Jin Suh

    2016-01-01

    Full Text Available Introduction. To characterize the demographic and clinical features, outcomes, and treatment costs of lung cancer in homeless people. Methods. Medical records of 22 homeless patients with lung cancer at Seoul National University Boramae Medical Center in Seoul, South Korea, were retrospectively analyzed. Results. All patients were men (median age, 62 years. Most patients (78% had advanced disease (stage IIIB, n=2; stage IV, n=15. Seven died during initial hospitalization (median survival, 1.5 months. Six were lost to follow-up after initial outpatient visits or discharges from initial admission (median follow-up, 13 days. Only 4 received appropriate treatment for their disease and survived for 1, 15, 19, and 28 months, respectively. Conversely, 4 of 5 patients with early stage disease (stage I, n=4; stage IIA, n=1 received curative surgery (median follow-up 25.5 months. The median treatment cost based on 29 days of hospitalization and 2 outpatient visits was $12,513, constituting 47.3% of the 2013 per capita income. Inpatient treatment accounted for 90% of the total costs. The National Health Insurance Service paid 82% of the costs. Conclusion. Among the homeless, lung cancer seems to be associated with poor prognosis and substantial costs during a relatively short follow-up and survival period.

  3. Are the mentally ill homeless a distinct homeless subgroup?

    Science.gov (United States)

    North, C S; Smith, E M; Pollio, D E; Spitznagel, E L

    1996-09-01

    The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is

  4. How Positive Is Their Future? Assessing the Role of Optimism and Social Support in Understanding Mental Health Symptomatology among Homeless Adults.

    Science.gov (United States)

    Fitzpatrick, Kevin M

    2017-04-01

    Optimism has been noted as a primary protective factor in understanding mental health symptomatology in clinical and non-clinical settings. Any exploration of optimism has been absent in understanding mental health outcomes among homeless people. This study, using intensive interviews with 168 homeless adults in Northwest Arkansas, examines the role that social support and optimism play in lessening the negative impact of homeless circumstances/experiences on mental health symptomatology. Using OLS, findings support a mediating/protective role that social support and optimism play in lowering the negative effects of childhood life experiences on depressive symptoms among homeless persons. Despite the overwhelming conditions of homelessness, persons with higher levels of optimism and social support report lower depression and anxiety symptoms. The findings are discussed paying particular attention to the importance of developing and maintaining the perception of support and resiliency in preserving a positive outlook for the future among homeless persons facing often-debilitating circumstances. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  5. A 10-year retrospective analysis of hospital admissions and length of stay among a cohort of homeless adults in Vancouver, Canada.

    Science.gov (United States)

    Russolillo, Angela; Moniruzzaman, Akm; Parpouchi, Milad; Currie, Lauren B; Somers, Julian M

    2016-02-17

    Homelessness is associated with a very high prevalence of substance use and mental disorders and elevated levels of acute health service use. Among the homeless, little is known regarding the relative impact of specific mental disorders on healthcare utilization. The aim of the present study was to examine the association between different categories of diagnosed mental disorders with hospital admission and length of stay (LOS) in a cohort of homeless adults in Vancouver, Canada. Participants were recruited as part of an experimental trial in which participants met criteria for both homelessness and mental illness. Administrative data were obtained (with separate consent) including comprehensive records of acute hospitalizations during the 10 years prior to recruitment and while participants where experiencing homelessness. Generalized Estimating Equations were used to estimate the associations between outcome variables (acute hospital admissions and LOS) and predictor variables (specific disorders). Among the eligible sample (n = 433) 80 % were hospitalized, with an average of 6.0 hospital admissions and 71.4 days per person during the 10-year observation period. Of a combined total 2601 admissions to hospital, 1982 were psychiatric and 619 were non-psychiatric. Significant (p mental disorders alongside high non-psychiatric service use were significantly associated with hospital admission and LOS. These findings suggest the importance of screening within the homeless population to identify individuals who may be at risk for acute illness and the implementation of services to promote recovery and prevent repeated hospitalization. ISRCTN57595077 ; ISRCTN66721740.

  6. Health and nutrition survey in a group of urban homeless adults.

    Science.gov (United States)

    Luder, E; Ceysens-Okada, E; Koren-Roth, A; Martinez-Weber, C

    1990-10-01

    Homeless persons eat foods from municipal and privately run shelters, fast-food restaurants, delicatessens, and garbage bins. Data on the adequacy of the diets and the nutritional status of homeless persons are sparse. Therefore, we surveyed the nutritional adequacy of the dietary intake, the quality of shelter meals, and objective clinical parameters indicative of nutritional status in a heterogeneous group of urban homeless persons. The group comprised mentally ill persons, alcohol and illicit drug users, and temporarily unemployed persons. Although 86 of the 96 subjects (90%) in our survey reported that they obtained enough to eat, a low dietary adequacy score, which was based on the basic four food groups, of 10.7 (norm = 16) indicated that the quality of their diets was inadequate. Shelter meals and diet records showed a high level of saturated fat and cholesterol. Serum cholesterol levels above the desirable limit of 5.17 mmol/L (200 mg) were observed in 79 subjects (82%). In addition to a prevalence of hypertension and obesity (observed in 37 subjects [39%], these homeless persons were at high risk for development of or worsening of cardiovascular disease. We conclude that homeless persons who obtain meals at shelters are getting enough to eat. However, the shelter meals should be modified to meet the nutritional needs and dietary prescriptions of the large number of clients who suffer from various health disorders.

  7. Risk and protective factors for adult and child hunger among low-income housed and homeless female-headed families.

    Science.gov (United States)

    Wehler, Cheryl; Weinreb, Linda F; Huntington, Nicholas; Scott, Richard; Hosmer, David; Fletcher, Kenneth; Goldberg, Robert; Gundersen, Craig

    2004-01-01

    We sought to identify factors associated with adult or child hunger. Low-income housed and homeless mothers were interviewed about socioeconomic, psychosocial, health, and food sufficiency information. Multinomial logistic regression produced models predicting adult or child hunger. Predictors of adult hunger included mothers' childhood sexual molestation and current parenting difficulties, or "hassles." Risk factors for child hunger included mothers' childhood sexual molestation, housing subsidies, brief local residence, having more or older children, and substandard housing. This study found that the odds of hunger, although affected by resource constraints in low-income female-headed families, were also worsened by mothers' poor physical and mental health. Eliminating hunger thus may require broader interventions than food programs.

  8. Predictors of Emergency Department and Inpatient Readmissions among Homeless Adolescents and Young Adults

    Science.gov (United States)

    Mackelprang, Jessica L.; Qiu, Qian; Rivara, Frederick P.

    2015-01-01

    Background Individuals under age 25 years are estimated to comprise one-third of the homeless population nationally. Understanding reasons homeless youth utilize hospitals is important for optimizing disposition planning. Objectives (1) Report prevalence of emergency department (ED) and inpatient admissions among homeless and unstably housed youth; (2) describe demographic characteristics of those youth who seek hospital care; (3) describe their patterns of injury, illness, psychiatric, and substance use conditions; and (4) identify demographic and diagnostic predictors of ED visit or hospital readmission. Methods Retrospective cohort study of 15-25 year-olds (N=402) who were admitted to the ED or inpatient floors of two urban teaching hospitals in King County, Washington between July 1, 2009 and June 30, 2012 and whose address was “homeless” or “none” or a homeless shelter or service agency (i.e., homeless or unstably housed), during any recorded encounter between July 1, 2009 and June 30, 2012. Results 1151 ED visits and 227 inpatient admissions were documented. Fifty percent of patients had an ED visit or hospital readmission within one year, with 43.1% receiving care within 30 days of discharge. Cox regression showed females with an injury diagnosis (hazard ratio [HR]=1.74, 95% confidence interval [CI]=1.06, 2.85) and males with an acute medical condition (HR=1.59, 95% CI=1.09, 2.32) at index visit were more likely to have an ED visit or hospital readmission during the following year, as were patients who provided a private address at their index visit. Conclusions Homeless young people who seek hospital care demonstrate a high rate of ED visits and hospital readmissions, with unique predictors of utilization associated with sex and housing status. Additional research is necessary to determine how best to transition these young people from hospital- to community-based care. PMID:26492212

  9. Later-Life Homelessness as Disenfranchised Grief.

    Science.gov (United States)

    Burns, Victoria F; Sussman, Tamara; Bourgeois-Guérin, Valérie

    2018-04-02

    ABSTRACTAlthough interest on older homelessness is gaining momentum, little research has considered the experiences of first-time homelessness from the perspective of older adults themselves. This constructivist grounded-theory study addresses this gap by exploring how societal perceptions of homelessness and aging shape access to housing, services, and perceptions of self for 15 older adults residing in emergency homeless shelters in Montreal, (Quebec, Canada). Findings revealed that homelessness evoked a grief response characterized by shock, despair, anger, and in some cases, relief. Connecting and receiving support from other shelter residents and staff helped participants to acknowledge and grieve their losses. However, difficult shelter conditions, the stigma associated with aging and homelessness, and not having their grief recognized or validated served to disenfranchise grief experiences. Conceptualizing later-life homelessness as disenfranchised grief contributes to the aging and homelessness literature while providing new avenues for understanding and validating the experiences of a growing population of vulnerable older adults.

  10. Posttraumatic stress disorder and substance use disorder comorbidity in homeless adults: Prevalence, correlates, and sex differences.

    Science.gov (United States)

    Torchalla, Iris; Strehlau, Verena; Li, Kathy; Aube Linden, Isabelle; Noel, Francois; Krausz, Michael

    2014-06-01

    Substance use disorders (SUDs) are highly prevalent in homeless populations, and rates are typically greater among males. Posttraumatic stress disorder (PTSD) is a common co-occurring condition among individuals with SUDs; however, little attention has been directed to examining this comorbidity in homeless populations. Although some studies indicate considerable sex differences among individuals with PTSD, it has also been suggested that sex differences in PTSD rates diminish in populations with severe SUDs. This cross-sectional study investigated SUD-PTSD comorbidity and its associations with indicators of psychosocial functioning in a sample of 500 homeless individuals from Canada. Sex-related patterns of SUD, PTSD, and their comorbidity were also examined. Males and females had similar SUD prevalence rates, but the rates of PTSD and PTSD-SUD comorbidity were higher in females. PTSD and sex were found to have significant main effects on suicidality, psychological distress, somatic symptoms, and incarceration among individuals with SUD. Sex also moderated the association of PTSD with suicide risk and psychological distress. Our results contradict assumptions that sex differences in PTSD rates attenuate in samples with severe SUDs. Organizations providing SUD treatment for homeless people should address PTSD as an integrated part of their services. SUD and integrated treatment programs may benefit from sex-specific components.

  11. Explaining excess morbidity amongst homeless shelter users: A multivariate analysis for the Danish adult population.

    Science.gov (United States)

    Benjaminsen, Lars; Birkelund, Jesper Fels

    2018-03-01

    This article analyses excess morbidity amongst homeless shelter users compared to the general Danish population. The study provides an extensive control for confounding and investigates to what extent excess morbidity is explained by homelessness or other risk factors. Data set includes administrative micro-data for 4,068,926 Danes who were 23 years or older on 1 January 2007. Nationwide data on shelter use identified 14,730 individuals as shelter users from 2002 to 2006. Somatic diseases were measured from 2007 to 2011 through diagnosis data from hospital discharges. The risk of somatic diseases amongst shelter users was analysed through a multivariate model that decomposed the total effect into a direct effect and indirect effects mediated by other risk factors. The excess morbidity associated with shelter use is substantially lower than in studies that did not include an extensive control. Approximately 80% of excess morbidity amongst shelter users is attributed to other risk factors. A large part of the excess morbidity is explained by substance abuse problems and lack of employment, whilst mental illness, low income, low education, civil status and ethnic minority background explain only a limited part. However, when conducting an extensive control for confounding, a significantly higher morbidity was identified amongst shelter users for infectious diseases, lung, skin, blood and digestive diseases, injuries, and poisoning. Ill health amongst homeless shelter users is widely explained by substance abuse problems and other risk factors. Nonetheless, for many diseases homelessness poses an additional risk to the health.

  12. Bidirectional Partner Violence among Homeless Young Adults: Risk Factors and Outcomes

    Science.gov (United States)

    Tyler, Kimberly A.; Melander, Lisa A.; Noel, HarmoniJoie

    2009-01-01

    One of the most prevalent forms of violence in contemporary society is the victimization of intimate partners. Although it has been established that homeless young people experience high levels of victimization on the street, little is known about partner violence (PV) experiences among this group, especially bidirectional violence. As such, the…

  13. Foster Care Placement, Poor Parenting, and Negative Outcomes among Homeless Young Adults

    Science.gov (United States)

    Tyler, Kimberly A.; Melander, Lisa A.

    2010-01-01

    Although homeless youth with and without foster care histories both face adverse life circumstances, little is known about how these two groups compare in terms of their early histories and whether they face similar outcomes. As such, we compared those with and without a history of foster care placement to determine if the associations between a…

  14. Child Abuse, Street Victimization, and Substance Use among Homeless Young Adults

    Science.gov (United States)

    Tyler, Kimberly A.; Melander, Lisa A.

    2015-01-01

    Although previous research documents high rates of child abuse, street victimization, and substance use among homeless youth, few studies have investigated these three constructs simultaneously, and thus little is known about how various forms of victimization are uniquely associated with substance use among this population. The purpose of this…

  15. Sexual Abuse as a Precursor to Prostitution and Victimization among Adolescent and Adult Homeless Women.

    Science.gov (United States)

    Simons, Ronald L.; Whitbeck, Les B.

    1991-01-01

    Studied 40 adolescent runaways and 95 homeless women to examine impact of early sexual abuse on prostitution and victimization. Findings suggest that early sexual abuse increases probability of involvement in prostitution irrespective of influence of running away, substance abuse, and other deviant acts; only indirectly affects chances of…

  16. Ending child homelessness in America.

    Science.gov (United States)

    Bassuk, Ellen L

    2010-10-01

    Approximately 1.5 million children experience homelessness in America each year. The current economic recession and staggering numbers of housing foreclosures have caused the numbers of homeless families to increase dramatically. The impact of homelessness on families and children is devastating. Without a place to call home, children are severely challenged by unpredictability, dislocation, and chaos. Homelessness and exposure to traumatic stresses place them at high risk for poor mental health outcomes. Despite the pressing needs of these children, federal policy during the last decade has focused primarily on chronically homeless adult individuals-to the exclusion of the families. In 2010, however, the U.S. Interagency Council on Homelessness issued a comprehensive plan to eradicate homelessness for all people through interagency collaboration and aligning mainstream services. A key goal is to prevent and end homelessness for families, youth, and children within 10 years. This policy-focused article describes several tools that can be used to help achieve this goal, including: general principles of care for serving homeless families and children; BSAFE-a promising practice that helps families access community-based services and supports; and the Campaign to End Child Homelessness aimed at action on behalf of homeless families and children at the national, state, and local levels. © 2010 American Orthopsychiatric Association.

  17. Pathways to homelessness among the mentally ill.

    Science.gov (United States)

    Sullivan, G; Burnam, A; Koegel, P

    2000-10-01

    Persons with mental illness are over-represented among the homeless relative to the general population, and mental illness is most likely one of many vulnerabilities that confer risk for homelessness. This paper elucidates the pathways to homelessness for persons with mental illness by comparing and contrasting groups of mentally ill homeless persons, non-mentally ill homeless persons, and housed mentally ill persons drawn from RAND's Course of Homelessness (COH) study and the Epidemiological Catchment Area (ECA) survey. Homeless persons share childhood histories of economic and social disadvantage. The mentally ill homeless appear to have a "double dose" of disadvantage: poverty with the addition of childhood family instability and violence. Among the mentally ill homeless, those who became homeless prior to becoming mentally ill have the highest levels of disadvantage and disruption; while those who become homeless after becoming ill have an especially high prevalence of alcohol dependence. Mental illness may play a role in initiating homelessness for some, but is unlikely in and of itself to be a sufficient risk factor for homelessness. In addition to outreach and treatment programs for adult mentally ill homeless persons, emphasis should be placed on interventions with children and on addressing more pervasive causes of homelessness.

  18. Risk and Resilience Factors Associated with Formal and Informal Income Generation among Homeless Young Adults in Three U.S. Cities

    Science.gov (United States)

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2018-01-01

    This study used the risk and resilience framework to examine predictors of formal and informal sources of income among homeless young adults. Formal sources of income generation consisted of full-time, part-time, or paid, temporary work. Informal sources included earning money from selling personal possessions, selling drugs, and theft. In all,…

  19. Cigarette, marijuana, and alcohol use and prior drug treatment among newly homeless young adults in New York City: Relationship to a history of foster care.

    Science.gov (United States)

    Thompson, Ronald G; Hasin, Deborah S

    2011-08-01

    This study examined whether a history of foster care was associated with the risk for substance use among newly homeless young adults, controlling for demographics and other risk factors. Multiple logistic regression analyses, adjusted for controls, among consecutive admissions of 424 newly homeless young adults (18-21 years), determined the association between foster care and substance use. A history of foster care was reported by 35% of the sample. Alcohol, marijuana, and cigarettes were the most frequently used substances. After adjusting for demographics, childhood emotional, physical, and sexual abuse, prior arrest, unemployment, lack of high school diploma, and family drug use, homeless young adults with histories of foster care were: three times as likely to smoke cigarettes (AOR=3.09); more than three times as likely to use marijuana (AOR=3.30); and almost nine times as likely to have been in drug treatment (AOR=8.81) than those without such histories. It is important to screen homeless young adults who exited foster care for substance use, particularly cigarettes and marijuana. Risk reduction interventions should be targeted and tailored to their substance prevention needs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Self-determination in relation to quality of life in homeless young adults : direct and indirect effects through psychological distress and social support

    NARCIS (Netherlands)

    Krabbenborg, M.A.M.; Boersma, S.N.; van der Veld, A.M.; Vollebergh, W.A.M.; Wolf, Jürgen

    2017-01-01

    The self-determination theory emphasizes the importance of satisfaction with autonomy, competence, and relatedness for a person’s psychological growth and well-being. This study examines associations between autonomy, competence, and relatedness with quality of life in homeless young adults; and

  1. Outcomes of homeless adults with mental illness in a housing program and in case management only.

    Science.gov (United States)

    Clark, Colleen; Rich, Alexander R

    2003-01-01

    The effectiveness of two types of service programs in ameliorating homelessness among individuals with severe mental illness was compared. Homeless persons with severe mental illness were recruited into the study on their entry into one of two types of homeless service programs. The first was a comprehensive housing program, in which consumers received guaranteed access to housing, housing support services, and case management. The second was a program of case management only, in which consumers received specialized case management services. In a quasi-experimental or nonrandom-assignment design, participants responded to instruments measuring housing status, mental health symptoms, substance use, physical health, and quality of life at baseline (program entry) and at six months and 12 months after entry. The baseline interview was completed by 152 participants and at least one of the two follow-up interviews by 108 participants. High-, medium-, and low-impairment subgroups, based on psychiatric symptoms and degree of alcohol and illegal drug use, were formed by means of a propensity score subclassification. Persons with high psychiatric symptom severity and high substance use achieved better housing outcomes with the comprehensive housing program than with case management alone. However, persons with low and medium symptom severity and low levels of alcohol and drug use did just as well with case management alone. The results suggest that the effectiveness, and ultimately the cost, of homeless services can be improved by matching the type of service to the consumer's level of psychiatric impairment and substance use rather than by treating mentally ill homeless persons as a homogeneous group.

  2. Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders.

    Science.gov (United States)

    Aquin, Joshua P; Roos, Leslie E; Distasio, Jino; Katz, Laurence Y; Bourque, Jimmy; Bolton, James M; Bolton, Shay-Lee; Wong, Jacquelyne Y; Chateau, Dan; Somers, Julian M; Enns, Murray W; Hwang, Stephen W; Frankish, James C; Sareen, Jitender

    2017-07-01

    This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour. The At Home/Chez Soi project is an unblinded, randomised control trial conducted across 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, Moncton) from 2009 to 2013. Homeless adults with a diagnosed major mental health disorder were recruited through community agencies and randomised to HF ( n = 1265) and TAU ( n = 990). HF participants were provided with private housing units and received case management support services. TAU participants retained access to existing community supports. Past-month suicidal ideation was measured at baseline and 6, 12, 18, and 21/24 months. A history of suicide attempts was measured at baseline and the 21/24-month follow-up. Compared to baseline, there was an overall trend of decreased past-month suicidal ideation (estimate = -.57, SE = .05, P housing-first intervention.

  3. Health-seeking challenges among homeless youth.

    Science.gov (United States)

    Hudson, Angela L; Nyamathi, Adeline; Greengold, Barbara; Slagle, Alexandra; Koniak-Griffin, Deborah; Khalilifard, Farinaz; Getzoff, Daniel

    2010-01-01

    Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults. The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons. This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults. Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general). Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services.

  4. All-cause, drug-related, and HIV-related mortality risk by trajectories of jail incarceration and homelessness among adults in New York City.

    Science.gov (United States)

    Lim, Sungwoo; Harris, Tiffany G; Nash, Denis; Lennon, Mary Clare; Thorpe, Lorna E

    2015-02-15

    We studied a cohort of 15,620 adults who had experienced at least 1 jail incarceration and 1 homeless shelter stay in 2001-2003 in New York City to identify trajectories of these events and tested whether a particular trajectory was associated with all-cause, drug-related, or human immunodeficiency virus (HIV)-related mortality risk in 2004-2005. Using matched data on jail time, homeless shelter stays, and vital statistics, we performed sequence analysis and assessed mortality risk using standardized mortality ratios (SMRs) and marginal structural modeling. We identified 6 trajectories. Sixty percent of the cohort members had a temporary pattern, which was characterized by sporadic experiences of brief incarceration and homelessness, whereas the rest had the other 5 patterns, which reflected experiences of increasing, decreasing, or persistent jail or shelter stays. Mortality risk among individuals with a temporary pattern was significantly higher than those of adults who had not been incarcerated or stayed in a homeless shelter during the study period (all-cause SMR: 1.35, 95% confidence interval (CI): 1.14, 1.59; drug-related SMR: 4.60, 95% CI: 3.17, 6.46; HIV-related SMR: 1.54, 95% CI: 1.03, 2.21); all-cause and HIV-related SMRs in other patterns were not statistically significantly different. When we compared all 6 trajectories, the temporary pattern was more strongly associated with higher mortality risk than was the continuously homelessness pattern. Institutional interventions to reduce recurrent cycles of incarceration and homelessness are needed to augment behavioral interventions to reduce mortality risk. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Characteristics of homeless adults with serious mental illness served by a state mental health transitional shelter.

    Science.gov (United States)

    Viron, Mark; Bello, Iruma; Freudenreich, Oliver; Shtasel, Derri

    2014-07-01

    Specialized transitional shelters are available in various cities to provide assistance to homeless individuals with serious mental illness. Little is known about the population using such shelters. The authors conducted a retrospective chart review to collect demographic, social, and clinical data of residents in a state-operated mental health transitional shelter in Massachusetts. A total of 74 subjects were included. Schizophrenia-spectrum disorders were present in 67.6 % of the sample and mood disorders in 35.1 %. Substance use disorders were documented in 44.6 %. Chronic medical illness (mostly hypertension, dyslipidemia, asthma, and diabetes) was found in 82.4 %. The co-occurrence of a psychiatric and substance use disorder and chronic medical illness was found in 36.5 %. The majority (75.7 %) of patients had a history of legal charges. Homeless individuals with serious mental illness served by specialized transitional shelters represent a population with complex psychiatric, medical and social needs.

  6. A Randomized Clinical Trial of a Therapeutic Workplace for Chronically Unemployed, Homeless, Alcohol-Dependent Adults

    OpenAIRE

    Koffarnus, Mikhail N.; Wong, Conrad J.; Diemer, Karly; Needham, Mick; Hampton, Jacqueline; Fingerhood, Michael; Svikis, Dace S.; Bigelow, George E.; Silverman, Kenneth

    2011-01-01

    Aims: To assess the efficacy of the Therapeutic Workplace, a substance abuse intervention that promotes abstinence while simultaneously addressing the issues of poverty and lack of job skills, in promoting abstinence from alcohol among homeless alcoholics. Methods: Participants (n = 124) were randomly assigned to conditions either requiring abstinence from alcohol to engage in paid job skills training (Contingent Paid Training group), offering paid job skills training with no abstinence conti...

  7. Injection drug use among homeless adults in the Southeast with severe mental illness.

    Science.gov (United States)

    Linn, J Gary; Brown, Michael; Kendrick, Lorna

    2005-11-01

    This study examined injection drug use and HIV risk behaviors in a predominantly African American sample of homeless men with mental illness. Personal interviews focusing on injection drug use and sexual risk behaviors were completed with 240 homeless mentally ill men in two shelters in a southeastern city. Sixty-two (26%) of the 240 men injected drugs. Among the injection drug users (IDUs), most reported high-risk behaviors, including needle sharing (70%) and participation in shooting galleries (71%). Very few performed risk reduction activities (e.g., cleaning needles with bleach [19%] or using a needle exchange program [0%]). Within the preceding 6 months, most of the IDUs had had sex with women (51%) or men (8%) without a condom. This investigation reported a high lifetime occurrence of injection drug use in a sample of predominantly African American homeless men with mental illness. The IDUs reported intravenous drug use and sexual activities with great risk of HIV transmission and provided little evidence of risk-reduction efforts. These men are outside of most social service and health care systems but must be included in special programs to decrease the transmission of HIV.

  8. Risk factors for stimulant use among homeless and unstably housed adult women.

    Science.gov (United States)

    Riley, Elise D; Shumway, Martha; Knight, Kelly R; Guzman, David; Cohen, Jennifer; Weiser, Sheri D

    2015-08-01

    One of the most common causes of death among homeless and unstably housed women is acute intoxication where cocaine is present. While correlates of stimulant use have been determined in prior research, few studies have assessed risk factors of use specifically in this high-risk population. We sampled biological women with a history of housing instability from community-based venues to participate in a cohort study. Baseline and 6-month follow-up data were used to determine the relative risk of stimulant use (crack cocaine, powder cocaine or methamphetamine) among individuals who did not use at baseline. Among 260 study participants, the median age was 47 years, 70% were women of color; 47% reported having unmet subsistence needs and 53% reported abstinence from stimulants at baseline. In analyses adjusting for baseline sociodemographics and drug treatment, the risk of using stimulants within 6 months was significantly higher among women who reported recent sexual violence (Adjusted Relative Risk [ARR]=4.31; 95% CI:1.97-9.45), sleeping in a shelter or public place (ARR=2.75; 95% CI:1.15-6.57), and using unprescribed opioid analgesics (ARR=2.54; 95% CI:1.01-6.38). We found that almost half of homeless and unstably housed women used stimulants at baseline and 14% of those who did not use began within 6 months. Addressing homelessness and sexual violence is critical to reduce stimulant use among impoverished women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Mental Illness, Healthcare, and Homelessness in Mississippi

    OpenAIRE

    Tamara Stewart

    2017-01-01

    Mental illness is prevalent among the homeless population and the rate of mentally ill homeless individuals has increased since deinstitutionalization. There is little information about homeless population mental health and access to mental healthcare. This study sought to describe the mental health status and utilization of mental healthcare services among homeless individuals in Mississippi. This is a cross-sectional study with 3,375 adults participants. There were 58% males, 42% females, 4...

  10. Cardiovascular risk factors and 30-year cardiovascular risk in homeless adults with mental illness.

    Science.gov (United States)

    Gozdzik, Agnes; Salehi, Roxana; O'Campo, Patricia; Stergiopoulos, Vicky; Hwang, Stephen W

    2015-02-23

    Cardiovascular disease (CVD) is a leading cause of death among homeless people. This study examines CVD risk factors and 30-year CVD risk in a population of homeless individuals with mental illness. CVD risks factors were assessed in 352 homeless individuals with mental illness in Toronto, Canada, at the time of their enrollment in the At Home/Chez Soi Project, a randomized trial of a Housing First intervention. The 30-year risk for CVD (coronary death, myocardial infarction, and fatal or nonfatal stroke) was calculated using published formulas and examined for association with need for mental health services, diagnosis of psychotic disorder, sex, ethnicity, access to a family physician and diagnosis of substance dependence. The 30-year CVD risk for study participants was 24.5 ± 18.4%, more than double the reference normal of 10.1 ± 7.21% (difference = -13.0% 95% CI -16.5% to -9.48%). Univariate analyses revealed 30-year CVD risk was greater among males (OR 3.99, 95% CI 2.47 to 6.56) and those who were diagnosed with substance dependence at baseline (OR 1.94 95% CI 1.23 to 3.06) and reduced among those who were non-white (OR 0.62 95% CI 0.39 to 0.97). In adjusted analyses, only male sex (OR 4.71 95% CI 2.76 to 8.05) and diagnosis of substance dependence (OR 1.78 95% CI 1.05 to 3.00) remained associated with increased CVD risk. Homeless people with mental illness have highly elevated 30-year CVD risk, particularly among males and those diagnosed with substance dependence. This study adds to the literature by reporting on CVD risk in a particularly vulnerable population of homeless individuals experiencing mental illness, and by using a 30-year CVD risk calculator which provides a longer time-frame during which the effect of modifiable CVD risk factors could be mitigated. Current Controlled Trials ISRCTN42520374.

  11. The Effects of Homelessness on the Academic Achievement of Children. Children of Poverty. Studies on the Effects of Single Parenthood, the Feminization of Poverty, and Homelessness.

    Science.gov (United States)

    Attles, Henrietta S. Evans

    This book is a study of the impact that changes in living environments (i.e. from homelessness in a shelter to a family's own dwelling unit) have on the academic achievement of school-age children. The study samples seven cases of public school children in grades 5 through 8 during the years 1988 to 1991. The children lived in the same shelter and…

  12. Monetary incentives to reinforce engagement and achievement in a job-skills training program for homeless, unemployed adults.

    Science.gov (United States)

    Koffarnus, Mikhail N; Wong, Conrad J; Fingerhood, Michael; Svikis, Dace S; Bigelow, George E; Silverman, Kenneth

    2013-01-01

    The current study examined whether monetary incentives could increase engagement and achievement in a job-skills training program for unemployed, homeless, alcohol-dependent adults. Participants (n=124) were randomized to a no-reinforcement group (n=39), during which access to the training program was provided but no incentives were given; a training reinforcement group (n=42), during which incentives were contingent on attendance and performance; or an abstinence and training reinforcement group (n=43), during which incentives were contingent on attendance and performance, but access was granted only if participants demonstrated abstinence from alcohol. abstinence and training reinforcement and training reinforcement participants advanced further in training and attended more hours than no-reinforcement participants. Monetary incentives were effective in promoting engagement and achievement in a job-skills training program for individuals who often do not take advantage of training programs. © Society for the Experimental Analysis of Behavior.

  13. How do homeless adults change their lives after completing an intensive job-skills program? A prospective study.

    Science.gov (United States)

    Gray, Heather M; Nelson, Sarah E; Shaffer, Howard J; Stebbins, Patricia; Farina, Andrea Ryan

    2017-09-01

    Among people experiencing homelessness, difficulty securing housing is often compounded by concurrent challenges including unemployment, chronic illness, criminal justice involvement, and victimization. The Moving Ahead Program (MAP) is a vocational rehabilitation program that seeks to help adults facing these challenges to secure competitive employment. We prospectively studied how MAP graduates (N = 97) changed from the beginning of MAP to about six months after graduation. We observed a variety of positive outcomes not just in employment and housing but also in health, substance use, and criminal justice involvement. However, these gains were not universal; for instance, participants were less likely to report positive outcomes at follow-up if they started MAP with a serious mental illness, made relatively small gains in work skills, or did not seek mental health treatment during the six months after they completed MAP. These findings might encourage program staff to devote additional resources toward supporting at-risk students.

  14. Maslow and mental health recovery: a comparative study of homeless programs for adults with serious mental illness.

    Science.gov (United States)

    Henwood, Benjamin F; Derejko, Katie-Sue; Couture, Julie; Padgett, Deborah K

    2015-03-01

    This mixed-methods study uses Maslow's hierarchy as a theoretical lens to investigate the experiences of 63 newly enrolled clients of housing first and traditional programs for adults with serious mental illness who have experienced homelessness. Quantitative findings suggests that identifying self-actualization goals is associated with not having one's basic needs met rather than from the fulfillment of basic needs. Qualitative findings suggest a more complex relationship between basic needs, goal setting, and the meaning of self-actualization. Transforming mental health care into a recovery-oriented system will require further consideration of person-centered care planning as well as the impact of limited resources especially for those living in poverty.

  15. A Longitudinal Study of Predictors of Housing Stability, Housing Quality, and Mental Health Functioning Among Single Homeless Individuals Staying in Emergency Shelters.

    Science.gov (United States)

    Aubry, Tim; Duhoux, Arnaud; Klodawsky, Fran; Ecker, John; Hay, Elizabeth

    2016-09-01

    The current study examined risk and resilience factors at multiple levels that affect homeless individuals' ability to exit homelessness and achieve housing stability. It also examined the relationship between housing status, housing quality and mental health functioning. The methodology is a longitudinal study of single homeless individuals staying in emergency shelters in a medium-sized Canadian city who were followed for a 2 year period. Data were collected from participants at a baseline interview when they were homeless and at a 2-year follow-up. There were 329 participants interviewed at baseline and 197 (59.9%) participants interviewed at follow-up. Results from a structural equation modelling analysis found that having interpersonal and community resources were predictive of achieving housing stability. Specifically, having a larger social support network, access to subsidized housing, and greater income was related to achieving housing stability. On the other hand, having a substance use problem was a risk factor associated with a failure to achieving housing stability. Being female, feeling personally empowered, having housing that is perceived of being of higher quality were directly predictive of mental health functioning at follow-up. Findings are discussed in the context of previous research and their policy implications. © Society for Community Research and Action 2016.

  16. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

    Science.gov (United States)

    2012-01-01

    Background The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study. PMID:22894551

  17. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: a multi-site focus group study.

    Science.gov (United States)

    Palepu, Anita; Hubley, Anita M; Russell, Lara B; Gadermann, Anne M; Chinni, Mary

    2012-08-15

    The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  18. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

    Directory of Open Access Journals (Sweden)

    Palepu Anita

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to identify what is most important to the quality of life (QoL of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  19. Barriers to Prescription Medication Adherence Among Homeless and Vulnerably Housed Adults in Three Canadian Cities.

    Science.gov (United States)

    Hunter, Charlotte E; Palepu, Anita; Farrell, Susan; Gogosis, Evie; O'Brien, Kristen; Hwang, Stephen W

    2015-07-01

    Medication adherence is an important determinant of successful medical treatment. Marginalized populations, such as homeless and vulnerably housed individuals, may face substantial barriers to medication adherence. This study aimed to determine the prevalence of, reasons for, and factors associated with medication nonadherence among homeless and vulnerably housed individuals. Additionally, we examined the association between medication nonadherence and subsequent emergency department utilization during a 1-year follow-up period. Data were collected as part of the Health and Housing in Transition study, a prospective cohort study tracking the health and housing status of 595 homeless and 596 vulnerably housed individuals in 3 Canadian cities. Logistic regression was used to identify factors associated with medication nonadherence, as well as the association between medication nonadherence at baseline and subsequent emergency department utilization. Among 716 participants who had been prescribed a medication, 189 (26%) reported nonadherence. Being ≥40 years old was associated with decreased likelihood of nonadherence (adjusted odds ratio [AOR] = 0.59; 95% confidence interval [CI] = 0.41-0.84), as was having a primary care provider (AOR = 0.49; 95% CI = 0.34-0.71). Having a positive screen on the AUDIT (Alcohol Use Disorders Identification Test; an indication of harmful or hazardous drinking) was associated with increased likelihood of nonadherence (AOR = 1.86; 95% CI = 1.31-2.63). Common reasons for nonadherence included side effects, cost, and lack of access to a physician. Self-reported nonadherence at baseline was significantly associated with frequent emergency department use (≥3 visits) over the follow-up period at the bivariate level (OR = 1.55; 95% CI = 1.02-2.35) but was not significant in a multivariate model (AOR = 1.49; 95% CI = 0.96-2.32). Homeless and vulnerably housed individuals face significant barriers to medication adherence. Health care

  20. Dietary intake and nutritional status of older adult homeless women: a pilot study.

    Science.gov (United States)

    Johnson, Lesley J; McCool, Audrey C

    2003-01-01

    A pilot study was conducted to identify eating patterns, food sources, and nutritional problems among a limited population of older homeless women located in a large urban area. Most of these women's food came from shelter meals, and their food intake was inadequate for most nutrients. The availability of fruits, vegetables, dairy products, and whole grains was very limited. Foods high in saturated fats and simple carbohydrates provided most of their caloric intake. Although some women were obese, most were found to have low BMI and mid-arm muscle mass area measurements indicating low body fat stores and potential muscle wasting.

  1. Illness narratives of people who are homeless

    OpenAIRE

    H?kanson, Cecilia; ?hl?n, Joakim

    2016-01-01

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description...

  2. Causes of homelessness prevalence: Relationship between homelessness and disability.

    Science.gov (United States)

    Nishio, Akihiro; Horita, Ryo; Sado, Tadahiro; Mizutani, Seiko; Watanabe, Takahiro; Uehara, Ryosuke; Yamamoto, Mayumi

    2017-03-01

    Many studies have reported that the prevalence of mental illness and cognitive disability is higher among homeless individuals compared to the general population, and the rates of mental illness among the homeless population have recently increased. This study: (i) compares causes of homelessness or barriers to escaping homelessness for people with/without mental illness/cognitive disability; (ii) reveals problems with the Japanese homeless policy; and (iii) proposes an effective and necessary support system. The participants were 114 homeless individuals. A psychiatric diagnostic interview and the Wechsler Adult Intelligence Scale, version III were used to measure participants' mental health and cognitive abilities. A questionnaire was administered comprising 17 items related to the causes of their homelessness and barriers to escaping from it. Participants were divided into four groups - with/without mental illness or cognitive disability - and Fisher's exact test was used to compare the questionnaire results. Individuals with cognitive disabilities considered bad relationships with their family members to be the cause of their homelessness. Conversely, normal individuals considered their homelessness to be the result of debt more so than did individuals with mental problems. Individuals with mental illness had more difficulties escaping homelessness than did either normal individuals or individuals with cognitive disability. This tendency was observed most strongly among individuals with both mental illness and cognitive disability. Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  3. Moving ahead: evaluation of a work-skills training program for homeless adults.

    Science.gov (United States)

    Nelson, Sarah E; Gray, Heather M; Maurice, Ingrid R; Shaffer, Howard J

    2012-12-01

    This study examines the impact of a work-skills program grounded in an integrated services approach on both employment and related life domains among homeless individuals. Six hundred thirty-eight participants in a 14-week work-skills program at a large day center in New England completed assessments at intake between 1999 and 2007; a subsample of 333 also completed assessments at graduation from the program; a smaller subsample of 55 participants were re-assessed 6 months after graduation. These assessments measured work and related life skills, employment, housing status, general health status, substance use, self-esteem and self-efficacy, and legal involvement. Results revealed improvement in all types of work and related life skills, employment and income, and multiple other life domains from baseline to graduation and follow-up. Exploratory analyses suggested that improvements in work and related life skills were associated with improvement in self-esteem and self-efficacy, and that these improvements predicted stable housing situations at follow-up. Overall, these findings indicate that, for individuals struggling with the challenges of homelessness, completion of a work-skills program has a positive impact on skills and employment, and on a diverse set of life domains.

  4. A randomized clinical trial of a Therapeutic Workplace for chronically unemployed, homeless, alcohol-dependent adults.

    Science.gov (United States)

    Koffarnus, Mikhail N; Wong, Conrad J; Diemer, Karly; Needham, Mick; Hampton, Jacqueline; Fingerhood, Michael; Svikis, Dace S; Bigelow, George E; Silverman, Kenneth

    2011-01-01

    To assess the efficacy of the Therapeutic Workplace, a substance abuse intervention that promotes abstinence while simultaneously addressing the issues of poverty and lack of job skills, in promoting abstinence from alcohol among homeless alcoholics. Participants (n = 124) were randomly assigned to conditions either requiring abstinence from alcohol to engage in paid job skills training (Contingent Paid Training group), offering paid job skills training with no abstinence contingencies (Paid Training group) or offering unpaid job skill training with no abstinence contingencies (Unpaid Training group). Participants in the Contingent Paid Training group had significantly fewer positive (blood alcohol level ≥ 0.004 g/dl) breath samples than the Paid Training group in both randomly scheduled breath samples collected in the community and breath samples collected during monthly assessments. The breath sample results from the Unpaid Training group were similar in absolute terms to the Contingent Paid Training group, which may have been influenced by a lower breath sample collection rate in this group and fewer reported drinks per day consumed at intake. Overall, the results support the utility of the Therapeutic Workplace intervention to promote abstinence from alcohol among homeless alcoholics, and support paid training as a way of increasing engagement in training programs.

  5. The Invisible Homeless: Non-Urban Homeless in Appalachian East Tennessee.

    Science.gov (United States)

    Hoover, Greg A.; Carter, Michael V.

    1991-01-01

    Studied 71 nonurban homeless adults over a period of approximately 3 years at 2 separate shelters. Two-thirds of the sample were local people. Common reasons for homelessness were family problems, economic problems, and personal problems. There was no evidence that mental illness played a substantial role in this homelessness. Describes…

  6. Childhood abuse as a precursor to homelessness for homeless women with severe mental illness.

    Science.gov (United States)

    Davies-Netzley, S; Hurlburt, M S; Hough, R L

    1996-01-01

    Previous studies of childhood abuse levels among homeless women have typically focused either on single homeless women or female heads of families; almost none have focused specifically on homeless women with severe mental illness. This study explores rates of childhood physical and sexual abuse among 120 homeless women with severe mental illness. Correlates of experiencing childhood abuse are considered, including mental health outcomes and when women first become homeless. The prevalence of childhood abuse in this sample of women was substantially higher than among homeless women in general. The experience of childhood abuse was related to increased suicidality, and resulted in symptoms of posttraumatic stress disorder for some women. Women who had suffered abuse were also much more likely to become homeless during childhood and it is suggested that this is an important precursor to homelessness for many homeless women with chronic and severe mental illness.

  7. Interventions by healthcare professionals to improve management of physical long-term conditions in adults who are homeless: a systematic review protocol.

    Science.gov (United States)

    Hanlon, Peter; Yeoman, Lynsey; Esiovwa, Regina; Gibson, Lauren; Williamson, Andrea E; Mair, Frances S; Lowrie, Richard

    2017-08-21

    People experiencing homelessness are at increased risk of, and have poorer outcomes from, a range of physical long-term conditions (LTCs). It is increasingly recognised that interventions targeting people who are homeless should be tailored to the specific needs of this population. This systematic review aims to identify, describe and appraise trials of interventions that aim to manage physical LTCs in homeless adults and are delivered by healthcare professionals. Seven electronic databases (Medline, EMBASE, Cochrane Central Register of Controlled Trials, Assia, Scopus, PsycINFO and CINAHL) will be searched from 1960 (or inception) to October 2016 and supplemented by forward citation searching, handsearching of reference lists and searching grey literature. Two reviewers will independently review titles, abstract and full-texts using DistillerSR software. Inclusion criteria include (1) homeless adults with any physical LTC, (2) interventions delivered by a healthcare professional (any professional trained to provide any form of healthcare, but excluding social workers and professionals without health-related training), (3) comparison with usual care or an alternative intervention, (4) report outcomes such as healthcare usage, physical and psychological health or well-being or cost-effectiveness, (5) randomised controlled trials, non-randomised controlled trials, controlled before-after studies. Quality will be assessed using the Cochrane EPOC Risk of Bias Tool. A meta-analysis will be performed if sufficient data are identified; however, we anticipate a narrative synthesis will be performed. This review will synthesise existing evidence for interventions delivered by healthcare professionals to manage physical LTCs in adults who are homeless. The findings will inform the development of future interventions and research aiming to improve the management of LTCs for people experiencing homelessness. Ethical approval will not be required for this systematic review as

  8. Interventions by healthcare professionals to improve management of physical long-term conditions in adults who are homeless: a systematic review protocol

    Science.gov (United States)

    Hanlon, Peter; Yeoman, Lynsey; Esiovwa, Regina; Gibson, Lauren; Williamson, Andrea E; Mair, Frances S; Lowrie, Richard

    2017-01-01

    Introduction People experiencing homelessness are at increased risk of, and have poorer outcomes from, a range of physical long-term conditions (LTCs). It is increasingly recognised that interventions targeting people who are homeless should be tailored to the specific needs of this population. This systematic review aims to identify, describe and appraise trials of interventions that aim to manage physical LTCs in homeless adults and are delivered by healthcare professionals. Methods and analysis Seven electronic databases (Medline, EMBASE, Cochrane Central Register of Controlled Trials, Assia, Scopus, PsycINFO and CINAHL) will be searched from 1960 (or inception) to October 2016 and supplemented by forward citation searching, handsearching of reference lists and searching grey literature. Two reviewers will independently review titles, abstract and full-texts using DistillerSR software. Inclusion criteria include (1) homeless adults with any physical LTC, (2) interventions delivered by a healthcare professional (any professional trained to provide any form of healthcare, but excluding social workers and professionals without health-related training), (3) comparison with usual care or an alternative intervention, (4) report outcomes such as healthcare usage, physical and psychological health or well-being or cost-effectiveness, (5) randomised controlled trials, non-randomised controlled trials, controlled before-after studies. Quality will be assessed using the Cochrane EPOC Risk of Bias Tool. A meta-analysis will be performed if sufficient data are identified; however, we anticipate a narrative synthesis will be performed. Ethics and dissemination This review will synthesise existing evidence for interventions delivered by healthcare professionals to manage physical LTCs in adults who are homeless. The findings will inform the development of future interventions and research aiming to improve the management of LTCs for people experiencing homelessness. Ethical

  9. Rural Homelessness in Northwest Ohio: Reasons, Patterns, Statistics, and Trends.

    Science.gov (United States)

    Podlin, Georgette A.

    Rural homelessness in America is difficult to define, to count, and to see. This article reports the findings of a 1993 county-wide study of rural homelessness. During a one year survey, 118 homeless households were interviewed. Of those surveyed, 25.8 percent were male adults, 30.9 percent were female adults, and 43.2 percent were children.…

  10. Mental Illness, Healthcare, and Homelessness in Mississippi

    Directory of Open Access Journals (Sweden)

    Tamara Stewart

    2017-09-01

    Full Text Available Mental illness is prevalent among the homeless population and the rate of mentally ill homeless individuals has increased since deinstitutionalization. There is little information about homeless population mental health and access to mental healthcare. This study sought to describe the mental health status and utilization of mental healthcare services among homeless individuals in Mississippi. This is a cross-sectional study with 3,375 adults participants. There were 58% males, 42% females, 45% Caucasian, 54% African Americans, and 1% other minorities (Asian, Indian, and Pacific Islander at intake into Mississippi United to End Homelessness' (MUTEH Homeless Management Information System (HMIS program. The data was collected during the initial screening of homeless individuals. The screening documented mental illness and utilization of healthcare. Frequency tables and Chi-SQ was used to test the relationship between mental illness and utilization of mental healthcare among the homeless in Mississippi. The result of the analysis revealed that 83% of the chronically homeless individual had a mental illness, and 78% of the chronically homeless participants were not receiving mental healthcare. Mental health services were successful in connecting mentally ill homeless individuals to mental healthcare in lieu of institutionalization. However, chronically homeless mentally ill individuals struggle with obtaining appropriate care.

  11. Understanding homelessness

    OpenAIRE

    Somerville, Peter

    2013-01-01

    This paper reviews the literature on understanding homelessness. It criticizes approaches that ignore, distort or diminish the humanity of homeless people, or else, add little to our understanding of that humanity. In particular, it rejects what it calls “epidemiological” approaches, which deny the possibility of agency for homeless people, insofar as those approaches view the situation of those people largely as a “social fact”, to be explained in terms of causal variables or “risk factors” ...

  12. The medical origins of homelessness.

    Science.gov (United States)

    Winkleby, M A; Rockhill, B; Jatulis, D; Fortmann, S P

    1992-01-01

    In 1989 through 1990, we conducted a cross-sectional survey of 1437 homeless adults in northern California (98% response rate). Prevalences of alcohol abuse, illegal drug use, and psychiatric hospitalization when adults first became homeless were 15% to 33% lower than prevalences following homelessness. The largest differences between the homeless and a comparison group of 3122 nonhomeless adults were for psychiatric hospitalization (odds ratios [ORs] of 4.6 for men and 5.9 for women) and alcohol abuse (ORs of 2.3 for men and 4.0 for women). However, when prehomeless prevalences of addictive and psychiatric disorders were compared with prevalences among the nonhomeless, absolute differences were no greater than 12%. PMID:1415869

  13. Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: a randomized trial.

    Science.gov (United States)

    Sadowski, Laura S; Kee, Romina A; VanderWeele, Tyler J; Buchanan, David

    2009-05-06

    Homeless adults, especially those with chronic medical illnesses, are frequent users of costly medical services, especially emergency department and hospital services. To assess the effectiveness of a case management and housing program in reducing use of urgent medical services among homeless adults with chronic medical illnesses. Randomized controlled trial conducted at a public teaching hospital and a private, nonprofit hospital in Chicago, Illinois. Participants were 407 social worker-referred homeless adults with chronic medical illnesses (89% of referrals) from September 2003 until May 2006, with follow-up through December 2007. Analysis was by intention-to-treat. Housing offered as transitional housing after hospitalization discharge, followed by placement in long-term housing; case management offered on-site at primary study sites, transitional housing, and stable housing sites. Usual care participants received standard discharge planning from hospital social workers. Hospitalizations, hospital days, and emergency department visits measured using electronic surveillance, medical records, and interviews. Models were adjusted for baseline differences in demographics, insurance status, prior hospitalization or emergency department visit, human immunodeficiency virus infection, current use of alcohol or other drugs, mental health symptoms, and other factors. The analytic sample (n = 405 [n = 201 for the intervention group, n = 204 for the usual care group]) was 78% men and 78% African American, with a median duration of homelessness of 30 months. After 18 months, 73% of participants had at least 1 hospitalization or emergency department visit. Compared with the usual care group, the intervention group had unadjusted annualized mean reductions of 0.5 hospitalizations (95% confidence interval [CI], -1.2 to 0.2), 2.7 fewer hospital days (95% CI, -5.6 to 0.2), and 1.2 fewer emergency department visits (95% CI, -2.4 to 0.03). Adjusting for baseline covariates

  14. Nurses in Supportive Housing are Associated With Decreased Health Care Utilization and Improved HIV Biomarkers in Formerly Homeless Adults.

    Science.gov (United States)

    Dobbins, Sarah K; Cruz, Marissa; Shah, Saima; Abt, Lyndsey; Moore, Jamie; Bamberger, Joshua

    2016-01-01

    A San Francisco study conducted in 2008 showed that the permanent supportive housing program, Direct Access to Housing, dramatically decreased the risk of death in people living with HIV. In our study, we compared the health care utilization patterns and HIV-related biological markers of formerly homeless adults with HIV before and during two types of permanent supportive housing: (a) housing with on-site nursing care for residents, and (b) housing without on-site nursing care. Using nearest-neighbor matching with propensity scoring, the difference in outcomes was calculated. In the matched analysis, adjusted for adherence to combination antiretroviral therapy, people housed at sites with nurses had 4.8 fewer emergency department visits per person (SE: 1.53, p < .01), and they had an increased mean CD4+ T cell count (101.14 cells per person [SE: 55.10, p < .05]) compared to those who lived at sites without nurses. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  15. Quality of life after housing first for adults with serious mental illness who have experienced chronic homelessness.

    Science.gov (United States)

    Henwood, Benjamin F; Matejkowski, Jason; Stefancic, Ana; Lukens, Jonathan M

    2014-12-15

    This 1-year longitudinal study of adults who have recently transitioned from homelessness to Permanent Supportive Housing (PSH) focuses on quality of life as a primary outcome of interest. Eighty of 103 new tenants participated in structured interviews at the time of entry into their new home and at 12-months post-housing. t-tests assessed differences in community participation and quality of life measures at the 2 time points. Mixed effects models examined the impact of community participation on quality of life. Results show that time in independent housing was significantly associated with several domains of quality of life. Symptom severity was also significantly and negatively related to quality of life domains. Community participation was significantly related to frequency of social contacts only. These findings suggest that community participation is not critical to improving quality of life, and that despite concerns that individuals may feel isolated and lonely when living independently, satisfaction with one׳s living situation and family relationships nevertheless improves with housing tenure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Growth delay in homeless children.

    Science.gov (United States)

    Fierman, A H; Dreyer, B P; Quinn, L; Shulman, S; Courtlandt, C D; Guzzo, R

    1991-11-01

    This study compared the growth of homeless children with National Center for Health Statistics (NCHS) standards and with growth of age-matched domiciled children of similar income level. Homeless children (n = 167) had lower height percentiles when compared with domiciled children (n = 167; P less than .001) and when compared with NCHS standards (P less than .001). The weight-height percentiles of homeless children did not differ from NCHS standards; however, domiciled children had higher weight-heights when compared with the homeless (P less than .001) and with NCHS standards (P less than .001). After controlling via regression analysis for the effects of potentially confounding factors that affect growth, it was found that homeless children from larger families and with single mothers accounted for the lower height percentiles observed. After controlling for confounding factors, domiciled children still had increased weight-height percentiles when compared with the homeless group. Duration of homelessness was not associated with decreased height or weight-height among homeless children. Homeless children in this study exhibited a pattern of stunting without wasting which is characteristic of poor children experiencing moderate, chronic nutritional stress. They exhibited a greater degree of nutritional stress than domiciled children at a similar income level and than that reported in other groups of poor children in the United States. Preexisting social factors in the families of homeless children were important in explaining the observed growth abnormalities. Further exploration of the associations between social characteristics of homeless children and their families and the growth of these children is warranted.

  17. Increasing Access to Higher Education for Unaccompanied Homeless Youth: Information for Colleges and Universities. Best Practices in Homeless Education Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2012

    2012-01-01

    Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

  18. Psychosocial functioning of homeless children.

    Science.gov (United States)

    Vostanis, P; Grattan, E; Cumella, S; Winchester, C

    1997-07-01

    To investigate the psychosocial characteristics of homeless children and their parents. Homeless families were assessed within 2 weeks of admission to seven hostels and were compared with a group of housed families matched for socioeconomic status. Measures included a semistructured interview, the General Health Questionnaire (GHQ), the interview Schedule for Social Interaction, the Child Behavior Checklist (CBCL), the Communication domain of the Vineland Adaptive Behavior Scales, and height and weight percentiles. The sample consisted of 113 homeless families (249 children aged 2 through 16 years) and 29 comparison families (83 children). Homeless families primarily consisted of single mothers and an average of two children, who had become homeless because of domestic violence (56%) or violence from neighbors (29%). Homeless mothers reported high rates of previous abuse (45%) and current psychiatric morbidity (49% caseness on the GHQ) and poor social support networks compared with housed controls. Homeless children were more likely to have histories of abuse, living in care, and being on the at-risk child protection register and less likely to have attended school or a preschool/day-care center since admission to the hostel. They also had delayed communication and higher CBCL scores. Maternal GHQ scores best predicted CBCL caseness. Homeless mothers and children have high rates of psychosocial morbidity, which are related to multiple risk factors and chronic adversities. Their complex needs should be best met by specialized and coordinated health, social, and educational services.

  19. Trajectories of Recovery Among Formerly Homeless Adults With Serious Mental Illness.

    Science.gov (United States)

    Padgett, Deborah K; Smith, Bikki Tran; Choy-Brown, Mimi; Tiderington, Emmy; Mercado, Micaela

    2016-06-01

    Recovery from mental illness is possible, but individuals with co-occurring disorders and homelessness face challenges. Although a nonlinear recovery course is assumed, few studies have analyzed recovery over time. This mixed-methods study examined recovery trajectories over 18 months after enrollment in supportive housing programs of 38 participants with DSM axis I diagnoses. Qualitative interview data were quantified through consensual ratings to generate a recovery score for four waves of data collection based on eight recovery domains culled from the literature. Case study analyses were conducted of participants whose scores varied by one standard deviation or more between baseline and 18 months to identify which domains were important. Most of the 38 participants (N=23) had no significant change in recovery; seven had a negative trajectory, and eight had a positive trajectory. Case studies of these 15 participants indicated domains that contributed to change: significant-other relationships (N=9), engagement in meaningful activities (N=9), mental health (N=7), family relationships (N=6), general medical health (N=5), housing satisfaction (N=5), employment (N=2), and substance use (N=1). Except for mental health and substance use (which contributed only to negative trajectories), the influence of domains was both positive and negative. Domains were intertwined; for example, variation in relationships was linked to changes in meaningful activities. This study showed little change in recovery over time for most participants and a decline in mental health for a small minority. Findings underscore the importance of social relationships and meaningful activities among individuals with serious mental illness, who experience complex challenges.

  20. Accessibility patterns and community integration among previously homeless adults: a Geographic Information Systems (GIS) approach.

    Science.gov (United States)

    Chan, Dara V; Gopal, Sucharita; Helfrich, Christine A

    2014-11-01

    Although a desired rehabilitation goal, research continues to document that community integration significantly lags behind housing stability success rates for people of a variety of ages who used to be homeless. While accessibility to resources is an environmental factor that may promote or impede integration activity, there has been little empirical investigation into the impact of proximity of community features on resource use and integration. Using a Geographic Information Systems (GIS) approach, the current study examines how accessibility or proximity to community features in Boston, United States related to the types of locations used and the size of an individual's "activity space," or spatial presence in the community. Significant findings include an inverse relationship between activity space size and proximity to the number and type of community features in one's immediate area. Specifically, larger activity spaces were associated with neighborhoods with less community features, and smaller activity spaces corresponded with greater availability of resources within one's immediate area. Activity space size also varied, however, based on proximity to different types of resources, namely transportation and health care. Greater community function, or the ability to navigate and use community resources, was associated with better accessibility and feeling part of the community. Finally, proximity to a greater number of individual identified preferred community features was associated with better social integration. The current study suggests the ongoing challenges of successful integration may vary not just based on accessibility to, but relative importance of, specific community features and affinity with one's surroundings. Community integration researchers and housing providers may need to attend to the meaning attached to resources, not just presence or use in the community. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Correlates of homeless episodes among indigenous people.

    Science.gov (United States)

    Whitbeck, Les B; Crawford, Devan M; Sittner Hartshorn, Kelley J

    2012-03-01

    This study reports the correlates of homeless episodes among 873 Indigenous adults who are part of an ongoing longitudinal study on four reservations in the Northern Midwest and four Canadian First Nation reserves. Descriptive analyses depict differences between those who have and have not experienced an episode of homelessness in their lifetimes. Multivariate analyses assess factors associated with a history of homeless episodes at the time of their first interview and differentiate correlates of "near homelessness" (i.e., doubling up) and "homeless episodes" (periods of actual homelessness). Results show that individuals with a history of homeless episodes had significantly more individual and family health, mental health, and substance abuse problems. Periods of homelessness also were associated with financial problems. Among the female caretakers who experienced episodes of homelessness over the course of the study, the majority had been homeless at least once prior to the start of the study and approximately one-fifth met criteria for lifetime alcohol dependence, drug abuse, or major depression. Family adversity during childhood was also common for women experiencing homelessness during the study.

  2. Addressing the health needs of the homeless.

    Science.gov (United States)

    John, William; Law, Kate

    2011-03-01

    Several authors have alluded to the complex health needs of the homeless population in the UK. The correlation between homelessness and a wide range of health problems has been explored in the literature. This paper presents a literature review exploring the biological, psychosocial and sexual health needs of single homeless people. The relationship between health and homelessness is analysed in relation to theories of health inequalities, which suggest that being homeless may be both a cause and a consequence of ill health. The contemporary nurse can play a vital role in helping to overcome the barriers that homeless people face when accessing health services. This paper explores the skills and approaches that nurses in a wide variety of settings can employ in addressing the health issues of homeless clients.

  3. Community-based services for homeless adults experiencing concurrent mental health and substance use disorders: a realist approach to synthesizing evidence.

    Science.gov (United States)

    O'Campo, Patricia; Kirst, Maritt; Schaefer-McDaniel, Nicole; Firestone, Michelle; Scott, Allison; McShane, Kelly

    2009-11-01

    Consultations with community-based service providers in Toronto identified a lack of strong research evidence about successful community-based interventions that address the needs of homeless clients experiencing concurrent mental health and substance use disorders. We undertook a collaborative research effort between academic-based and community-based partners to conduct a systematic evidence synthesis drawing heavily from Pawson's realist review methodology to focus on both whether programs are successful and why and how they lead to improved outcomes. We examined scholarly and nonscholarly literature to explore program approaches and program elements that lead to improvements in mental health and substance use disorders among homeless individuals with concurrent disorders (CD). Information related to program contexts, elements, and successes and failures were extracted and further supplemented by key informant interviews and author communication regarding reviewed published studies. From the ten programs that we reviewed, we identified six important and promising program strategies that reduce mental health and, to a far lesser degree, substance use problems: client choice in treatment decision-making, positive interpersonal relationships between client and provider, assertive community treatment approaches, providing supportive housing, providing supports for instrumental needs, and nonrestrictive program approaches. These promising program strategies function, in part, by promoting and supporting autonomy among homeless adults experiencing CD. Our realist informed review is a useful methodology for synthesizing complex programming information on community-based interventions.

  4. Caring, social policy, and homelessness.

    Science.gov (United States)

    Noddings, Nel

    2002-01-01

    Care theory offers a way to overcome a weakness of liberalism--its reluctance to intervene in the private lives of adults. In caring for the homeless, we must sometimes use a limited form of coercion, but our intervention is always interactive, and the process of finding a solution is one of negotiation between the needs expressed by the homeless and the needs we infer for them.

  5. Correlates of Homeless Episodes among Indigenous People

    OpenAIRE

    Whitbeck, Les B.; Crawford, Devan M.; Hartshorn, Kelley J. Sittner

    2012-01-01

    This study reports the correlates of homeless episodes among 873 Indigenous adults who are part of an ongoing longitudinal study on four reservations in the Northern Midwest and four Canadian First Nation reserves. Descriptive analyses depict differences between those who have and have not experienced an episode of homelessness in their lifetimes. Multivariate analyses assess factors associated with a history of homeless episodes at the time of their first interview. Results show that individ...

  6. Mental Health Services for Homeless Mentally Ill Persons: Federal Initiatives and Current Service Trends.

    Science.gov (United States)

    Levine, Irene S.; Rog, Debra J.

    1990-01-01

    Recent research suggests that approximately one-third of homeless single adults suffer from severe mental illnesses. Discusses federal initiatives undertaken by the National Institutes of Mental Health (NIMH) to encourage research and improve services for this subgroup. Describes the target population, NIMH research findings, and current mental…

  7. Housing Stability among Homeless Individuals with Serious Mental Illness Participating in Housing First Programs

    Science.gov (United States)

    Pearson, Carol; Montgomery, Ann Elizabeth; Locke, Gretchen

    2009-01-01

    This article presents findings from an exploratory study of three programs using the Housing First approach to provide permanent supportive housing for single, homeless adults with serious mental illness and often co-occurring substance-related disorders. This approach provides direct, or nearly direct, access to housing that is intended to be…

  8. Predictors of Emergency Department Visits and Inpatient Admissions Among Homeless and Unstably Housed Adolescents and Young Adults.

    Science.gov (United States)

    Mackelprang, Jessica L; Qiu, Qian; Rivara, Frederick P

    2015-12-01

    Individuals under age 25 years are estimated to comprise one third of the homeless population nationally. Understanding the reasons for utilization of hospitals by homeless youth is important for optimizing disposition planning. Objectives of the present study were to: (1) report prevalence of emergency department (ED) and inpatient admissions among homeless and unstably housed youth; (2) describe demographic characteristics of those youth who seek hospital care; (3) describe their patterns of injury, illness, psychiatric, and substance use conditions; and (4) identify demographic and diagnostic predictors of ED visit or hospital readmission. Retrospective cohort study of 15-25-year-olds (N=402) who were admitted to the ED or inpatient floors of 2 urban teaching hospitals in King County, WA between July 1, 2009 and June 30, 2012 and whose address was "homeless" or "none" or a homeless shelter or service agency (ie, homeless or unstably housed), during any recorded encounter between July 1, 2009 and June 30, 2012. A total of 1151 ED visits and 227 inpatient admissions were documented. Fifty percent of patients had an ED visit or hospital readmission within 1 year, with 43.1% receiving care within 30 days of discharge. Cox regression showed that female individuals with an injury diagnosis (hazard ratio=1.74, 95% confidence interval=1.06, 2.85) and male individuals with an acute medical condition (hazard ratio=1.59, 95% confidence interval=1.09, 2.32) at index visit were more likely to have an ED visit or hospital readmission during the following year, as were patients who provided a private address at their index visit. Homeless young people who seek hospital care demonstrate a high rate of ED visits and hospital readmissions, with unique predictors of utilization associated with sex and housing status. Additional research is necessary to determine how best to transition these young people from hospital-based to community-based care.

  9. Indigenous homelessness

    DEFF Research Database (Denmark)

    Being homeless in one’s homeland is a colonial legacy for many Indigenous people in settler societies. The construction of Commonwealth nation-states from colonial settler societies depended on the dispossession of Indigenous peoples from their lands. The legacy of that dispossession and related...... attempts at assimilation that disrupted Indigenous practices, languages, and cultures—including patterns of housing and land use—can be seen today in the disproportionate number of Indigenous people affected by homelessness in both rural and urban settings. Essays in this collection explore the meaning...... and scope of Indigenous homelessness in the Canada, Australia, and New Zealand. They argue that effective policy and support programs aimed at relieving Indigenous homelessness must be rooted in Indigenous conceptions of home, land, and kinship, and cannot ignore the context of systemic inequality...

  10. Responding to the needs of the homeless mentally ill.

    OpenAIRE

    Frazier, S H

    1985-01-01

    The homeless mentally ill represent a pivotal and urgent challenge to the mental health field in the 1980s. Those homeless who have extended histories of psychiatric hospitalization stand as harsh reminders of the failures of deinstitutionalization, while young mentally ill homeless adults who never have been treated as inpatients testify to the gaps and unrealized promises of community-based care under deinstitutionalization. Homelessness and mental illness are social and clinical problems, ...

  11. Homelessness Felt

    OpenAIRE

    Robinson, Catherine

    2011-01-01

    The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Throu...

  12. Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial.

    Science.gov (United States)

    Stergiopoulos, Vicky; Gozdzik, Agnes; Misir, Vachan; Skosireva, Anna; Connelly, Jo; Sarang, Aseefa; Whisler, Adam; Hwang, Stephen W; O'Campo, Patricia; McKenzie, Kwame

    2015-01-01

    Housing First (HF) is being widely disseminated in efforts to end homelessness among homeless adults with psychiatric disabilities. This study evaluates the effectiveness of HF with Intensive Case Management (ICM) among ethnically diverse homeless adults in an urban setting. 378 participants were randomized to HF with ICM or treatment-as-usual (TAU) in Toronto (Canada), and followed for 24 months. Measures of effectiveness included housing stability, physical (EQ5D-VAS) and mental (CSI, GAIN-SS) health, social functioning (MCAS), quality of life (QoLI20), and health service use. Two-thirds of the sample (63%) was from racialized groups and half (50%) were born outside Canada. Over the 24 months of follow-up, HF participants spent a significantly greater percentage of time in stable residences compared to TAU participants (75.1% 95% CI 70.5 to 79.7 vs. 39.3% 95% CI 34.3 to 44.2, respectively). Similarly, community functioning (MCAS) improved significantly from baseline in HF compared to TAU participants (change in mean difference = +1.67 95% CI 0.04 to 3.30). There was a significant reduction in the number of days spent experiencing alcohol problems among the HF compared to TAU participants at 24 months (ratio of rate ratios = 0.47 95% CI 0.22 to 0.99) relative to baseline, a reduction of 53%. Although the number of emergency department visits and days in hospital over 24 months did not differ significantly between HF and TAU participants, fewer HF participants compared to TAU participants had 1 or more hospitalizations during this period (70.4% vs. 81.1%, respectively; P=0.044). Compared to non-racialized HF participants, racialized HF participants saw an increase in the amount of money spent on alcohol (change in mean difference = $112.90 95% CI 5.84 to 219.96) and a reduction in physical community integration (ratio of rate ratios = 0.67 95% CI 0.47 to 0.96) from baseline to 24 months. Secondary analyses found a significant reduction in the number of days

  13. Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial

    Science.gov (United States)

    Stergiopoulos, Vicky; Gozdzik, Agnes; Misir, Vachan; Skosireva, Anna; Connelly, Jo; Sarang, Aseefa; Whisler, Adam; Hwang, Stephen W.; O’Campo, Patricia; McKenzie, Kwame

    2015-01-01

    Housing First (HF) is being widely disseminated in efforts to end homelessness among homeless adults with psychiatric disabilities. This study evaluates the effectiveness of HF with Intensive Case Management (ICM) among ethnically diverse homeless adults in an urban setting. 378 participants were randomized to HF with ICM or treatment-as-usual (TAU) in Toronto (Canada), and followed for 24 months. Measures of effectiveness included housing stability, physical (EQ5D-VAS) and mental (CSI, GAIN-SS) health, social functioning (MCAS), quality of life (QoLI20), and health service use. Two-thirds of the sample (63%) was from racialized groups and half (50%) were born outside Canada. Over the 24 months of follow-up, HF participants spent a significantly greater percentage of time in stable residences compared to TAU participants (75.1% 95% CI 70.5 to 79.7 vs. 39.3% 95% CI 34.3 to 44.2, respectively). Similarly, community functioning (MCAS) improved significantly from baseline in HF compared to TAU participants (change in mean difference = +1.67 95% CI 0.04 to 3.30). There was a significant reduction in the number of days spent experiencing alcohol problems among the HF compared to TAU participants at 24 months (ratio of rate ratios = 0.47 95% CI 0.22 to 0.99) relative to baseline, a reduction of 53%. Although the number of emergency department visits and days in hospital over 24 months did not differ significantly between HF and TAU participants, fewer HF participants compared to TAU participants had 1 or more hospitalizations during this period (70.4% vs. 81.1%, respectively; P=0.044). Compared to non-racialized HF participants, racialized HF participants saw an increase in the amount of money spent on alcohol (change in mean difference = $112.90 95% CI 5.84 to 219.96) and a reduction in physical community integration (ratio of rate ratios = 0.67 95% CI 0.47 to 0.96) from baseline to 24 months. Secondary analyses found a significant reduction in the number of days

  14. Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Vicky Stergiopoulos

    Full Text Available Housing First (HF is being widely disseminated in efforts to end homelessness among homeless adults with psychiatric disabilities. This study evaluates the effectiveness of HF with Intensive Case Management (ICM among ethnically diverse homeless adults in an urban setting. 378 participants were randomized to HF with ICM or treatment-as-usual (TAU in Toronto (Canada, and followed for 24 months. Measures of effectiveness included housing stability, physical (EQ5D-VAS and mental (CSI, GAIN-SS health, social functioning (MCAS, quality of life (QoLI20, and health service use. Two-thirds of the sample (63% was from racialized groups and half (50% were born outside Canada. Over the 24 months of follow-up, HF participants spent a significantly greater percentage of time in stable residences compared to TAU participants (75.1% 95% CI 70.5 to 79.7 vs. 39.3% 95% CI 34.3 to 44.2, respectively. Similarly, community functioning (MCAS improved significantly from baseline in HF compared to TAU participants (change in mean difference = +1.67 95% CI 0.04 to 3.30. There was a significant reduction in the number of days spent experiencing alcohol problems among the HF compared to TAU participants at 24 months (ratio of rate ratios = 0.47 95% CI 0.22 to 0.99 relative to baseline, a reduction of 53%. Although the number of emergency department visits and days in hospital over 24 months did not differ significantly between HF and TAU participants, fewer HF participants compared to TAU participants had 1 or more hospitalizations during this period (70.4% vs. 81.1%, respectively; P=0.044. Compared to non-racialized HF participants, racialized HF participants saw an increase in the amount of money spent on alcohol (change in mean difference = $112.90 95% CI 5.84 to 219.96 and a reduction in physical community integration (ratio of rate ratios = 0.67 95% CI 0.47 to 0.96 from baseline to 24 months. Secondary analyses found a significant reduction in the number of days

  15. Preliminary Findings on Rural Homelessness in Ohio.

    Science.gov (United States)

    First, Richard J.; And Others

    This report is designed to present preliminary findings from the first comprehensive study of rural homelessness in the United States. The study was conducted during the first 6 months of 1990, and data were collected from interviews with 921 homeless adults in 21 randomly selected rural counties in Ohio. The sample counties represent 26% of the…

  16. Risk factors for homelessness among US veterans.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  17. Risk Factors for Homelessness Among US Veterans

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  18. 77 FR 1971 - Supplemental Security Income and Homeless Individuals

    Science.gov (United States)

    2012-01-12

    ... Report, almost 650,000 people were homeless on a single night in January 2010, an increase of 1.1 percent... Homeless Individuals AGENCY: Social Security Administration. ACTION: Notice; Request for Comments. SUMMARY: We are requesting information from the public regarding the unique needs of homeless Supplemental...

  19. Community integration of adults with psychiatric disabilities and histories of homelessness.

    Science.gov (United States)

    Gulcur, Leyla; Tsemberis, Sam; Stefancic, Ana; Greenwood, Ronni M

    2007-06-01

    This study tests components of Wong and Solomon's (2002, Mental Health Services Research, 4(2), 13-28) model of community integration, identifying both the dimensions and predictors of integration. It evaluates community integration among adults with psychiatric disabilities assigned randomly to receive either independent scatter-site apartments with the Housing First approach (experimental) or services as usual (control). Factor analysis supported a definition of community integration that includes psychological, physical, and social domains, but also suggested the existence of another factor, independence/self-actualization. Regression analysis suggested that choice and independent scatter-site housing were predictors of psychological and social integration respectively. Psychiatric hospitalization, symptomatology and participation in substance use treatment were also found to influence aspects of integration. We discuss several issues that future studies should explore including the possibility that the same factor can differentially influence discrete aspects of integration, the role of person-environment fit, integration that is not based in the neighborhood, and, finally, conceptions of community integration from the perspective of consumers themselves.

  20. Homeless Women, Special Possessions, and the Meaning of "Home": An Ethnographic Case Study.

    OpenAIRE

    Hill, Ronald Paul

    1991-01-01

    This article investigates homelessness among adult women, an important and growing subpopulation among the homeless. To examine their situation within a consumer-behavior context, an ethnographic case study of a shelter for homeless women run by an order of Roman Catholic sisters was performed. The study focused on how these women became homeless, the effects of early life experiences on their homelessness, available emotional and financial support, possessions that were lost, maintained, or ...

  1. Homelessness Felt

    Directory of Open Access Journals (Sweden)

    Catherine Robinson

    2011-04-01

    Full Text Available The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Through a series of short ‘felt’ reflections, consideration of the critical role of corporeality in coming to know and inscribe the experiences of others is prompted.  The feeling, researching body is posited as central to new, productive and holistic intertwinings with felt-experience and the mixed trajectories of grief, humour, violence and trauma that often characterise persistent homelessness are made vivid. 

  2. Homelessness Felt

    Directory of Open Access Journals (Sweden)

    Catherine Robinson

    2011-04-01

    Full Text Available The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Through a series of short ‘felt’ reflections, consideration of the critical role of corporeality in coming to know and inscribe the experiences of others is prompted.  The feeling, researching body is posited as central to new, productive and holistic intertwinings with felt-experience and the mixed trajectories of grief, humour, violence and trauma that often characterise persistent homelessness are made vivid.

  3. Mortality and Cause of Death in Younger Homeless Veterans.

    Science.gov (United States)

    Schinka, John A; Leventhal, Katherine C; Lapcevic, William A; Casey, Roger

    Increased mortality has been documented in older homeless veterans. This retrospective study examined mortality and cause of death in a cohort of young and middle-aged homeless veterans. We examined US Department of Veterans Affairs records on homelessness and health care for 2000-2003 and identified 23 898 homeless living veterans and 65 198 non-homeless living veterans aged 30-54. We used National Death Index records to determine survival status. We compared survival rates and causes of death for the 2 groups during a 10-year follow-up period. A greater percentage of homeless veterans (3905/23 898, 16.3%) than non-homeless veterans (4143/65 198, 6.1%) died during the follow-up period, with a hazard ratio for risk of death of 2.9. The mean age at death (52.3 years) for homeless veterans was approximately 1 year younger than that of non-homeless veterans (53.2 years). Most deaths among homeless veterans (3431/3905, 87.9%) and non-homeless veterans (3725/4143, 89.9%) were attributed to 7 cause-of-death categories in the International Classification of Diseases, 10th Revision (cardiovascular system; neoplasm; external cause; digestive system; respiratory system; infectious disease; and endocrine, nutritional, and metabolic diseases). Death by violence was rare but was associated with a significantly higher risk among homeless veterans than among non-homeless veterans (suicide hazard ratio = 2.7; homicide hazard ratio = 7.6). Younger and middle-aged homeless veterans had higher mortality rates than those of their non-homeless veteran peers. Our results indicate that homelessness substantially increases mortality risk in veterans throughout the adult age range. Health assessment would be valuable for assessing the mortality risk among homeless veterans regardless of age.

  4. Homelessness in a national sample of incarcerated veterans in state and federal prisons.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; McGuire, James F

    2014-05-01

    The Veterans Health Administration (VHA) has been increasing efforts to reach out to assist incarcerated veterans. While previous studies have shown strong associations between incarceration and homelessness, few studies have examined distinctive characteristics of incarcerated homeless and non-homeless veterans. National administrative data on 30,348 incarcerated veterans served by the Health Care for Re-entry Veterans (HCRV) program were analyzed. Incarcerated veterans were classified into four groups based on their history of past homelessness: not homeless, transiently homeless, episodically homeless, and chronically homeless. Multinomial logistic regression was used to compare groups on sociodemographic characteristics, criminal justice status, clinical status, and their interest in using VHA services. Of the sample, 70 % were classified as not homeless, 8 % as transiently homeless, 11 % as episodically homeless, and 11 % as chronically homeless. Thus, 30 % of the sample had a homeless history, which is five times the 6 % rate of past homelessness among adult men in the general population. Compared to non-homeless incarcerated veterans, all three homeless groups reported significantly more mental health problems, more substance abuse, more times arrested in their lifetime, more likely to be incarcerated for a non-violent offense, and were more interested in receiving VHA services after release from prison. Together, these findings suggest re-entry programs, like HCRV, can address relevant mental health-related service needs, especially among formerly homeless veterans and veterans in need of services are receptive to the offer of assistance.

  5. Homelessness Assistance and Resources

    Science.gov (United States)

    ... Report (AHAR) to Congress: Part 1 found that homelessness among families with children declined 5.4 percent nationwide since ... on the front lines of serving individuals and families experiencing homelessness. Disaster Recovery Homelessness Toolkit Recovery Guide for Local ...

  6. People Experiencing Chronic Homelessness

    Science.gov (United States)

    ... Home Goals Ending Chronic Homelessness Share Ending Chronic Homelessness Last updated on August 04, 2017 We can ... the USICH newsletter. We know how to end homelessness. Let's do it, together. Sign up for our ...

  7. Veterans and Homelessness

    Science.gov (United States)

    2013-11-29

    who have one short stay in a homeless shelter before returning to permanent housing. In the second category, those who are episodically homeless ...p. 123. 3 See Randall Kuhn and Dennis P. Culhane, “Applying Cluster Analysis to Test a Typology of Homelessness by Pattern of Shelter Utilization...be considered homeless . Literal Homelessness : An individual or family is homeless if they lack a fixed, regular, and adequate nighttime residence

  8. Effect of scattered-site housing using rent supplements and intensive case management on housing stability among homeless adults with mental illness: a randomized trial.

    Science.gov (United States)

    Stergiopoulos, Vicky; Hwang, Stephen W; Gozdzik, Agnes; Nisenbaum, Rosane; Latimer, Eric; Rabouin, Daniel; Adair, Carol E; Bourque, Jimmy; Connelly, Jo; Frankish, James; Katz, Laurence Y; Mason, Kate; Misir, Vachan; O'Brien, Kristen; Sareen, Jitender; Schütz, Christian G; Singer, Arielle; Streiner, David L; Vasiliadis, Helen-Maria; Goering, Paula N

    2015-03-03

    Scattered-site housing with Intensive Case Management (ICM) may be an appropriate and less-costly option for homeless adults with mental illness who do not require the treatment intensity of Assertive Community Treatment. To examine the effect of scattered-site housing with ICM services on housing stability and generic quality of life among homeless adults with mental illness and moderate support needs for mental health services. The At Home/Chez Soi project was an unblinded, randomized trial. From October 2009 to July 2011, participants (N = 1198) were recruited in 4 Canadian cities (Vancouver, Winnipeg, Toronto, and Montreal), randomized to the intervention group (n = 689) or usual care group (n = 509), and followed up for 24 months. The intervention consisted of scattered-site housing (using rent supplements) and off-site ICM services. The usual care group had access to existing housing and support services in their communities. The primary outcome was the percentage of days stably housed during the 24-month period following randomization. The secondary outcome was generic quality of life, assessed by a EuroQoL 5 Dimensions (EQ-5D) health questionnaire. During the 24 months after randomization, the adjusted percentage of days stably housed was higher among the intervention group than the usual care group, although adjusted mean differences varied across sites. [table: see text] The mean change in EQ-5D score from baseline to 24 months among the intervention group was not statistically different from the usual care group (60.5 [95%CI, 58.6 to 62.5] at baseline and 67.2 [95%CI, 65.2 to 69.1] at 24 months for the intervention group vs 62.1 [95% CI, 59.9 to 64.4] at baseline and 68.6 [95%CI, 66.3 to 71.0] at 24 months for the usual care group, difference in mean changes, 0.10 [95%CI, −2.92 to 3.13], P=.95). Among homeless adults with mental illness in 4 Canadian cities, scattered site housing with ICM services compared with usual access to existing housing and

  9. Feasibility and Acceptability of a Pilot Housing Transition Program for Homeless Adults with Mental Illness and Substance Use.

    Science.gov (United States)

    Gutman, Sharon A; Raphael-Greenfield, Emily I; Simon, Phyllis M

    2016-01-01

    The purpose of this study was to determine if a housing transition program was feasible and acceptable to homeless clients with mental illness and substance use histories. Ten male residents of a homeless shelter participated in the 3-week housing intervention. The intervention used a DVD format with instructional videos, graphics, and opportunities for hands-on practice of functional skills in a simulated apartment environment. Outcome measures included goal attainment scale scores (GAS), satisfaction surveys, and case manager reports. Six of the 10 participants completed the program and achieved GAS scores at a greater level than expected at baseline (T > 50). Participants reported the intervention to be engaging and enhanced their knowledge of the housing transition process. The intervention appears to have assisted the participants in the attainment of housing skills and warrants further study.

  10. Housing first reduces re-offending among formerly homeless adults with mental disorders: results of a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Julian M Somers

    Full Text Available BACKGROUND: Homelessness and mental illness have a strong association with public disorder and criminality. Experimental evidence indicates that Housing First (HF increases housing stability and perceived choice among those experiencing chronic homelessness and mental disorders. HF is also associated with lower residential costs than common alternative approaches. Few studies have examined the effect of HF on criminal behavior. METHODS: Individuals meeting criteria for homelessness and a current mental disorder were randomized to one of three conditions treatment as usual (reference; scattered site HF; and congregate HF. Administrative data concerning justice system events were linked in order to study prior histories of offending and to test the relationship between housing status and offending following randomization for up to two years. RESULTS: The majority of the sample (67% was involved with the justice system, with a mean of 8.07 convictions per person in the ten years prior to recruitment. The most common category of crime was "property offences" (mean=4.09. Following randomization, the scattered site HF condition was associated with significantly lower numbers of sentences than treatment as usual (Adjusted IRR=0.29; 95% CI 0.12-0.72. Congregate HF was associated with a marginally significant reduction in sentences compared to treatment as usual (Adjusted IRR=0.55; 95% CI: 0.26-1.14. CONCLUSIONS: This study is the first randomized controlled trial to demonstrate benefits of HF among a homeless sample with mental illness in the domain of public safety and crime. Our sample was frequently involved with the justice system, with great personal and societal costs. Further implementation of HF is strongly indicated, particularly in the scattered site format. Research examining interdependencies between housing, health, and the justice system is indicated. TRIAL REGISTRATION: ISRCTN57595077.

  11. Housing first reduces re-offending among formerly homeless adults with mental disorders: results of a randomized controlled trial.

    Science.gov (United States)

    Somers, Julian M; Rezansoff, Stefanie N; Moniruzzaman, Akm; Palepu, Anita; Patterson, Michelle

    2013-01-01

    Homelessness and mental illness have a strong association with public disorder and criminality. Experimental evidence indicates that Housing First (HF) increases housing stability and perceived choice among those experiencing chronic homelessness and mental disorders. HF is also associated with lower residential costs than common alternative approaches. Few studies have examined the effect of HF on criminal behavior. Individuals meeting criteria for homelessness and a current mental disorder were randomized to one of three conditions treatment as usual (reference); scattered site HF; and congregate HF. Administrative data concerning justice system events were linked in order to study prior histories of offending and to test the relationship between housing status and offending following randomization for up to two years. The majority of the sample (67%) was involved with the justice system, with a mean of 8.07 convictions per person in the ten years prior to recruitment. The most common category of crime was "property offences" (mean=4.09). Following randomization, the scattered site HF condition was associated with significantly lower numbers of sentences than treatment as usual (Adjusted IRR=0.29; 95% CI 0.12-0.72). Congregate HF was associated with a marginally significant reduction in sentences compared to treatment as usual (Adjusted IRR=0.55; 95% CI: 0.26-1.14). This study is the first randomized controlled trial to demonstrate benefits of HF among a homeless sample with mental illness in the domain of public safety and crime. Our sample was frequently involved with the justice system, with great personal and societal costs. Further implementation of HF is strongly indicated, particularly in the scattered site format. Research examining interdependencies between housing, health, and the justice system is indicated. ISRCTN57595077.

  12. Correlates of hepatitis B virus and HIV knowledge among gay and bisexual homeless young adults in Hollywood.

    Science.gov (United States)

    Nyamathi, Adeline; Salem, Benissa; Reback, Cathy J; Shoptaw, Steven; Branson, Catherine M; Idemundia, Faith E; Kennedy, Barbara; Khalilifard, Farinaz; Marfisee, Mary; Liu, Yihang

    2013-01-01

    Homeless gay and bisexual (G/B) young men have multiple risk factors that increase their risk of contracting hepatitis B virus (HBV) and human immunodeficiency virus (HIV). This study used baseline information from structured instruments to assess correlates of knowledge to HIV and HBV infection from 267 young (18-39 year old) G/B active methamphetamine, cocaine, and crack-using homeless men enrolled in a longitudinal trial. The study is designed to reduce drug use and improve knowledge of hepatitis and HIV/AIDS in a community center in Hollywood, California. Regression modeling revealed that previous hepatitis education delivered to G/B men was associated with higher levels of HIV/AIDS and hepatitis knowledge. Moreover, higher HIV/AIDS knowledge was associated with combining sex and drinking alcohol. Associations with hepatitis B knowledge was found among G/B men who were engaging in sex while under the influence of marijuana, who were receiving support from non-drug users, and who had been homeless in the last 4 months. Although being informed about HIV/AIDS and hepatitis did not preclude risky sexual and drug use behavior, knowledge about the dangers of concurrent sex with substance use is important. As higher levels of knowledge of hepatitis was associated with more moderate drug use, early access to testing and teaching harm reduction strategies remain critical to reduce exposure and infection of HBV and HIV in this population.

  13. Increasing Access to Higher Education for Unaccompanied Youth: Information for Colleges and Universities. Best Practices in Homeless Education

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2010

    2010-01-01

    Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

  14. Assessment of health status and quality of life of homeless persons in Belgrade, Serbia.

    Science.gov (United States)

    Sarajlija, Marija; Jugović, Aleksandar; Zivaljević, Dragan; Merdović, Boro; Sarajlija, Adrijan

    2014-02-01

    Homelessness is a problem with social, medical, economic, political and other implications. Despite a large number of studies, reports about health-related quality of life (HRQoL) of homeless persons remain sparse. There is a summary of consistent evidence that homeless people have higher prevalence of chronic disease (mental and somatic) than general population. The aim of this study was to assess HRQoL and depression in homeless persons in Belgrade, to describe their sociodemographic factors and health status (the presence of chronic mental and somatic diseases and addiction disorders) and analyse impact of sociodemographic factors and health status to HRQoL and depression of homeless persons. The study was conducted in the Shelter for Adult and Elderly Persons in Belgrade, from January 1 to January 31, 2012. A set of questionnaires used in survey included Serbian translation of SF-36 questionnaire, Serbian translation of Beck Depression Inventory-II (BDI-II) and sociodemographic questionnaire. Statistical analysis was performed by descriptive and analytic methods. Our study sample consisted of 104 adult participants. The majority of them were male (74%) and the mean age in the sample was 48.2 +/- 13.0 years. We have found that 35.6% participants had lifetime diagnosis of psychiatric disorder, most frequently depression (lifetime prevalence of 15.4% in the study group). The history of suicide attempts was registered in 28 (26.9%) participants. Lifetime illicit drugs use was reported by 12.5%, daily smoking by 82.7% and daily alcohol consumption by 8.7% of the participants. Most common somatic chronic diseases were cardiovascular while chronic lung diseases were the second most frequent. Single chronic disaese was present in 33 (31.7%) of the participants and comorbidity of 2 chronic diseases was present in 20 of them. A statistically significant difference between participants HRQoL SF-36 domain scores and norms of general population was found only for role

  15. The Meaning of "Being Single" for Mormon College-Age Single Adults

    OpenAIRE

    Darrington, Jana

    2003-01-01

    This study researched the meaning of being single among 24 college-age adults of The Church of Jesus Christ of Latter-day Saints (i.e., Mormons). It examined influences on the construction of meanings of singlehood, gender patterns regarding the meaning of singlehood, and pressures on L.D.S. singles to date and marry. The most important finding was that positive attitudes toward singlehood are more prevalent than negative or ambivalent attitudes. Families, as gate-keepers and transmitters ...

  16. Community participation and belonging among formerly homeless adults with mental illness after 12 months of Housing First in Vancouver, British Columbia: a randomized controlled trial.

    Science.gov (United States)

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2014-07-01

    This study examines community integration among homeless adults with mental illness 6 and 12 months after random assignment to Housing First (independent apartments or congregate residence) with support services or to treatment as usual (TAU). Residence in independent apartments was associated with increased 'psychological integration' for participants with less severe needs; however, no significant improvement in 'physical integration' was observed among any of the intervention groups. Analysis of individual items on the Psychological Integration subscale revealed that, compared to TAU, participants assigned to independent apartments were more likely to endorse statements related to the emotional components of community but not statements related to neighboring. Participants assigned to the congregate residence were more likely to endorse knowing their neighbors, but not interacting with neighbors or the emotional components of community. Findings are discussed in terms of housing program as well as broader contextual factors.

  17. Emotional Health Among Youth Experiencing Family Homelessness.

    Science.gov (United States)

    Barnes, Andrew J; Gilbertson, Jace; Chatterjee, Debanjana

    2018-04-01

    Youth who are homeless with adult family members comprise 37% of the US homeless population, yet mental health among this group has not yet been well described. We aimed to compare the risk of suicidality, and factors that may protect against it, between family-homeless and nonhomeless youth. We used cross-sectional data, representing 62 034 eighth- to 12th-graders, to estimate the adjusted odds ratio (aOR) of emotional distress, self-injury, suicidal ideation, and attempted suicide in the past 12 months for youth who experienced family homelessness in the past 12 months compared with housed youth, controlling for covariates. We then tested whether developmental assets moderated these outcomes. Four percent ( n = 4594) of youth (mean age 14.9 years) were homeless with an adult family member. Among these, 29.1% ( n = 1317; aOR: 2.52, 95% confidence interval [CI] 2.34-2.69) reported self-injury, 21% ( n = 940; aOR: 2.30, 95% CI: 2.14-2.48) reported suicidal ideation, and 9.3% ( n = 416; aOR: 3.24, 95% CI: 2.91-3.60) reported suicide attempts. Developmental assets decreased the odds of these outcomes for all youth but were less protective for homeless youth. Youth experiencing recent family homelessness are at higher risk of suicidality than their nonhomeless peers, suggesting homelessness itself as a marker of risk. Factors that protect emotional health are less impactful among youth experiencing recent family homelessness. Thus, interventions among homeless youth may need to address social determinants of health such as stable housing and adversity in addition to developmental assets. Copyright © 2018 by the American Academy of Pediatrics.

  18. Characteristics of the old and homeless: identifying distinct service needs.

    Science.gov (United States)

    Kimbler, Kristopher J; DeWees, Mari A; Harris, Ashley N

    2017-02-01

    Research suggests that being older and homeless is associated with unique characteristics and potential barriers to improved living conditions. Additional research is needed to better understand the vulnerabilities associated with this population. The purpose of this study was to identify characteristics related to aging and homelessness. It was hypothesized that older adults would exhibit more vulnerability compared to other age groups related to health, social support proximity, occupational perceptions, and recent living conditions prior to seeking assistance at an emergency shelter. It was also hypothesized that these age-related characteristics would predict the amount of time that individuals resided in the emergency shelter. A cross-sectional sample of young, middle-aged, and older homeless adults seeking shelter at two emergency homeless shelters was utilized for this study. Data included information obtained during a structured interview after participants arrived at the shelter and the number of days that were spent at the shelter. Older adults were more likely to exhibit several characteristics (i.e., poorer health, being further from social support, longer durations of homelessness, lack of employment area, prior residence types, and mental health treatment) potentially contributing to and/or recovering from homelessness. Duration of homelessness, reports of having no career area, and age were predictive of the amount of time spent at the shelter. The various characteristics that differentiate older homeless populations (e.g., health, social support, homelessness duration, and employment) could create potential barriers to overcoming homelessness that should be considered when serving this population.

  19. Discrimination and Exiting Homelessness among Homeless Adolescents

    OpenAIRE

    Milburn, Norweeta G.; Ayala, George; Rice, Eric; Batterham, Philip; Rotheram-Borus, Mary Jane

    2006-01-01

    This paper examines how newly homeless adolescents’ discrimination experiences were associated with exiting homelessness after six months. A sample of 262 homeless adolescents, aged 12 to 20 years, were recruited and followed longitudinally (six-month retention rate = 88%). Discrimination was related to being gay, lesbian, or bisexual (LGB). Discrimination from family was related to exiting homelessness. Other than those who were LGB, adolescents who reported discrimination from their familie...

  20. Correlates of Homeless Episodes among Indigenous People

    Science.gov (United States)

    Whitbeck, Les B.; Crawford, Devan M.; Hartshorn, Kelley J. Sittner

    2011-01-01

    This study reports the correlates of homeless episodes among 873 Indigenous adults who are part of an ongoing longitudinal study on four reservations in the Northern Midwest and four Canadian First Nation reserves. Descriptive analyses depict differences between those who have and have not experienced an episode of homelessness in their lifetimes. Multivariate analyses assess factors associated with a history of homeless episodes at the time of their first interview. Results show that individuals with a history of homeless episodes had significantly more individual and family health, mental health, and substance abuse problems. Periods of homelessness also were associated with financial problems. Among the female caretakers who experienced episodes of homelessness over the course of the study, the majority had been homeless at least once prior to the start of the study and approximately one–fifth met criteria for lifetime alcohol dependence, drug abuse, or major depression. Family adversity during childhood was also common for women experiencing homelessness during the study. PMID:21656303

  1. Gender and Homelessness.

    Science.gov (United States)

    Hagen, Jan L.

    1987-01-01

    Examines a homeless population (N=227) requesting social services including similarities and differences for women and men. Findings indicated women and men experienced homelessness somewhat differently. Women were more likely to become homeless because of eviction and domestic violence, whereas men were more likely to become homeless as a result…

  2. Homelessness in Public Libraries

    Science.gov (United States)

    Wong, Yi Ling

    2009-01-01

    This paper takes a theoretical and practical approach in defining the "problem" of homelessness in libraries. The author examines three fundamental problems on homelessness. The three fundamental questions are: (a) Who are the homeless? (b) Why are they homeless? (c) What are their information needs in libraries? These questions are important in…

  3. Homeless Families and Children.

    Science.gov (United States)

    Lewit, Eugene M.; Baker, Linda Schuurmann

    1996-01-01

    Available data on homeless families and children are reviewed, focusing on definitions of homelessness and the most common methods used to estimate the size of the homeless population. Trends in the duration of homelessness and the numbers of families at risk of losing housing are discussed. (SLD)

  4. Adult Attachment and Relationship Status (Single vs. Partnered in Polish Young Adults

    Directory of Open Access Journals (Sweden)

    Jamila Bookwala

    2013-12-01

    Full Text Available This study examined links between adult attachment and relationship status (single vs. partnered in Polish young adults. Three hundred and seventeen participants (173 females and 144 males aged 22-27 years old (M = 24.69, SD = 1.87, completed the Polish-language version of the Revised Adult Attachment Scale (RAAS used to measure adult attachment. All the respondents were heterosexual, unmarried and had no children. One hundred and fifty seven (49.50% students declared being in a romantic relationship at the time of the assessment whilst 160 students (50.50% were not. Results indicated that single participants reported higher levels of worry about being rejected or unloved (Anxiety dimension and lower levels of comfort with closeness (Close dimension, and comfort with depending on others (Depend dimension. In terms of attachment categories, analyses indicated that higher proportions of single participants were categorized into fearful and preoccupied attachment styles and a lower proportion of them were categorized into the secure attachment style compared to partnered individuals. Discriminant analysis revealed that worry of being rejected or unloved (Anxiety dimension was the strongest factor discriminating between single and partnered relationship status: the higher the anxiety dimension scores, the higher chances of being single. No gender differences were obtained on attachment dimensions and styles.

  5. Deinstitutionalised patients, homelessness and imprisonment: systematic review.

    Science.gov (United States)

    Winkler, Petr; Barrett, Barbara; McCrone, Paul; Csémy, Ladislav; Janous̆ková, Miroslava; Höschl, Cyril

    2016-05-01

    Reports linking the deinstitutionalisation of psychiatric care with homelessness and imprisonment have been published widely. To identify cohort studies that followed up or traced back long-term psychiatric hospital residents who had been discharged as a consequence of deinstitutionalisation. A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalised patients were examined in detail. Twenty-three studies of unique populations assessed homelessness and imprisonment among patients discharged from long-term care. Homelessness and imprisonment occurred sporadically; in the majority of studies no single case of homelessness or imprisonment was reported. Our results contradict the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and an increasing number of people with mental health problems who were homeless or in prison. © The Royal College of Psychiatrists 2016.

  6. Outbreak of Invasive Infections From Subtype emm26.3 Group A Streptococcus Among Homeless Adults-Anchorage, Alaska, 2016-2017.

    Science.gov (United States)

    Mosites, Emily; Frick, Anna; Gounder, Prabhu; Castrodale, Louisa; Li, Yuan; Rudolph, Karen; Hurlburt, Debby; Lecy, Kristen D; Zulz, Tammy; Adebanjo, Tolu; Onukwube, Jennifer; Beall, Bernard; Van Beneden, Chris A; Hennessy, Thomas; McLaughlin, Joseph; Bruce, Michael G

    2018-03-19

    In 2016, we detected an outbreak of group A Streptococcus (GAS) invasive infections among the estimated 1000 persons experiencing homelessness (PEH) in Anchorage, Alaska. We characterized the outbreak and implemented a mass antibiotic intervention at homeless service facilities. We identified cases through the Alaska GAS laboratory-based surveillance system. We conducted emm typing, antimicrobial susceptibility testing, and whole-genome sequencing on all invasive isolates and compared medical record data of patients infected with emm26.3 and other emm types. In February 2017, we offered PEH at 6 facilities in Anchorage a single dose of 1 g of azithromycin. We collected oropharyngeal and nonintact skin swabs on a subset of participants concurrent with the intervention and 4 weeks afterward. From July 2016 through April 2017, we detected 42 invasive emm26.3 cases in Anchorage, 35 of which were in PEH. The emm26.3 isolates differed on average by only 2 single-nucleotide polymorphisms. Compared to other emm types, infection with emm26.3 was associated with cellulitis (odds ratio [OR], 2.5; P = .04) and necrotizing fasciitis (OR, 4.4; P = .02). We dispensed antibiotics to 391 PEH. Colonization with emm26.3 decreased from 4% of 277 at baseline to 1% of 287 at follow-up (P = .05). Invasive GAS incidence decreased from 1.5 cases per 1000 PEH/week in the 6 weeks prior to the intervention to 0.2 cases per 1000 PEH/week in the 6 weeks after (P = .01). In an invasive GAS outbreak in PEH in Anchorage, mass antibiotic administration was temporally associated with reduced invasive disease cases and colonization prevalence.

  7. Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV.

    Science.gov (United States)

    Royal, Scott W; Kidder, Daniel P; Patrabansh, Satyendra; Wolitski, Richard J; Holtgrave, David R; Aidala, Angela; Pals, Sherri; Stall, Ron

    2009-04-01

    The aim of this study is to investigate adherence to highly active antiretroviral therapy (HAART) in persons living with HIV/AIDS (PLWHA) who are homeless or unstably housed. We evaluated homeless or unstably housed PLWHA (n=644) in three US cities were enrolled in the Housing and Health Study. Using baseline data and controlling for gender, race, age, and education, we examined associations between self-reported two- and Seven-day adherence and access to healthcare, mental health, substance use, and attitudes toward HIV medical therapy. Of the 644 participants, 358 (55%) were currently on HAART. For two-day adherence, 280 (78%) reported missing no prescribed doses (100% adherence), and for seven-day adherence, 291 (81%) reported > or =90% adherence. Logistic regression analyses indicated being younger, not having health insurance, and drug use were associated with missing > or =1 dose over the past two days. Scoring lower on SF-36 mental component summary scale and having greater risk of depression (CES-D) and stress (Perceived Stress Scale) were associated with poorer adherence for both two- and seven-day outcomes. Negative attitudes toward HIV treatment were also associated with lower adherence. Adherence to HIV medications in this population is similar to other groups. Coexisting problems of access to healthcare, higher risk of mental health problems, along with poorer attitudes toward treatment are associated with increased likelihood of missing doses. Comprehensive models of HIV care that include a continuum of medical and social services are essential for treating this population.

  8. Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia.

    Science.gov (United States)

    Patterson, Michelle; Moniruzzaman, Akm; Palepu, Anita; Zabkiewicz, Denise; Frankish, Charles J; Krausz, Michael; Somers, Julian M

    2013-08-01

    This study used an experimental design to examine longitudinal changes in subjective quality of life (QoL) among homeless adults with mental illness after assignment to different types of supported housing or to treatment as usual (TAU, no housing or supports through the study). We hypothesized that subjective QoL would improve over time among participants assigned to supported housing as compared to TAU, regardless of the type of supported housing received or participants' level of need. Participants (n = 497) were stratified by level of need ("high" or "moderate") and randomly assigned to Housing First (HF) in scattered-site apartments, HF in a congregate setting (high needs only), or TAU. Linear mixed-effects regression was used to model the association between study arm and self-reported QoL at baseline and at 6 and 12 months post-baseline by need level. Based on the adjusted overall score on the QoL measure, participants randomized to HF reported significantly greater overall QoL as compared to TAU, regardless of need level or type of supported housing at both 6 and 12 months post-baseline. Scores on the safety and living situation subscales were significantly greater for both high and moderate need participants assigned to supported housing regardless of type at both 6 and 12 months post-baseline as compared to TAU. Despite multiple health and social challenges faced by homeless individuals with mental illness, HF in both scattered-site and congregate models results in significantly greater perceived QoL as compared to individuals who do not receive HF even after a relatively short period of time.

  9. Overdose Deaths Among Homeless Persons

    Science.gov (United States)

    ... Twitter Overdose Deaths Among Homeless Persons January 2013 Homelessness is a persistent problem—nearly 690,000 people ... will ultimately help address the tragic problem of homelessness too, as many homeless people cite drug or ...

  10. 24 CFR 291.415 - Lease with option to purchase properties for use by the homeless.

    Science.gov (United States)

    2010-04-01

    ... properties for use by the homeless. 291.415 Section 291.415 Housing and Urban Development Regulations...-ACQUIRED SINGLE FAMILY PROPERTY Lease and Sale of HUD-Acquired Single Family Properties for the Homeless § 291.415 Lease with option to purchase properties for use by the homeless. (a) Certification. Eligible...

  11. Homeless youths and HIV infection.

    Science.gov (United States)

    Rotheram-Borus, M J; Koopman, C; Ehrhardt, A A

    1991-11-01

    Risk of human immunodeficiency virus (HIV) infection exacerbates the already difficult lives of 1.5 million homeless adolescents in the United States. Homeless youths engage in sexual and substance-abuse behaviors that place them at increased risk of contracting HIV, and they demonstrate other problem behaviors that reduce their coping responses. Model HIV prevention programs and interventions for HIV-positive youths, implemented for homeless adolescents, need to be disseminated on a national level. Social policies must recognize adolescents' rights to satisfaction of basic survival needs; comprehensively address the needs of dysfunctional, disenfranchised, and single-parent families; and provide continuity of care for adolescents to facilitate independent living. Special provisions must be made when designing programs for gay, sexually abused, and substance-abusing youths.

  12. Pathways to youth homelessness.

    Science.gov (United States)

    Martijn, Claudine; Sharpe, Louise

    2006-01-01

    Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as "complex subsidiary pathways". The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service

  13. The complexities of elder homelessness, a shifting political landscape and emerging community responses.

    Science.gov (United States)

    Gonyea, Judith G; Mills-Dick, Kelly; Bachman, Sara S

    2010-10-01

    Despite their growing numbers, homeless older adults remain largely invisible in society and there has been a pervasive lack of public focus on elder homelessness. In this article, we seek to shine light on this forgotten population and deepen understanding of difficult challenges they confront in regaining housing security. We also examine the shifting political climate regarding homelessness, particularly the enactment and subsequent reauthorizations of the McKinney-Vento Homeless Assistance Act, and how these shifts are influencing community responses to elder homelessness. Finally, future challenges and policy directions for breaking the cycle of elder homelessness in the U.S. are discussed.

  14. Becoming homeless, being homeless, and resolving homelessness among women.

    Science.gov (United States)

    Finfgeld-Connett, Deborah

    2010-07-01

    The purpose of this investigation was to more comprehensively articulate the experiences of homeless women and make evidence-based inferences regarding optimal social services. This study was conducted using qualitative meta-synthesis methods. As youth, homeless women experience challenging circumstances that leave them ill-prepared to prevent and resolve homelessness in adulthood. Resolution of homelessness occurs in iterative stages: crisis, assessment, and sustained action. To enhance forward progression through these stages, nurses are encouraged to promote empowerment in concordance with the Transtheoretical and Harm Reduction Models. Services that are highly valued include physical and mental health care and child care assistance.

  15. For Youth, by Youth: A Third Student-Run Homeless Shelter

    Science.gov (United States)

    Seider, Scott C.

    2016-01-01

    This past winter, the third student-run homeless shelter in the United States came into being. Two recent Harvard graduates, Sam Greenberg and Sarah Rosenkrantz, who had volunteered at the Harvard Square Homeless Shelter as college students, saw a need within the Boston and Cambridge communities for a homeless shelter serving young adults. Drawing…

  16. Make or Break: How Homeless Young People Struggle To Fulfil Their Potential.

    Science.gov (United States)

    Foyer Foundation, London (England).

    Homelessness in the United Kingdom has very wide ramifications. Young homeless people face a difficult transition into adult life as poverty, low self-esteem, lack of family support, and lack of qualifications reinforce each others' effects. Homeless young people start behind their peers in educational achievement. Government policies put up…

  17. Homelessness as an independent risk factor for mortality: results from a retrospective cohort study.

    Science.gov (United States)

    Morrison, David S

    2009-06-01

    Homelessness is associated with increased risks of mortality but it has not previously been possible to distinguish whether this is typical of other socio-economically deprived populations, the result of a higher prevalence of morbidity or an independent risk of homelessness itself. The aim of this study was to describe mortality among a cohort of homeless adults and adjust for the effects of morbidity and socio-economic deprivation. Retrospective 5-year study of two fixed cohorts, homeless adults and an age- and sex-matched random sample of the local non-homeless population in Greater Glasgow National Health Service Board area for comparison. Over 5 years of observation, 1.7% (209/12 451) of the general population and 7.2% (457/6323) of the homeless cohort died. The hazard ratio of all-cause mortality in homeless compared with non-homeless cohorts was 4.4 (95% CI: 3.8-5.2). After adjustment for age, sex and previous hospitalization, homelessness was associated with an all-cause mortality hazard ratio of 1.6 (95% CI: 1.3-1.9). Homelessness had differential effects on cause-specific mortality. Among patients who had been hospitalized for drug-related conditions, the homeless cohort experienced a 7-fold increase in risk of death from drugs compared with the general population. Homelessness is an independent risk factor for deaths from specific causes. Preventive programmes might be most effectively targeted at the homeless with these conditions.

  18. Homeless mentally ill or mentally ill homeless?

    Science.gov (United States)

    Cohen, C I; Thompson, K S

    1992-06-01

    Mainstream psychiatry conceptualizes people who are homeless and mentally ill as distinct from other homeless persons because it is thought that their status stems from their mental disorder and the poor implementation of deinstitutionalization. The authors believe this dichotomy is illusory. They present data indicating that recent socioeconomic and political shifts contributed greatly to homelessness among all groups, regardless of mental illness; that those with and without mental illness have similar biographical and demographic profiles; that high levels of mental distress are common to all homeless persons; and that few mentally ill homeless persons require involuntary hospitalization. This perspective suggests novel responses that de-emphasize clinical solutions and focus on empowerment, consumerism, entitlement, community-level interventions, and closer alliances with other advocates for the homeless.

  19. Homelessness and Emergency Medicine: A Review of the Literature.

    Science.gov (United States)

    Salhi, Bisan A; White, Melissa H; Pitts, Stephen R; Wright, David W

    2017-12-09

    We aimed to synthesize the available evidence on the demographics, prevalence, clinical characteristics, and evidence-based management of homeless persons in the emergency department (ED). Where appropriate, we highlight knowledge gaps and suggest directions for future research. We conducted a systematic literature search following databases: PubMed, Ovid, and Google Scholar for articles published between January 1, 1990, and December 31, 2016. We supplemented this search by cross-referencing bibliographies of the retrieved publications. Peer-reviewed studies written in English and conducted in the United States that examined homelessness within the ED setting were included. We used a qualitative approach to synthesize the existing literature. Twenty-eight studies were identified that met the inclusion criteria. Based on our study objectives and the available literature, we grouped articles examining homeless populations in the ED into four broad categories: 1) prevalence and sociodemographic characteristics of homeless ED visits, 2) ED utilization by homeless adults, 3) clinical characteristics of homeless ED visits, and 4) medical education and evidence-based management of homeless ED patients. Homelessness may be underrecognized in the ED setting. Homeless ED patients have distinct care needs and patterns of ED utilization that are unmet by the current disease-oriented and episodic models of emergency medicine. More research is needed to determine the prevalence and characteristics of homelessness in the ED and to develop evidence-based treatment strategies in caring for this vulnerable population. © 2017 by the Society for Academic Emergency Medicine.

  20. Posthumously Assessing a Homeless Population: Services Use and Characteristics.

    Science.gov (United States)

    Metraux, Stephen; Manjelievskaia, Janna; Treglia, Dan; Hoffman, Roy; Culhane, Dennis P; Ku, Bon S

    2016-12-01

    Data on services use, characteristics, and geographic distribution of homeless individuals who died in Philadelphia from 2009 to 2011 provided perspective on assessments of the homeless population that rely on conventional counts and surveys. Data from the City of Philadelphia Medical Examiner's Office were used to parse homeless decedents into three groups on the basis of use of homelessness services (known users, occasional users, and nonusers), and differences among the groups were assessed by using descriptive and multivariate methods. Of 141 adult decedents, 49% made substantial use of the homelessness services system (known users), 27% made occasional use of these services (occasional users), and 24% had no record of use of homelessness services (nonusers). Compared with known users, nonusers and occasional users were less likely to have had a severe mental illness diagnosis or to have received either disability benefits or Medicaid coverage and were more likely to be white. Nonusers and occasional users were also more likely than known users to have died in outlying parts of the city. More conventional homeless surveys and enumerations miss a substantial portion of the homeless population. Including these "hidden homeless" persons would alter perceptions about the composition of Philadelphia's homeless population, lowering estimates of the incidence of psychiatric disability and increasing estimates of racial diversity.

  1. Homelessness: Recent Statistics, Targeted Federal Programs, and Recent Legislation

    Science.gov (United States)

    2005-05-31

    number. 1. REPORT DATE 31 MAY 2005 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Homelessness : Recent Statistics , Targeted...Prescribed by ANSI Std Z39-18 Homelessness : Recent Statistics , Targeted Federal Programs, and Recent Legislation Summary There is no single federal...2290 pgraney@crs.loc.gov Paul Irwin Education for Homeless Children and Youth 7-7573 pirwin@crs.loc.gov Garrine Laney Violence Against Women Act

  2. Homeless youth: causes, consequences and the role of occupational therapy.

    Science.gov (United States)

    Aviles, Ann M; Helfrich, Christine A

    2006-01-01

    SUMMARY This paper reviews the current literature on youth homelessness in the United States and the role of occupational therapy with this population. Youth homelessness is increasing with many youths becoming homeless due to a myriad of causes such as abusive situations in their homes and decreases in affordable housing. Definitions, causes, physical and mental health consequences and the impact of homelessness on youths' development into adult roles are discussed. The role of occupational therapy is described with a focus on useful assessments and intervention principles. Finally, a case study is presented to illustrate the use of these assessments and occupational therapy intervention with a female youth living in an emergency shelter.

  3. From homeless to housed: caring for people in transition.

    Science.gov (United States)

    Drury, Lin J

    2008-01-01

    This ethnographic study was conducted to determine what homeless people experience during the transition from street life into community housing. Data were gathered through participant observation at a program designed to secure housing and support services for homeless people upon discharge from a psychiatric hospital. Sixty homeless, mentally ill adults were followed from hospital discharge through their first 2 years in community housing. Homeless people interact with health care providers across a cultural divide produced by vast differences in their lived experiences. This cultural distance limits access to the services that these individuals require to achieve residential stability.

  4. HIV and the urban homeless in Johannesburg | Lohrmann ...

    African Journals Online (AJOL)

    city homeless and marginally housed individuals in South Africa. Methods. We recruited 136 adults from a Johannesburg inner-city homeless clinic; mean age was 32.4 years, 129 (95%) were male, and 90 (66%) were of South African ...

  5. Attitudes toward the Homeless: A U.S.-Japan Comparison.

    Science.gov (United States)

    Guzewicz, Tony D.; Takooshian, Harold

    1993-01-01

    Compares attitudes toward the homeless in Japan and the United States through a survey of 268 Japanese and 254 U.S. adults and adolescents interviewed in public places. In Japan, homelessness is seldom discussed, and poverty, which may be as widespread as in the United States, is often not recognized. (SLD)

  6. Community care for people who are homeless and mentally ill.

    Science.gov (United States)

    Drury, Lin J

    2003-05-01

    This qualitative longitudinal study documents the experiences of 60 people who are homeless and mentally ill from their state mental hospital discharge through their first two years in community housing. The study explores the personal, cultural, and environmental contexts of life for adults who are homeless and mentally ill and examines the interaction between an individual's needs and community resources. The research identifies forces that perpetuate homelessness and traces the struggles that people who are homeless and mentally ill encounter during the transition from the streets to stable housing. The findings describe a culturally based pattern of mutual avoidance between homeless mentally ill clients and caregivers, which limits delivery of services to the population. Recommendations include development of alternative systems of care delivery, expansion of educational experiences with underserved populations, and increased funding for service or research with people who are homeless and mentally ill.

  7. Homelessness in a Scandinavian welfare state

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    2016-01-01

    This article analyses the risk of homelessness in the Danish adult population. The study is based on individual, administrative micro-data for about 4.15 million Danes who were 18 years or older on 1 January 2002. Homelessness is measured by shelter use from 2002 to 2011. Data also cover civil...... status, immigration background, education, employment, income, mental illness, drug and alcohol abuse, and previous imprisonment over five years prior to the measurement period.Prevalence of shelter use shows a considerable risk of homelessness amongst individuals experiencing multidimensional social...... exclusion. Nonetheless, even in high-risk groups such as drug abusers and people with a dual diagnosis, the majority have not used shelters. A multivariate analysis shows significantly higher use of homeless shelters amongst immigrants and individuals with low income, unemployment, low education, mental...

  8. Homelessness and mental illness.

    Science.gov (United States)

    Scott, J

    1993-03-01

    In Great Britain 1-2 million people may be homeless. Most homeless people are men, but about 10-25% are women, of whom about half are accompanied by children. Significant mental illness is present in 30-50% of the homeless: functional psychoses predominate; acute distress and personality dysfunction are also prevalent. Co-morbidity of mental illness and substance abuse occurs in 20%, and physical morbidity rates exceed those of domiciled populations. The homeless mentally ill also have many social needs. Pathways to homelessness are complex; deinstitutionalization may be only one possible cause of the increase in the number of homeless people. There is much recent research estimating the extent of mental illness and the characteristics of selected subgroups of accessible homeless people. The evaluation of potential service solutions has received less attention. This review outlines the research, highlights current views on the definition and classification of homeless populations, and offers some guidelines on avenues which need to be explored.

  9. Parenting while Being Homeless

    Science.gov (United States)

    Swick, Kevin J.; Williams, Reginald; Fields, Evelyn

    2014-01-01

    This article explores the dynamics of parenting while being in a homeless context. The mosaic of stressors involved in this homeless parenting process are explicated and discussed. In addition, resources and strategies that may support parenting are presented and discussed.

  10. Homeless Health Concerns

    Science.gov (United States)

    ... make it worse. That's why the health of homeless people in the United States is worse than that of the general population. Common health problems include Mental health ... skin infections Many homeless women are victims of domestic or sexual abuse. ...

  11. Life shocks and homelessness.

    Science.gov (United States)

    Curtis, Marah A; Corman, Hope; Noonan, Kelly; Reichman, Nancy E

    2013-12-01

    We exploited an exogenous health shock-namely, the birth of a child with a severe health condition-to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide.

  12. Veterans and Homelessness

    National Research Council Canada - National Science Library

    Perl, Libby

    2007-01-01

    .... The Department of Veterans Affairs (VA) estimates that it has served approximately 300 returning veterans in its homeless programs and has identified over 1,000 more as being at risk of homelessness...

  13. Life Shocks and Homelessness

    Science.gov (United States)

    Corman, Hope; Noonan, Kelly; Reichman, Nancy E.

    2014-01-01

    We exploited an exogenous health shock—namely, the birth of a child with a severe health condition—to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide. PMID:23868747

  14. Organizing homeless people

    DEFF Research Database (Denmark)

    Anker, Jørgen

    2008-01-01

    People who are homeless belong to some of the most vulnerable, dispersed and disorganized groups in welfare societies. Yet in 2001, a national interest organization of homeless people was formed for the first time in Denmark. This article identifies the processes that facilitated the formation...... been homeless. The analysis may thus serve as a case of inspiration for activists and professionals who want to improve homeless people's opportunities for participation in other national settings....

  15. Chronic pain among homeless persons: characteristics, treatment, and barriers to management.

    Science.gov (United States)

    Hwang, Stephen W; Wilkins, Emma; Chambers, Catharine; Estrabillo, Eileen; Berends, Jon; MacDonald, Anna

    2011-07-08

    Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada. Participants were randomly selected at shelters for single homeless adults between September 2007 and February 2008 and screened for chronic pain, defined as having pain in the body for ≥ 3 months or receiving treatment for pain that started ≥ 3 months ago. Cross-sectional surveys obtained information on demographic characteristics, characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use. Whenever possible, participants' physicians were also interviewed. Among 152 homeless participants who experienced chronic pain, 11 (8%) were classified as Chronic Pain Grade I (low disability-low intensity), 47 (32%) as Grade II (low disability-high intensity), 34 (23%) as Grade III (high disability-moderately limiting), and 54 (37%) as Grade IV (high disability-severely limiting). The most common self-reported barriers to pain management were stress of shelter life, inability to afford prescription medications, and poor sleeping conditions. Participants reported using over-the-counter medications (48%), street drugs (46%), prescribed medications (43%), and alcohol (29%) to treat their pain. Of the 61 interviewed physicians, only 51% reported treating the patient's pain. The most common physician-reported difficulties with pain management were reluctance to prescribe narcotics due to the patient's history of substance abuse, psychiatric comorbidities, frequently missed appointments, and difficulty getting the patient to take medications correctly. Clinicians who provide healthcare for homeless people should screen for chronic pain and

  16. Chronic pain among homeless persons: characteristics, treatment, and barriers to management

    Directory of Open Access Journals (Sweden)

    Berends Jon

    2011-07-01

    Full Text Available Abstract Background Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada. Methods Participants were randomly selected at shelters for single homeless adults between September 2007 and February 2008 and screened for chronic pain, defined as having pain in the body for ≥ 3 months or receiving treatment for pain that started ≥ 3 months ago. Cross-sectional surveys obtained information on demographic characteristics, characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use. Whenever possible, participants' physicians were also interviewed. Results Among 152 homeless participants who experienced chronic pain, 11 (8% were classified as Chronic Pain Grade I (low disability-low intensity, 47 (32% as Grade II (low disability-high intensity, 34 (23% as Grade III (high disability-moderately limiting, and 54 (37% as Grade IV (high disability-severely limiting. The most common self-reported barriers to pain management were stress of shelter life, inability to afford prescription medications, and poor sleeping conditions. Participants reported using over-the-counter medications (48%, street drugs (46%, prescribed medications (43%, and alcohol (29% to treat their pain. Of the 61 interviewed physicians, only 51% reported treating the patient's pain. The most common physician-reported difficulties with pain management were reluctance to prescribe narcotics due to the patient's history of substance abuse, psychiatric comorbidities, frequently missed appointments, and difficulty getting the patient to take medications correctly. Conclusions Clinicians who provide healthcare for

  17. Teaching Our Homeless Children

    Science.gov (United States)

    Sheldon, George H.

    2011-01-01

    This paper discusses some of the major concerns associated with the instructional process of our homeless children. The reader is provided with a brief overview of the prevalence of this population. According to the National Center on Family Homelessness the number of school children who are homeless is growing rapidly with 1.4 to 1.5 million…

  18. Pennsylvania's Rural Homeless Reality.

    Science.gov (United States)

    Center for Rural Pennsylvania, Harrisburg.

    The Center for Rural Pennsylvania analyzed data from the Pennsylvania Department of Public Welfare concerning rural homelessness for fiscal years 1997 through 1999. Findings indicate that rural Pennsylvania has a homeless population and it is growing. In 1999, more than 21,700 clients received homeless assistance in rural areas, 44 percent of whom…

  19. Educating Homeless Students.

    Science.gov (United States)

    Berliner, BethAnn

    2002-01-01

    Over the past decade, the number of homeless children in America has more than doubled. Educators, however, are still legally obligated to enroll and support them, because of the passage of the "No Child Left Behind" Act of 2001, which reauthorized the McKinney-Vento Homeless Assistance Act. Although schools cannot solve homelessness,…

  20. Homelessness in America.

    Science.gov (United States)

    Baumohl, Jim, Ed.

    This book about homelessness in the United States offers 16 chapters in three parts. Part 1, "History Definitions, and Causes," includes: (1) "Redefining the Cursed Word: A Historical Interpretation of American Homelessness" (Kim Hopper and Jim Baumohl); (2) "Homelessness: Definitions and Counts" (Martha R. Burt); (3)…

  1. A Status Report on Homeless Families in America's Cities. A 29-City Survey.

    Science.gov (United States)

    Waxman, Laura DeKoven; Reyes, Lilia M.

    This survey assesses the status of homelessness among families in cities. The data were collected from city officials during April 1987. The findings include the following: (1) the number of homeless families increased by 31 percent during the last two years; (2) families represented one-third of the homeless and a single parent headed two-thirds…

  2. Using Housing First in Integrated Homelessness Strategies : A Review of the Evidence

    OpenAIRE

    Pleace, Nicholas

    2018-01-01

    This rapid evidence review shows that Housing First is highly effective in ending homelessness among people with high and complex needs, but it does not constitute an entire solution to single homelessness, or rough sleeping, in itself. The international evidence, including Finnish experience, shows that Housing First services need to be a part of an integrated homelessness strategy to be truly effective. Fully recognising the effectiveness and strengths of existing homelessness services, bui...

  3. Health-promoting behaviors of sheltered homeless women.

    Science.gov (United States)

    Wilson, Meg

    2005-01-01

    To expand the body of knowledge and provide further insight into the complex area of homelessness and health, health practices of sheltered homeless women were investigated using a cross-sectional, descriptive, and non-experimental design using Pender's Health Promotion Model as the theoretical framework. The sample (n=137) was well educated, mostly unemployed, primarily single, and homeless due to relationship problems/conflict per self-report. Homeless women were noted to practice health-promoting behaviors in all areas but scored the lowest on physical activity and nutrition. Significant findings reflected women's personal strengths and resources in the areas of spiritual growth and interpersonal relations.

  4. Homelessness and Cognitive Impairment: An Exploratory Study in Tokyo, Japan.

    Science.gov (United States)

    Pluck, G; Nakakarumai, M; Sato, Y

    2015-09-01

    Homelessness has frequently been associated with neuropsychological impairment. This has been observed using general screening tests for dementia as well as tests of more focal abilities, particularly executive function. Most studies have been of homeless individuals from North America with none reported from Japan. In this exploratory study we interviewed a sample of 16 homeless adults from Tokyo, Japan, and performed tests of cognitive function, assessed head injury, addictive behaviours (drug use, gambling, alcohol abuse), and recorded details of homelessness history. The cognitive examination involved the Japanese Adult Reading Test to estimate premorbid intelligence quotient, the Wisconsin Card Sorting Test to measure frontal lobe-related cognitive function, and the Mini-Mental State Examination to measure global cognitive impairment associated with dementia. Among the 16 homeless individuals, 7 (44%) displayed global cognitive impairment. In addition, executive function tended to be poor. In contrast, estimated premorbid intelligence quotient was within the normal range. Substance abuse in general was not at a level to cause clinical concern, although a high level of pathological gambling was observed. There were no associations between cognitive function and clinical and addictive behaviour variables, although associations were noted between cognitive scores and time spent homeless. The results suggest high levels of neuropsychological impairment in this sample of homeless adults in Japan. Furthermore, cognitive impairment is acquired rather than developmental in origin, and is proportional to the length of time spent homeless.

  5. Family and Child Homelessness. Revised.

    Science.gov (United States)

    Homelessness Exchange, Washington, DC.

    This packet contains documents that provide information about family and child homelessness and the need to address homelessness within the context of community development. The following sections are included: (1) "Family Homelessness" (Homelessness Information Exchange); (2) "A Report on the 1988 National Survey on Shelters for the Homeless"…

  6. Homeless Families in Rural and Non-Urban Communities.

    Science.gov (United States)

    Rife, John C.; And Others

    1992-01-01

    Interviews with 247 homeless families (including 480 children) in 21 rural Ohio counties found that over two-thirds were headed by young single females. The most frequently cited reasons for homelessness were family conflict or dissolution and economic factors. Implications for service provision and policy development are discussed. (LP)

  7. Homelessness, cigarette smoking and desire to quit: results from a US national study.

    Science.gov (United States)

    Baggett, Travis P; Lebrun-Harris, Lydie A; Rigotti, Nancy A

    2013-11-01

    We determined whether or not homelessness is associated with cigarette smoking independent of other socio-economic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. We analyzed data from 2678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using US federally funded community health centers. We used multivariable logistic regression to examine the association between homelessness and (i) current cigarette smoking among all adults, and (ii) past-year desire to quit among current smokers, adjusting for demographic, socio-economic and behavioral health characteristics. Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57 versus 27%, P homelessness was associated independently with current smoking [adjusted odds ratio (AOR) 2.09; 95% confidence interval (CI) = 1.49-2.93], even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness and alcohol and drug abuse. Housing status was not associated significantly with past-year desire to stop smoking in unadjusted (P = 0.26) or adjusted (P = 0.60) analyses; 84% of currently homeless, 89% of formerly homeless and 82% of never homeless smokers reported wanting to quit. Among patients of US health centers, a history of homelessness doubles the odds of being a current smoker independent of other socio-economic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. © 2013 Society for the Study of Addiction.

  8. Homelessness and CKD: A Cohort Study

    Science.gov (United States)

    Choi, Andy I.; Himmelfarb, Jonathan; Chertow, Glenn M.; Bindman, Andrew B.

    2012-01-01

    Summary Background and objectives This study examined the associations between homelessness and clinical outcomes of CKD among adults from the urban healthcare safety net. Design, setting, participants, & measurements This retrospective cohort study examined 15,343 adults with CKD stages 3–5 who received ambulatory care during 1996–2005 from the Community Health Network of San Francisco. Main outcome measures were time to ESRD or death and frequency of emergency department visits and hospitalizations. Results Overall, 858 persons (6%) with CKD stages 3–5 were homeless. Homeless adults were younger, were disproportionately male and uninsured, and suffered from far higher rates of depression and substance abuse compared with adults with stable housing (Phomeless adults experienced significantly higher crude risk of ESRD or death (hazard ratio=1.82, 95% confidence interval=1.49–2.22) compared with housed adults. This elevated risk was attenuated but remained significantly higher (adjusted hazard ratio=1.28, 95% confidence interval=1.04–1.58) after controlling for differences in sociodemographics, comorbid conditions, and laboratory variables. Homeless adults were also far more likely to use acute care services (median [interquartile range] number of emergency department visits was 9 [4–20] versus 1 [0–4], PHomeless adults with CKD suffer from increased morbidity and mortality and use costly acute care services far more frequently than peers who are stably housed. These findings warrant additional inquiry into the unmet health needs of the homeless with CKD to provide appropriate and effective care to this disadvantaged group. PMID:22700883

  9. Racial-Ethnic Differences in Health Service Use in a Large Sample of Homeless Adults With Mental Illness From Five Canadian Cities.

    Science.gov (United States)

    Stergiopoulos, Vicky; Gozdzik, Agnes; Nisenbaum, Rosane; Vasiliadis, Helen-Maria; Chambers, Catharine; McKenzie, Kwame; Misir, Vachan

    2016-09-01

    This study examined factors associated with health care use in an ethnically diverse Canadian sample of homeless adults with mental illness, a particularly disadvantaged group. Baseline survey data were available from five sites across Canada for 2,195 At Home/Chez Soi demonstration project participants. Negative binomial regression models examined the relationship between racial-ethnic or cultural group membership (white, N=1,085; Aboriginal, N=476; black, N=244; and other ethnoracial minority groups, N=390) and self-reported emergency department (ED) visits and hospitalizations in the past six months and past-month visits to a medical, other clinical, or social service provider. Adjusted models included other predisposing, enabling, and need factors, based on Andersen's behavioral model for vulnerable populations. Compared with white participants, black participants had a lower rate of ED visits (adjusted rate ratio [ARR]=.54, 95% confidence interval [CI]=.43-.69) and Aboriginal participants had a lower rate of medical visits (ARR=.84, CI=.71-.99) and a higher rate of visits to social service providers (ARR=1.54, CI=1.18-2.01). Participants in other ethnoracial minority groups had a higher rate of social service provider visits than white participants (ARR=1.44, CI=1.10-1.89). Access to a family physician, having at least high school education, and high needs for mental health services were associated with greater use of ED and medical visits and hospitalizations. Rates of ED and medical visits were lower with increased age and better physical health. In a system of universal health insurance that prioritizes access to and quality of care, the presence of racial-ethnic disparities experienced by this vulnerable population merits further attention.

  10. Reliability, validity, and composition of a subset of the Centers for Disease Control and Prevention acquired immunodeficiency syndrome knowledge questionnaire in a sample of homeless and impoverished adults.

    Science.gov (United States)

    Leake, B; Nyamathi, A; Gelberg, L

    1997-08-01

    Measures of acquired immunodeficiency syndrome (AIDS)-related knowledge that have good psychometric properties are needed to evaluate the impact of educational interventions, particularly among impoverished populations. Few measures that satisfy these requirements are available. The authors describe the psychometric characteristics and composition of a subset of 21 AIDS knowledge items from the questionnaire used by the National Center for Health Statistics. The study was conducted with a convenience sample of women and their significant others or close friends in nine homeless shelters and 11 residential drug recovery programs in the skid row area of Los Angeles from 1991 to 1993. Trained nurses and outreach workers collected data from 486 predominately African-American adults before delivery of well-established, culturally sensitive AIDS educational intervention. A subset of 334 participants were re-interviewed 6 months later. A total scale score was calculated from a one-factor solution, and two subscale scores were formed based on a two-factor solution. One subscale was composed of primarily cognitive items, whereas the second subscale contained mainly transmission-related items. The internal consistency reliability of the overall scale was 0.89; the two subscales had alphas of 0.80 and 0.92. The measures have face validity, and support for convergent validity was found. Further, even though AIDS knowledge in the sample was relatively high, all three measures showed marked improvement in the subsample of respondents who were re-interviewed after receiving AIDS-related educational information. These measures show promise for assessing AIDS knowledge and the efficacy of AIDS education programs in vulnerable populations. The findings reported here, however, are preliminary. Test-retest reliability needs to be examined, and additional studies are needed with samples that are more culturally diverse and include socially isolated individuals.

  11. Experiences of being homeless or at risk of being homeless among Canadian youths.

    Science.gov (United States)

    Miller, Pamela; Donahue, Peter; Este, Dave; Hofer, Marvin

    2004-01-01

    A qualitative study was undertaken with four groups--immigrants, youths, Aboriginal people, and landlords--in order to explore, compare, and contrast diversity issues among the homeless population and those at risk of homelessness in a larger Canadian city (Calgary, Alberta) with a smaller city (Lethbridge, Alberta), to better understand their and to needs make recommendations for improvement in service delivery and policy formation. This paper focuses on the findings from our sample of youths who shared information on a range of factors that contributed to their being homeless or at risk of being homeless. The youths in this study also shared their positive as well as negative experiences with educators, peers, family members, and social service providers. Canada's homeless include growing numbers of young people, families, women, and members of various ethnic communities, including Aboriginal people and immigrants. Today it is no longer possible to articulate a single silhouette of the homeless, but rather a diversity of profiles is needed. It was in the light of this reality that a study, "Diversity Among the Homeless and Those At Risk," was carried out. It was undertaken with four groups--immigrants, youths, Aboriginal people, and landlords.

  12. Hospital care and costs for homeless people.

    Science.gov (United States)

    McCormick, Barry; White, Jonathan

    2016-12-01

    The national picture of the comparative costs and diagnoses of hospitalised homeless patients are examined using the 'no fixed abode' flag in English hospital statistics. Comparable studies sample patients in single cities, eg New York and Toronto. The most common diagnosis is substance misuse; the share of homeless NHS patients with this diagnosis is rising, and now equals that found in North American cities. About half of the cost of homeless patients relates to diagnoses of mental illness, although these comprise a much smaller share of homeless patients than in North America. Hospital costs for homeless patients - both total and per admission - have fallen significantly in recent years, primarily because of fewer admissions and shorter lengths of stay for mentally ill patients. Aims to reduce NHS costs at the level of individual institutions have often shaped policy. Broader policy to prevent and reduce homelessness offers substantial long-term reductions in the cost of chronic care. © Royal College of Physicians 2016. All rights reserved.

  13. Dimensions of homelessness.

    Science.gov (United States)

    Argeriou, M; McCarty, D; Mulvey, K

    1995-01-01

    Investigations of homelessness have been hampered by the lack of operational definitions sensitive enough to achieve subgroup differentiation and simple enough to permit replication. As a consequence, programming and policy development have often proceeded based on varying assessments of the composition, size, and needs of the homeless population. This paper describes the empirical use of duration of homelessness and dwelling place as elements of an operational definition of homelessness. The approach reflects a conceptualization of homelessness as a continuous variable that can be described by coordinates of time and place. A screening instrument that quantified the homeless experience was developed and evaluated in conjunction with a federally funded demonstration project for homeless substance-abusing men and women. Eight hundred and thirty-nine men and women from six public detoxification centers were screened over a two-year period that began in August 1988. Respondents were asked eight questions to assess duration (time) and location (place) of homelessness before they entered the detoxification center. A simple index was constructed retrospectively and found to differentiate the sample into homeless and near-homeless subgroups. Between-group differences were statistically significant in demographics, presenting problems, and probability for successful intervention. These data paralleled previously reported differences between homeless subgroups and support the concurrent validity of the index. Cronbach's alpha (.72) showed the index to be moderately reliable. Differentiation of homeless persons into meaningful subgroups appears possible and programmatically recommended. Homelessness is not a unitary phenomenon, and it is unlikely to respond to therapeutic interventions that fail to consider individual differences.

  14. Illness narratives of people who are homeless.

    Science.gov (United States)

    Håkanson, Cecilia; Öhlén, Joakim

    2016-01-01

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and "freedom" in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  15. Illness narratives of people who are homeless

    Science.gov (United States)

    Håkanson, Cecilia; Öhlén, Joakim

    2016-01-01

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets. PMID:27914194

  16. Illness narratives of people who are homeless

    Directory of Open Access Journals (Sweden)

    Cecilia Håkanson

    2016-11-01

    Full Text Available Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony. The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  17. Who's There to Help? Assessment of Social Supports Received by Homeless and Unaccompanied Youth in High School

    Science.gov (United States)

    Brase, Monica Kay

    2011-01-01

    The purpose of this qualitative study was to examine how urban, young adults assessed received social supports (Vaux, 1988) during homelessness in high school. According to the National Alliance to End Homelessness (2007), approximately 1 to 1.5 million youth under the age of 18 in America experience at least one incident of homelessness each…

  18. Personal goals and factors related to QoL in Dutch homeless people : What is the role of goal-related self-efficacy?

    NARCIS (Netherlands)

    van der Laan, Jorien; Boersma, Sandra N; van Straaten, Barbara; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

    2017-01-01

    Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their

  19. Personal goals and factors related to QoL in Dutch homeless people: what is the role of goal-related self-efficacy?

    NARCIS (Netherlands)

    Laan, J. van der; Boersma, S.N.; Straaten, B. Van; Rodenburg, G.; Mheen, D. Van de; Wolf, J.R.

    2017-01-01

    Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their

  20. Homelessness and Gender Reconsidered

    OpenAIRE

    Bretherton, Joanne

    2017-01-01

    Although research has been sporadic, the available evidence indicates that gender is consistently associated with differentiated trajectories through homelessness in Europe. Women’s pathways through homelessness have been linked to domestic violence, women being ‘protected’ by welfare systems when dependent children are living with them and an apparently greater tendency for women to use and exhaust informal support, rather than homelessness or welfare services. This evidence is frequently di...

  1. Life Shocks and Homelessness

    OpenAIRE

    Marah A. Curtis; Hope Corman; Kelly Noonan; Nancy Reichman

    2011-01-01

    We exploit an exogenous health shock--the birth of a child with a severe health condition--to investigate the causal effect of a life shock on homelessness. Using survey data from the Fragile Families and Child Wellbeing study that have been augmented with information from hospital medical records, we find that the health shock increases the likelihood of homelessness three years later, particularly in cities with high housing costs. Homelessness is defined using both a traditional measure an...

  2. Homeless in America, Homeless in California

    OpenAIRE

    Quigley, John M.; Raphael, Steven; Smolensky, Eugene

    2002-01-01

    It is generally believed that the increased incidence of homelessness in the United States has arisen from broad societal factors, such as changes in the institutionalization of the mentally ill, increases in drug addiction and alcohol usage, and so forth. This paper presents a comprehensive test of the alternate hypothesis that variations in homelessness arise from changed circumstances in the housing market and in the income distribution. We assemble essentially all the systematic informati...

  3. Homelessness, Cigarette Smoking, and Desire to Quit: Results from a U.S. National Study

    Science.gov (United States)

    Baggett, Travis P.; Lebrun-Harris, Lydie A.; Rigotti, Nancy A.

    2013-01-01

    Aims We determined whether homelessness is associated with cigarette smoking independent of other socioeconomic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. Design, Setting, and Participants We analyzed data from 2,678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using U.S. federally-funded community health centers. Measurements We used multivariable logistic regression to examine the association between homelessness and (1) current cigarette smoking among all adults, and (2) past-year desire to quit among current smokers, adjusting for demographic, socioeconomic, and behavioral health characteristics. Findings Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57% vs. 27%, phomelessness was independently associated with current smoking (AOR 2.09; 95% CI 1.49-2.93), even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness, and alcohol and drug abuse. Housing status was not significantly associated with past-year desire to stop smoking in unadjusted (p=0.26) or adjusted (p=0.60) analyses; 84% of currently homeless, 89% of formerly homeless, and 82% of never homeless smokers reported wanting to quit. Conclusions Among patients of U.S. health centers, a history of homelessness doubles the odds of being a current smoker independent of other socioeconomic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. PMID:23834157

  4. Characteristics of Mothers Caring for Children During Episodes of Homelessness.

    Science.gov (United States)

    Welch-Lazoritz, Melissa L; Whitbeck, Les B; Armenta, Brian E

    2015-11-01

    This study provides a description of the physical, psychological, and substance use problems of adult homeless women who are and are not caring for children. We also examined differences in the characteristics of these two groups of women. Interviews were conducted with 148 homeless women from three mid-sized U.S. cities, 24.3 % of whom were caring for at least one child. Our results showed that women caring for children were more likely to be sheltered and have health insurance. Homeless women caring for children and solitary homeless women were generally similar in terms of substance abuse problems. However, rates of Borderline Personality Disorder were higher among women caring for children than among solitary homeless women. Our results are somewhat consistent with previous research, with the exception of substance abuse problems and mental health problems, which were shown to be equally problematic for all women, regardless of current caregiving status.

  5. Homeless women with minor children in the Detroit metropolitan area.

    Science.gov (United States)

    Mills, C

    1989-11-01

    Eighty-seven homeless families served by the emergency shelter of the Coalition on Temporary Shelter in Detroit during the first quarter of 1987 were studies through a review of admission data. Most of the families were black and contained an adult female with one or two minor children. Most of the mothers were young, did not have a high school diploma, and had no income. Some had histories of psychiatric disorders or substance abuse. Many had been in a dependent living situation before becoming homeless. Children accounted for more than one-fourth of admissions during the study period. Policies should address prevention of homelessness through income support programs, provision of low-income housing, basic living skill training programs, and mental health service delivery. When available resources fail in prevention, programming should address the effects of homelessness on children, because these effects perpetuate a cycle that will increase the homeless population in future generations.

  6. Ending homelessness. Policy challenges.

    Science.gov (United States)

    Kondratas, A

    1991-11-01

    The extent and nature of homelessness is discussed. Only after understanding these parameters was the federal government able to develop an appropriate homelessness policy, including an explicit goal to help end, rather than simply address, the problem. The article describes how, with increased information, federal programs for the homeless have evolved, beginning with emergency remedies and shifting to more permanent solutions. Significantly increased cooperation at federal, state, and local levels is called for to effectively address this multifaceted problem. In the long term, we must wage a broad attack on poverty if we are to eradicate the root problems that force people into homelessness.

  7. Homelessness in California

    OpenAIRE

    Quigley, John M.; Raphael, Steven; Smolensky, Eugene

    2001-01-01

    Rapidly rising homelessness in the 1980s shocked Americans and led to a flurry of studies, a deluge of news stories, and to Public Law 100-77, the Stewart B. McKinney Homeless Assistance Act of July 1987. The McKinney Act marked the entrance of the federal government into homelessness policy, which, until then, had been a purely local issue. A dozen years later, housing the homeless remains a recurrent political issue in many cities in California. Improving the quality of life of those withou...

  8. Permanent Homelessness in America?

    OpenAIRE

    Richard B. Freeman; Brian Hall

    1986-01-01

    This paper seeks to determine the approximate number of homeless persons in the U.S., the rate of change in the number, and whether or not the problem is likely to be permanent or transitory. It makes particular use of a new 1985 survey of over 503 homeless people in New York City. It finds: (1) that the much maligned 1984 Department of Housing and Urban Affairs study was roughly correct in its estimate of 250,000 - 350,000 homeless persons for 1983; (2) the number of homeless has grown since...

  9. Homelessness in schizophrenia.

    Science.gov (United States)

    Foster, Adriana; Gable, James; Buckley, John

    2012-09-01

    The impact of mental illness, comorbid substance abuse, and medication nonadherence, coupled with disjointed psychiatric and social services, conspires to a disproportionately high rate of psychiatric disorders among people who are homeless in the United States. This article reviews the prevalence of homeless among the mentally ill as well as the prevalence of mental illness among the homeless and details barriers in access to care and the solutions that have been attempted. The need and solutions to introduce a new generation of physicians and allied health care workers to the unique health care needs of the homeless population are highlighted. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Intellectual disability and homelessness.

    Science.gov (United States)

    Mercier, C; Picard, S

    2011-04-01

    The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a team dedicated to homeless persons. (1) To describe the characteristics, history and current situation of these persons; and (2) to report within-group differences as a function of gender and current residential status. The data were collected from files using an anonymous chart summary. Descriptive statistics on the whole sample (n = 68) and inferential statistics on cross-tabulations by gender and residential status were performed. Persons with ID exhibited several related problems. Some of these persons, primarily women, experienced relatively short periods of homelessness and their situations stabilised once they were identified and followed up. Other persons with ID experienced chronic homelessness that appeared to parallel the number and severity of their other problems. When compared with a previous epidemiological study of the homeless in Montreal, the population of homeless persons with ID differed from the overall homeless population in a number of respects. The results suggest prevention and intervention targets. The need for epidemiological research appears particularly clear in light of the fact that below-average intellectual functioning has been identified as a risk factor for homelessness and a predisposing factor for vulnerability among street people. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

  11. The homeless pregnant woman.

    Science.gov (United States)

    Esen, Umo I

    2017-09-01

    Women who are pregnant and homeless constitute a unique group at significant risk of adverse foetal and maternal outcomes. Despite this heightened risk profile, social housing support to this group of women is less than satisfactory. Concerted effort and more collaborative working is needed by all who provide social, and healthcare services to homeless pregnant women, to improve the lot of these women. Clear definitions and legislative provisions in respect of the homeless will go a long way in reducing ambiguity and close loopholes which currently act to deny the homeless pregnant woman social housing support at a time when it is most needed.

  12. Enumerating the Hidden Homeless: Strategies to Estimate the Homeless Gone Missing From a Point-in-Time Count

    Directory of Open Access Journals (Sweden)

    Agans Robert P.

    2014-06-01

    Full Text Available To receive federal homeless funds, communities are required to produce statistically reliable, unduplicated counts or estimates of homeless persons in sheltered and unsheltered locations during a one-night period (within the last ten days of January called a point-in-time (PIT count. In Los Angeles, a general population telephone survey was implemented to estimate the number of unsheltered homeless adults who are hidden from view during the PIT count. Two estimation approaches were investigated: i the number of homeless persons identified as living on private property, which employed a conventional household weight for the estimated total (Horvitz-Thompson approach; and ii the number of homeless persons identified as living on a neighbor’s property, which employed an additional adjustment derived from the size of the neighborhood network to estimate the total (multiplicity-based approach. This article compares the results of these two methods and discusses the implications therein.

  13. Applying a Time-Patterned Typology of Homelessness Among Individuals with Mental Illness.

    Science.gov (United States)

    Brown, Molly; Chodzen, Gia; Mihelicova, Martina; Collins, Kelly

    2017-06-01

    Identification of subgroups of the homeless populations, or typologies, has been an important research priority to guide homelessness services and policies. This study builds on previous typological research conducted in the general homeless population by focusing on individuals with mental illness to further delineate typologies within a more homogenous subset of the homeless population. A time-patterned typology based on episodes of street and shelter homelessness over a four-year period was applied to a sample of 246 individuals identified through mental health administrative records. Four groups were created based upon patterns of homelessness: 26.8% experienced homelessness for 4 years, 13.4% had one episode of homelessness but were no longer homeless at the end of the follow-up, 48.4% had at least two episodes of homelessness, and 11.4% had a single episode of homelessness lasting 3 months or less. Findings from a multinomial logistic regression indicated that gender, presence of a psychotic disorder, substance abuse, and year of study enrollment significantly predicted group membership. Residential trajectories upon exit from homelessness and at the end of the four-year follow-up were examined. Implications for current policy and future research are discussed. © Society for Community Research and Action 2017.

  14. Single dose oral tenoxicam for acute postoperative pain in adults.

    Science.gov (United States)

    Moore, Owen A; McIntyre, Mairead; Moore, R Andrew; Derry, Sheena; McQuay, Henry J

    2009-07-08

    Tenoxicam is a non-steroidal anti-inflammatory drug (NSAID) licensed for use in rheumatic disease and other musculoskeletal disorders in the UK, and is widely available in other countries worldwide. This review sought to evaluate the efficacy and safety of oral tenoxicam in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties. To assess the efficacy of single dose oral tenoxicam in acute postoperative pain, and any associated adverse events. We searched The Cochrane Library (Issue 1, 2009), MEDLINE (March 2009); EMBASE via Ovid (March 2009); the Oxford Pain Relief Database. Randomised, double-blind, placebo-controlled clinical trials of oral tenoxicam for relief of acute postoperative pain in adults. Two review authors independently assessed trial quality and extracted data. The area under the "pain relief versus time" curve was used to derive the proportion of participants with tenoxicam experiencing least 50% pain relief over 4 to 6 hours, using validated equations. The number needed to treat to benefit (NNT) was calculated using 95% confidence intervals (CI). The proportion of participants using rescue analgesia over a specified time period, and time to use of rescue analgesia, were sought as additional measures of efficacy. Information on adverse events and withdrawals was also collected. Not one of sixteen studies identified by the searches and examined in detail studied oral tenoxicam in patients with established postoperative pain and therefore no results are available. In the absence of evidence of efficacy for oral tenoxicam in acute postoperative pain, its use in this indication is not justified at present. Because trials clearly demonstrating analgesic efficacy in the most basic of acute pain studies is lacking, use in other indications should be

  15. Chronically homeless women report high rates of substance use problems equivalent to chronically homeless men.

    Science.gov (United States)

    Edens, Ellen Lockard; Mares, Alvin S; Rosenheck, Robert A

    2011-01-01

    The U.S. federal government recently committed itself to ending chronic homelessness within 5 years. Women constitute one out of four chronically homeless adults and represent a particularly vulnerable group, but have been little studied. To identify potentially unique needs in this group, we report characteristics and 2-year outcomes in a large sample of male and female chronically homeless adults participating in a multisite, supportive housing program. Men and women participating in the outcome evaluation of the 11-site Collaborative Initiative on Chronic Homelessness (n = 714) supportive housing program and who received at least one follow-up assessment were compared on baseline characteristics and up to 2-year follow-up outcomes. Mixed model multivariate regression adjusted outcome findings for baseline group differences. Few significant baseline differences existed between males and females, with both sexes self-reporting very high rates of lifetime mental health (83% women, 74% men) and substance use (68% women, 73% men) problems. Throughout the 2-year follow-up, both men and women dramatically increased the number of days housed, showed minimal changes in substance use patterns, and had modest improvements in mental health outcomes, without significant differences between genders. Unlike other U.S. populations, chronically homeless adults do not demonstrate substantial gender differences on mental health or addiction problems. Policy and service delivery must address these remarkably high rates of substance use and mental illness. Published by Elsevier Inc.

  16. Homeless and incarcerated: an epidemiological study from Canada.

    Science.gov (United States)

    Saddichha, Sahoo; Fliers, Joelle M; Frankish, Jim; Somers, Julian; Schuetz, Christian G; Krausz, Michael R

    2014-12-01

    Incarceration and homelessness are closely related yet studied rarely. This article aimed to study the incarcerated homeless and identify specific vulnerabilities, which rendered them different from the nonincarcerated homeless. It also aimed to describe the homeless population and its significant involvement with the criminal justice and enforcement system. Data were derived from the British Columbia Health of the Homeless Study (BCHOHS), carried out in three cities in British Columbia, Canada: the large urban center Vancouver (n = 250), Victoria (n = 150) and Prince George (n = 100). Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ) and the Mini International Neuropsychiatric Interview (MINI) Plus. Incarcerated homeless were more often male (66.6%), were in foster care (56.4%) and had greater substance use especially of crack cocaine (69.6%) and crystal methamphetamine (78.7%). They also had greater scores on emotional and sexual abuse domains of CTQ, indicating greater abuse. A higher prevalence of depression (57%) and psychotic disorders (55.3%) was also observed. Risk factors identified which had a positive predictor value were male gender (p Homeless individuals may be traumatized at an early age, put into foster care, rendered homeless, initiated into substance use and re-traumatized on repeated occasions in adult life, rendering them vulnerable to incarceration and mental illness. © The Author(s) 2014.

  17. Longitudinal Predictors of Homelessness: Findings from the National Longitudinal Survey of Youth-97.

    Science.gov (United States)

    Sznajder-Murray, Brittany; Jang, Joy Bohyun; Slesnick, Natasha; Snyder, Anastasia

    2015-01-01

    Homeless youth represent a vulnerable and understudied population. Little research has prospectively identified factors that may place youth at risk for experiencing homelessness. The current study utilizes data from the National Longitudinal Survey of Youth-97 (NLSY-97) to examine predictors of experiencing homelessness as a young adult (before age 25). The NLSY-97 includes a nationally representative sample of 8,984 youth. Data were first collected from these youth when they were between the ages of 12 to 18 years. The current study examined whether individual and family risk factors reported during adolescence predict homelessness by the age of 25. The findings showed that multiple runaway episodes, non-traditional family structure, lower educational attainment, and parental work limitations due to health increased the risk of homelessness. A permissive parenting style and being Hispanic protected against homelessness. This study offers unique insight into risk and protective factors for youth homelessness, and has important clinical implications.

  18. Housing and Homelessness: A Report.

    Science.gov (United States)

    National Alliance to End Homelessness, Washington, DC.

    This report focuses on options for rehousing the individuals and families who are currently homeless in America, and on strategies for preventing homelessness of additional people. As many as 736,000 persons are estimated to be homeless on any given night, and between 1.3 million and 2 million different individuals may experience homelessness at…

  19. Homelessness: A General Information Packet.

    Science.gov (United States)

    Homelessness Exchange, Washington, DC.

    This packet contains documents that provide general information about homelessness and the need for both Federal and local action to help the homeless people in America. Sections 1 and 2 contain the following articles released by the Homelessness Information Exchange: (1) "The Problem of Homelessness Nationwide"; and "Alternative Family Housing…

  20. The Rights of Homeless Students.

    Science.gov (United States)

    Strong, Penny

    This booklet presents information concerning homelessness and the education of homeless children nationwide and in Illinois. Estimates of the number of homeless children vary widely. Reasons for homeless children's failure to attend school include school residency requirements, delays in transfer of documents, and lack of transportation. The…

  1. Health care needs of homeless adolescents.

    Science.gov (United States)

    Morey, M A; Friedman, L S

    1993-08-01

    Most homeless teenagers are running away from abusive or violent home situations. Many of the daily survival tactics employed by runaways put them at risk for a variety of medical problems, including sexually transmitted diseases, hepatitis, tuberculosis, trauma, accidents, and HIV infection. Mental health issues of depression, low self-esteem, hostility, and suicidal behavior or ideation are common and may be compounded by drug abuse or addiction. Barriers to obtaining care for the uninsured homeless teenager encompass confidentiality issues, minor status, and general distrust of adult authority figures. To improve the health care of homeless adolescents, practitioners must encourage research and data collection while supporting and providing accessible medical outreach programs and mental health services.

  2. Intellectual Disability and Homelessness

    Science.gov (United States)

    Mercier, C.; Picard, S.

    2011-01-01

    Background: The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a…

  3. The Faces of Homelessness.

    Science.gov (United States)

    Hope, Marjorie; Young, James

    Homelessness affects a wide cross-section of society. Causes of homelessness, attempted remedies, and potential solutions for the future are presented. Descriptions of the experiences of men, women, and children who have fallen through the "safety net" of social services are included from cities throughout the country. Support is given for the…

  4. Women and Homelessness

    DEFF Research Database (Denmark)

    Koch-Nielsen, Inger; Munk, Anders; Raun, Mette

    This report has been produced for the Observatory on Homelessness, managed by FEANTSA: European Federation of National Organizations Working with the Homeless. The Observatory is supported financially by the Commission of the European Union. The paper is based on the guidelines set up...

  5. Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

    Directory of Open Access Journals (Sweden)

    Kiss Alex

    2010-02-01

    Full Text Available Abstract Background Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale were examined using regression analyses. Results Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years and for a longer duration (mean 4.8 vs. 2.9 years. Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively. Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2 but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3. Conclusions Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.

  6. Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status.

    Science.gov (United States)

    Grinman, Michelle N; Chiu, Shirley; Redelmeier, Donald A; Levinson, Wendy; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Hwang, Stephen W

    2010-02-24

    Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses. Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)). Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.

  7. Homelessness and Hunger*

    Science.gov (United States)

    Lee, Barrett A; Greif, Meredith J

    2014-01-01

    We employ data from the National Survey of Homeless Assistance Providers and Clients to examine the character and correlates of hunger among homeless people. Our analysis, couched in an adaptation framework, finds more support for the differentiation hypothesis than for the leveling hypothesis: Complex patterns of food insecurity exist at the individual level, and they vary with the resources available (e.g., higher monthly income, regular shelter use) and obstacles faced (e.g., alcohol, drug, and physical and mental health problems). The chronically homeless, who suffer from multiple deficits, appear particularly food-insecure, a finding that favors the desperation hypothesis over its street-wisdom alternative. We conclude that hunger is not uniformly experienced by members of the homeless population. Rather, some individuals are better situated than others to cope with the stressful nature of homelessness when addressing their sustenance needs. PMID:18418982

  8. Homelessness among a nationally representative sample of US veterans: prevalence, service utilization, and correlates.

    Science.gov (United States)

    Tsai, Jack; Link, Bruce; Rosenheck, Robert A; Pietrzak, Robert H

    2016-06-01

    To examine the prevalence of lifetime homelessness among veterans and use of Veterans Affairs (VA) homeless services, as well as their association with sociodemographic and clinical characteristics. A nationally representative sample of 1533 US veterans was surveyed July-August 2015. Among all veterans, 8.5 % reported any lifetime homelessness in their adult life, but only 17.2 % of those reported using VA homeless services. Prevalence of homelessness and VA homeless service use did not significantly differ by gender. Being low income, aged 35-44, and having poor mental and physical health were each independently associated with lifetime homelessness. Veterans who were White or lived in rural areas were significantly less likely to have used VA homeless services. Homelessness remains a substantial problem across different generations of veterans. The low reported uptake of VA homeless services suggests there are barriers to care in this population, especially for veterans who live in rural areas. Governmental resources dedicated to veteran homelessness should be supported, and obtaining accurate prevalence estimates are important to tracking progress over time.

  9. Changes in Public Attitudes and Perceptions about Homelessness Between 1990 and 2016.

    Science.gov (United States)

    Tsai, Jack; Lee, Crystal Yun See; Byrne, Thomas; Pietrzak, Robert H; Southwick, Steven M

    2017-12-01

    Public attitudes on homelessness can and has influenced policies and services for homeless populations. This study surveyed national public attitudes about homelessness in the 21st century and examined changes in attitudes in the past two decades. An online survey of public attitudes about homelessness was conducted with 541 U.S. adults across 47 states in November 2016 using Amazon Mechanical Turk. Survey results were compared to two public surveys conducted in 1990. Compared to previous surveys, the current sample endorsed more compassion, government support, and liberal attitudes about homelessness. The largest changes were related to increased support for homeless individuals to use public spaces for sleeping and panhandling. When asked about the demographic composition of the homeless population, the contemporary sample tended to overestimate the proportions who were young and racial/ethnic minorities, while underestimating the proportions who were married, or had mental health or substance abuse problems. Together, the findings suggest there has been an increase in compassion and liberal attitudes toward homelessness in the past two decades. Greater support for homeless individuals during an era of economic recessions and governmental homeless initiatives presents opportunities for new public health approaches to address homelessness. © Society for Community Research and Action 2017.

  10. Affiliation, gender, and parental status among homeless persons.

    Science.gov (United States)

    Morris, J M

    1998-04-01

    Affiliation, loss of affiliation, and the associated effects on homeless individuals were assessed via a survey of 230 homeless adults in Florida. Women accompanied by dependent children, unaccompanied women, and unaccompanied men were compared regarding levels of affiliation and associations among affiliation, self-esteem, and locus of control. The women accompanied by children maintained more family contacts and had higher levels of self-esteem; for the group, locus of control was more external than for either the unaccompanied women or the unaccompanied men. Women with children also had the lowest median number of days homeless and the highest average monthly incomes.

  11. Access Issues in Adult Vocational Guidance and Counselling for People at Risk of Social Exclusion. Perspectives from Two Qualitative Research Projects.

    Science.gov (United States)

    Clayton, Pamela; McGill, Paul

    2000-01-01

    Two studies (of 105 Scottish adults returning to study and of social exclusion and lifelong learning) identified structural barriers in adult access to guidance services: rural location, disability, single parenthood, eldercare, homelessness, criminal record, and refugee status. Solutions include publicity, partnerships, outreach, and supportive…

  12. Assessment of health status and quality of life of homeless persons in Belgrade, Serbia

    Directory of Open Access Journals (Sweden)

    Sarajlija Marija

    2014-01-01

    Full Text Available Background/Aim. Homelessness is a problem with social, medical, economic, political and other implications. Despite a large number of studies, reports about health-related quality of life (HRQoL of homeless persons remain sparse. There is a summary of consistent evidence that homeless people have higher prevalence of chronic disease (mental and somatic than general population. The aim of this study was to assess HRQoL and depression in homeless persons in Belgrade, to describe their sociodemographic factors and health status (the presence of chronic mental and somatic diseases and addiction disorders and analyse impact of sociodemographic factors and health status to HRQoL and depression of homeless persons. Methods. The study was conducted in the Shelter for Adult and Elderly Persons in Belgrade, from January 1 to January 31, 2012. A set of questionnaires used in survey included Serbian translation of SF-36 questionnaire, Serbian translation of Beck Depression Inventory-II (BDI-II and sociodemographic questionnaire. Statistical analysis was performed by descriptive and analytic methods. Results. Our study sample consisted of 104 adult participants. The majority of them were male (74% and the mean age in the sample was 48.2 ± 13.0 years. We have found that 35.6% participants had lifetime diagnosis of psychiatric disorder, most frequently depression (lifetime prevalence of 15.4% in the study group. The history of suicide attempts was registered in 28 (26.9% participants. Lifetime illicit drugs use was reported by 12.5%, daily smoking by 82.7% and daily alcohol consumption by 8.7% of the participants. Most common somatic chronic diseases were cardiovascular while chronic lung diseases were the second most frequent. Single chronic disease was present in 33 (31.7% of the participants and comorbidity of 2 chronic diseases was present in 20 of them. A statistically significant difference between participants` HRQoL SF-36 domain scores and norms of

  13. Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness.

    Science.gov (United States)

    Paul, Sayani; Corneau, Simon; Boozary, Tanya; Stergiopoulos, Vicky

    2018-03-01

    The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. This study is an in-depth investigation of the personal perceived strengths, attitudes and coping behaviors of homeless adults of diverse ethnoracial backgrounds experiencing homelessness and mental illness in Toronto, Canada. Using qualitative methods, 36 in-depth semi-structured interviews were conducted to capture the perspectives of ethnoracial homeless participants with mental illness on coping and resilience. Transcripts were analyzed using thematic analysis. Similar to prior findings in the general homeless population, study participants recognized personal strengths and attitudes as great sources of coping and resilience, describing hope and optimism, self-esteem and confidence, insight into their challenges and spirituality as instrumental to overcoming current challenges. In addition, participants described several coping strategies, including seeking support from family, friends and professionals; socializing with peers; engaging in meaningful activities; distancing from overwhelming challenges; and finding an anchor. Findings suggest that homeless adults with mental illness from ethnoracial groups use similar coping strategies and sources of resilience with the general homeless population and highlight the need for existing services to foster hope, recognize and support individual coping strategies and sources of resilience of homeless individuals experiencing complex challenges.

  14. Self-reported oral health of a metropolitan homeless population in Australia: comparisons with population-level data.

    Science.gov (United States)

    Parker, E J; Jamieson, L M; Steffens, M A; Cathro, P; Logan, R M

    2011-09-01

    There is limited information on self-perceived oral health of homeless populations. This study quantified self-reported oral health among a metropolitan homeless adult population and compared against a representative sample of the metropolitan adult population obtained from the National Survey of Adult Oral Health. A total of 248 homeless participants (age range 17-78 years, 79% male) completed a self-report questionnaire. Data for an age-matched, representative sample of metropolitan-dwelling adults were obtained from Australia's second National Survey of Adult Oral Health. Percentage responses and 95% confidence intervals were calculated, with non-overlapping 95% confidence intervals used to identify statistically significant differences between the two groups. Homeless adults reported poorer oral health than their age-matched general population counterparts. Twice as many homeless adults reported visiting a dentist more than a year ago and that their usual reason for dental attendance was for a dental problem. The proportion of homeless adults with a perceived need for fillings or extractions was also twice that of their age-matched general population counterparts. Three times as many homeless adults rated their oral health as 'fair' or 'poor'. A significantly greater proportion of homeless adults in an Australian metropolitan location reported poorer oral health compared with the general metropolitan adult population. © 2011 Australian Dental Association.

  15. Screening for tuberculosis in an urban shelter for homeless in Switzerland: a prospective study

    OpenAIRE

    Janssens, Jean-Paul; Wuillemin, Timothee; Adler, Dan; Jackson, Yves

    2017-01-01

    Background Whereas high risk groups such as asylum seekers are systematically screened for active tuberculosis (TB) upon entry in Switzerland, this strategy does not apply to homeless persons despite a reported high risk. Geneva health and social authorities implemented an intersectoral project to screen for active TB in homeless persons. We aimed to assess acceptability of this program and prevalence of active TB in this group. Methods This prospective study targeted all homeless adults regi...

  16. Longitudinal Predictors of Homelessness: Findings from the National Longitudinal Survey of Youth-97

    OpenAIRE

    Sznajder-Murray, Brittany; Jang, Joy Bohyun; Slesnick, Natasha; Snyder, Anastasia

    2015-01-01

    Homeless youth represent a vulnerable and understudied population. Little research has prospectively identified factors that may place youth at risk for experiencing homelessness. The current study utilizes data from the National Longitudinal Survey of Youth-97 (NLSY-97) to examine predictors of experiencing homelessness as a young adult (before age 25). The NLSY-97 includes a nationally representative sample of 8,984 youth. Data were first collected from these youth when they were between th...

  17. Mortality and life expectancy in homeless men and women in Rotterdam: 2001-2010.

    Science.gov (United States)

    Nusselder, Wilma J; Slockers, Marcel T; Krol, Luuk; Slockers, Colette T; Looman, Caspar W N; van Beeck, Ed F

    2013-01-01

    Data on mortality among homeless people are limited. Therefore, this study aimed to describe mortality patterns within a cohort of homeless adults in Rotterdam (the Netherlands) and to assess excess mortality as compared to the general population in that city. Based on 10-year follow-up of homeless adults aged ≥ 20 years who visited services for homeless people in Rotterdam in 2001, and on vital statistics, we assessed the association of mortality with age, sex and type of service used (e.g. only day care, convalescence care, other) within the homeless cohort, and also compared mortality between the homeless and general population using Poisson regression. Life tables and decomposition methods were used to examine differences in life expectancy. During follow-up, of the 2096 adult homeless 265 died. Among the homeless, at age 30 years no significant sex differences were found in overall mortality rates and life expectancy. Compared with the general Rotterdam population, mortality rates were 3.5 times higher in the homeless cohort. Excess mortality was larger in women (rate ratio [RR] RR 5.56, 95% CI 3.95-7.82) as compared to men (RR 3.31, 95% CI 2.91-3.77), and decreased with age (RR 7.67, 95% CI 6.87-8.56 for the age group 20-44 and RR 1.63, 95% CI 1.41-1.88 for the age group 60+ years). Life expectancy at age 30 years was 11.0 (95% CI 9.1-12.9) and 15.9 (95% CI 10.3-21.5) years lower for homeless men and women compared to men and women in the general population respectively. Homeless adults face excessive losses in life expectancy, with greatest disadvantages among homeless women and the younger age groups.

  18. Mortality and Life Expectancy in Homeless Men and Women in Rotterdam: 2001–2010

    Science.gov (United States)

    Nusselder, Wilma J.; Slockers, Marcel T.; Krol, Luuk; Slockers, Colette T.; Looman, Caspar W. N.; van Beeck, Ed F.

    2013-01-01

    Background Data on mortality among homeless people are limited. Therefore, this study aimed to describe mortality patterns within a cohort of homeless adults in Rotterdam (the Netherlands) and to assess excess mortality as compared to the general population in that city. Methods Based on 10-year follow-up of homeless adults aged ≥ 20 years who visited services for homeless people in Rotterdam in 2001, and on vital statistics, we assessed the association of mortality with age, sex and type of service used (e.g. only day care, convalescence care, other) within the homeless cohort, and also compared mortality between the homeless and general population using Poisson regression. Life tables and decomposition methods were used to examine differences in life expectancy. Results During follow-up, of the 2096 adult homeless 265 died. Among the homeless, at age 30 years no significant sex differences were found in overall mortality rates and life expectancy. Compared with the general Rotterdam population, mortality rates were 3.5 times higher in the homeless cohort. Excess mortality was larger in women (rate ratio [RR] RR 5.56, 95% CI 3.95–7.82) as compared to men (RR 3.31, 95% CI 2.91–3.77), and decreased with age (RR 7.67, 95% CI 6.87–8.56 for the age group 20–44 and RR 1.63, 95% CI 1.41–1.88 for the age group 60+ years). Life expectancy at age 30 years was 11.0 (95% CI 9.1–12.9) and 15.9 (95% CI 10.3–21.5) years lower for homeless men and women compared to men and women in the general population respectively. Conclusion Homeless adults face excessive losses in life expectancy, with greatest disadvantages among homeless women and the younger age groups. PMID:24098329

  19. Jail incarceration, homelessness, and mental health: a national study.

    Science.gov (United States)

    Greenberg, Greg A; Rosenheck, Robert A

    2008-02-01

    This study sought to investigate the rates and correlates of homelessness, especially mental illness, among adult jail inmates. Data from a national survey of jail inmates (N=6,953) were used to compare the proportion of jail inmates who had been homeless in the previous year with the proportion of persons in the general population who had been homeless in the previous year, after standardization to the age, race and ethnicity, and gender distribution of the jail sample. Logistic regression was then used to examine the extent to which homelessness among jail inmates was associated with factors such as symptoms or treatment of mental illness, previous criminal justice involvement, specific recent crimes, and demographic characteristics. Inmates who had been homeless (that is, those who reported an episode of homelessness anytime in the year before incarceration) made up 15.3% of the U.S. jail population, or 7.5 to 11.3 times the standardized estimate of 1.36% to 2.03% in the general U.S. adult population. In comparison with other inmates, those who had been homeless were more likely to be currently incarcerated for a property crime, but they were also more likely to have past criminal justice system involvement for both nonviolent and violent offenses, to have mental health and substance abuse problems, to be less educated, and to be unemployed. Recent homelessness was 7.5 to 11.3 times more common among jail inmates than in the general population. Homelessness and incarceration appear to increase the risk of each other, and these factors seem to be mediated by mental illness and substance abuse, as well as by disadvantageous sociodemographic characteristics.

  20. Homelessness in the state and federal prison population.

    Science.gov (United States)

    Greenberg, Greg A; Rosenheck, Robert A

    2008-01-01

    This study sought to investigate the rates and correlates of homelessness (i.e. living on the street or in a homeless shelter), including mental illness, among US adult state and federal prison inmates (ASFPIs). Data from a national survey of ASFPIs based on a random sampling survey (N = 17,565) were used to compare the homelessness rate among AFSPIs with that in the general population. Logistic regression was then used to examine the association of homelessness among ASFPIs with factors including symptoms, treatment of mental illness, previous criminal justice involvement, specific crimes, and demographic characteristics. Nine percent of ASFPIs reported an episode of homelessness in the year prior to arrest, 4-6 times the estimated rate in the general US adult population after allowing for age, race/ethnicity, and gender. In comparison to other inmates, these homeless inmates were more likely to be currently incarcerated for a property crime, but also to have had previous criminal justice system involvement for both property and violent crimes, to suffer from mental health and/or substance abuse problems, and to be more likely to have been unemployed and with a low income. Recent homelessness is far more common among ASFPIs than the general population. Prior incarceration, mental illness, substance abuse and disadvantageous socio-demographic characteristics were all found to be associated with homelessness among prison inmates, suggesting that there are several important factors in addition to efforts to survive with limited resources through criminal acts that influence the rates of homelessness among incarcerated individuals.

  1. Recognizing the Needs of the Homeless.

    Science.gov (United States)

    France, Joseph B.

    This paper summarizes reports and research on the homeless in the United States, presents findings of a survey of Red Cross chapters on services to the homeless, and describes programs for the homeless of selected Red Cross chapters. Section 1 discusses definitions of homelessness and methodologies used to count homeless people. The homeless are…

  2. A portrait of homelessness.

    Science.gov (United States)

    Wallsten, S M

    1992-09-01

    The homeless elderly are vulnerable, silent, and fearful. Their trajectory into homelessness more often than not precludes recovery and takes them on a course toward early death or nursing home placement. Psychiatric nurses who work in community or acute care settings are in key positions to recognize elderly victims of homelessness, assess their needs, match them to services, start them on the road to recovery, and become their advocates. The definition of a homeless person as agreed on in the Report of the Federal Task Force on Homelessness and Severe Mental Illness (1992) is the one used in the Stewart B. McKinney Homeless Assistance Act (Public Law 100-77). A homeless person is someone "who lacks a fixed, regular, and adequate nighttime residence" and whose main nighttime residence is a "supervised public or private shelter designed to provide temporary living accommodations; an institution that provides a temporary residence for individuals intended to be institutionalized; or a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings." This definition, then, excludes those individuals living on the "fringes" in substandard or condemned housing, a condition that warrants attention in general and particularly among the elderly.

  3. The effects of housing stability on service use among homeless adults with mental illness in a randomized controlled trial of housing first.

    Science.gov (United States)

    Kerman, Nick; Sylvestre, John; Aubry, Tim; Distasio, Jino

    2018-03-20

    Housing First is an effective intervention to stably house and alter service use patterns in a large proportion of homeless people with mental illness. However, it is unknown whether there are differences in the patterns of service use over time among those who do or do not become stably housed and what effect, if any, Housing First has on these differing service use patterns. This study explored changes in the service use of people with mental illness who received Housing First compared to standard care, and how patterns of use differed among people who did and did not become stably housed. The study design was a multi-site randomized controlled trial of Housing First, a supported housing intervention. 2039 participants (Housing First: n = 1131; standard care: n = 908) were included in this study. Outcome variables include nine types of self-reported service use over 24 months. Linear mixed models examined what effects the intervention and housing stability had on service use. Participants who achieved housing stability, across the two groups, had decreased use of inpatient psychiatric hospitals and increased use of food banks. Within the Housing First group, unstably housed participants spent more time in prison over the study period. The Housing First and standard care groups both had decreased use of emergency departments and homeless shelters. The temporal service use changes that occurred as homeless people with mental illness became stably housed are similar for those receiving Housing First or standard care, with the exception of time in prison. Service use patterns, particularly with regard to psychiatric hospitalizations and time in prison, may signify persons who are at-risk of recurrent homelessness. Housing support teams should be alert to the impacts of stay-based services, such as hospitalizations and incarcerations, on housing stability and offer an increased level of support to tenants during critical periods, such as discharges. ISRCTN

  4. Homeless for the First Time in Later Life: Uncovering More Than One Pathway.

    Science.gov (United States)

    Burns, Victoria F; Sussman, Tamara; Bowers, Barbara J

    2018-01-29

    Increasingly, researchers have recognized the heterogeneity with the growing population of older homeless adults. However, scant research has considered the complex pathways into first-time homelessness from the perspective of older adults themselves. Through in-depth interviews, this constructivist grounded theory study aimed to address this gap by exploring the pathways of 15 adults, aged 50 years and older, into late-life homelessness. Two divergent pathways were revealed: gradual and rapid. Individuals with gradual pathways endured many years of struggle related to poor housing conditions, lack of social support, and social distress. They had reached out for support on several occasions, with little success due to their limited social capital. In contrast, for individuals with rapid moves to homelessness, multiple unanticipated losses threatened their economic and social resources and they were propelled into homelessness with little warning. Despite having access to social networks to help buffer these losses, they preferred homelessness over asking for help and being perceived as dependent. Our study revealed that different pathways into homelessness require divergent strategies of prevention and support. For individuals with gradual moves, strengthening pre-homeless social supports and addressing social distress may have mitigated the eventual loss of housing. For individuals with rapid pathways, homelessness may have been prevented if independence and self-sufficiency were less idealized in our society. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Youth Homelessness: The Impact of Supportive Relationships on Recovery.

    Science.gov (United States)

    Gasior, Sara; Forchuk, Cheryl; Regan, Sandra

    2018-03-01

    Background Homeless youth are the fastest growing sub-group within the homeless population. They face impaired access to health services and are often left unsupported. They lack social and family support or relationships with service providers. Unsupported homeless youth often become homeless adults. Purpose To test a model based on Peplau's Theory of Interpersonal Relations, examining the influence of a network of service providers, perceptions of social supports, and family relations on a homeless youth's perceptions of recovery. Methods This study is a secondary analysis and used a sample (n = 187) of data collected as part of the original Youth Matters in London study. A cross-sectional design was used to analyze the relationship between variables. Participants were interviewed at 6-month intervals over a 2.5-year period. Hierarchical multiple regression analysis was used. Results Network of service providers, perceived social supports, and perceived family relations explained 21.8% of the variance in homeless youth perceptions of recovery. Perceived social support and family relations were significantly, positively correlated to perceptions of recovery. Network of service providers was not significantly correlated to perceptions of recovery. Conclusions The findings suggest that stronger social supports and family relations may contribute to increased perceptions of recovery among homeless youth.

  6. Reproductive health of homeless adolescent women in Seattle, Washington, USA.

    Science.gov (United States)

    Ensign, J

    2000-01-01

    Homeless adolescent women are at high risk for negative health outcomes including early unplanned pregnancy and sexually transmitted diseases. The purpose of this study was to hear the perspectives of homeless adolescent females on the topics of health issues, self-care and fertility control, as well as on lessons from being homeless. The rescarch was descriptive, using semi-structured interviews and focus groups with a purposeful sample of 20 clinic-based female youth ages 15-23 years. The data were coded and analyzed following standard qualitative tcchniques. The youth described female-specific health issues of being homeless, such as problems with hygiene, sexual exploitation, survival sex. Most knew of homeless female youth who had tried self-induced abortions through drugs, herbs or physical abuse. They spoke of fertility control practices of young women living on the streets. The women also spoke of the lessons they had learned while being homeless, including the development of self-sufficiency. The young women in this study were willing to discuss their perspectives and experiences of being homeless. Health care providers should receive increased training in how to ask about sensitive subjects such as survival sex and the practice of self-induced abortions. Programs should be structured to ensure engagement of the women in healthy relationships with adults.

  7. Responding to the needs of the homeless mentally ill.

    Science.gov (United States)

    Frazier, S H

    1985-01-01

    The homeless mentally ill represent a pivotal and urgent challenge to the mental health field in the 1980s. Those homeless who have extended histories of psychiatric hospitalization stand as harsh reminders of the failures of deinstitutionalization, while young mentally ill homeless adults who never have been treated as inpatients testify to the gaps and unrealized promises of community-based care under deinstitutionalization. Homelessness and mental illness are social and clinical problems, respectively, distinct in some ways but intertwined in others. Some of the factors that contribute to homelessness--such as economic deprivations, a dearth of low-cost housing, discontinuities in social service systems, and radical changes in the composition of American families--are felt particularly keenly by many persons who are mentally ill. And symptoms of mental disorders, in turn, frequently impede an individual's capacities to cope with those, as well as other, stressors. Developing appropriate and effective responses to the needs of homeless people who are mentally ill requires precise definition and identification of the target population, innovations in the mental health service system, encouragement of those who staff it to work with homeless mentally ill patients, and public education. Ultimately, however, fundamental answers will be found in an improved understanding of severe mental illness, enhanced treatment capacities, and greater attention to the rehabilitative needs of mentally ill persons.

  8. Researching Homelessness: Challenging Exclusion?

    Directory of Open Access Journals (Sweden)

    Isobel Anderson

    2016-10-01

    Full Text Available This themed issue of Social Inclusion provides a timely opportunity to reflect on how contemporary research is addressing the multi-dimensional issue of homelessness around the world. The papers presented here provide a wide range of new evidence on homelessness including theoretical, methodological and empirical contributions. They draw on a range of national experiences in Europe and beyond, and addressing the issue of social inclusion and social exclusion of homeless or previously homeless people from a range of perspectives and approaches. It is hoped that the contributions to this themed issue will prove influential in terms of both scholarship and potential to enhance policy making and service delivery to some of our most excluded citizens.

  9. The New Homelessness Revisited

    OpenAIRE

    Lee, Barrett A.; Tyler, Kimberly A.; Wright, James D.

    2010-01-01

    The ‘new homelessness’ has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide cr...

  10. Youth Homelessness Strategy

    OpenAIRE

    Department of Health (Ireland)

    2001-01-01

    This Strategy aims to build on this work and to ensure a more co-ordinated and planned approach to tackling youth homelessness. Particular emphasis is placed on prevention and on the importance of supporting schools, communities, the young people themselves and their families in this context. Where a young person becomes homeless the Strategy stresses the need for a prompt child focused service which will address the individual needs of the young person. Download the Report here

  11. Youth Homelessness in Denmark?

    DEFF Research Database (Denmark)

    Børner Stax, Tobias

    Based on a literature study this chapter reflects upon the existence of youth homelessness in Denmark. The chapter contains reflections upon the juridical measures directed towards youngsters living on the margin of the Danish society and presents two concrete project directed towards young people...... living rough. The chapter is taken form an anthology discussion youth homelessness in the different member states of the European Union....

  12. Health and lifestyle issues as risk factors for homelessness.

    Science.gov (United States)

    Heffron, W A; Skipper, B J; Lambert, L

    1997-01-01

    The objective of this study was to test the hypothesis that there are health and lifestyle issues among homeless persons that differentiate them from other segments of the population and that can be described as risk factors for homelessness. This case-control study investigated health and lifestyle issues in a panel of patients visiting a health care clinic for homeless persons. The same information was collected from a panel of county indigent patients and an equal number of privately insured patients enrolled in a nearby academic family practice center. We found significant differences among these three groups. Differences in health problems were evident, as significantly more homeless persons reported mental health, drug and alcohol abuse, and smoking problems. There were no differences in the prevalence of other general medical conditions as listed by the patients. Homeless persons were younger than the control group respondents and more likely to be male, a member of a minority group, and unmarried. The childhood experiences of homeless persons were distinctive; they were more likely to have lived in a group home or some other nonfamily situation, considered themselves to have been delinquent, run away from home, been expelled from school, or been placed in reform school. The same held true for having been in jail as an adult. They had significantly less education, their job experiences were in manual and unskilled arenas, and they were more likely to have a gambling problem. A continuum of risk also appeared in that for the most part the characteristics and experiences of the indigent group members ranked in frequency between those of the homeless and insurance groups. Causes of homelessness appear to be multifactorial. Issues related to mental health, alcohol, nicotine, and other drug and substance abuse could be responsible for their medical problems, whereas other lifestyle issues might be regarded as risk factors for homelessness.

  13. Characterizing Stressors and Modifiable Health Risk Factors among Homeless Smokers: An Exploratory Pilot Study

    Science.gov (United States)

    Kendzor, Darla E.; Reitzel, Lorraine R.; Businelle, Michael S.

    2015-01-01

    This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were…

  14. Impact on health care adds to the social cost of homelessness, MDs say.

    OpenAIRE

    Lowry, F

    1996-01-01

    Homelessness has become a visible part of Canada's urban landscape, infecting adult men and women, youths and families with children alike, and the issue becomes particularly serious as winter approaches. During a workshop in Toronto earlier this year, physicians, researchers and social workers examined the effects of homelessness on health, identifying many of the unique health needs of this vulnerable segment of society.

  15. Mortality and Life Expectancy in Homeless Men and Women in Rotterdam: 2001-2010

    NARCIS (Netherlands)

    W.J. Nusselder (Wilma); M.T. Slockers (Marcel); L. Krol (Luuk); C.T. Slockers (Colette); C.W.N. Looman (Caspar); E.F. van Beeck (Ed)

    2013-01-01

    textabstractBackground:Data on mortality among homeless people are limited. Therefore, this study aimed to describe mortality patterns within a cohort of homeless adults in Rotterdam (the Netherlands) and to assess excess mortality as compared to the general population in that city.Methods:Based on

  16. Impact on health care adds to the social cost of homelessness, MDs say.

    Science.gov (United States)

    Lowry, F

    1996-12-15

    Homelessness has become a visible part of Canada's urban landscape, infecting adult men and women, youths and families with children alike, and the issue becomes particularly serious as winter approaches. During a workshop in Toronto earlier this year, physicians, researchers and social workers examined the effects of homelessness on health, identifying many of the unique health needs of this vulnerable segment of society.

  17. Pedro's circuits in the city of São Paulo: religiosity and homelessness

    Directory of Open Access Journals (Sweden)

    Debora Galvani

    2010-01-01

    Full Text Available This is a case study based on the reconstitution of the life history of a homeless adult person in São Paulo City. Ethnographic research and life history were the strategies in a 12-month long data collecting. Analysis tried to reveal, in the process of identity construction, singularities able to re-signify and confer historicity to homeless experience. To discuss Pedro’s path, religiosity analysis is a crucial element for re-assessing his homelessness history. Allied to other nets, religiosity showed different possibilities of constructing interdependence nets, thus characterizing re-signifying and sense reconstructing movements, and eluding disaffiliation processes so frequent in the case of people that experience rupture conducting to homelessness. In those processes, the socially negative identity linked to homelessness can be dislodged and widened, acquiring more elucidative delineations and dynamics. Nonetheless, there is always the need and the challenge of constructing collective alternatives to precarious homelessness experience.

  18. Understanding the Attainment of Stable Housing: A Seven-Year Longitudinal Analysis of Homeless Adolescents.

    Science.gov (United States)

    Braciszewski, Jordan M; Toro, Paul A; Stout, Robert L

    2016-04-01

    Stable housing provides a solid foundation for youth development, making it an essential topic of study among young homeless people. Although gains have been made in research with adolescents and young adults experiencing homelessness, few longitudinal studies of this population exist, clouding the long-term housing outcome picture. The current study examined the course and risk factors for homelessness in a sample of 243 homeless adolescents followed over a seven-year period. The vast majority of youth returned to stable housing quickly; however, early experiences of homelessness, even at this young age, were observed to have a substantial negative impact on future housing. Participants from poorer neighborhoods and those identifying as ethnic minorities also took longer to achieve stable housing. The data suggest that family reunification interventions may serve this population well. Preparing youth for returning home may prevent subsequent homeless episodes, while also improving their overall functioning.

  19. A Comparison of Homeless and Non-Homeless Adolescents.

    Science.gov (United States)

    LeClair, Mary C.; Hansen, James C.

    The goal of this study was to extend what is currently understood regarding attitudes toward the homeless population. The study focused on how homeless and nonhomeless adolescents attribute the causes of homelessness. Grounded in attribution theory, the study hypothesized that nonhomeless adolescents would ascribe causality to dispositional or…

  20. The Old Homeless and the New Homelessness in Historical Perspective.

    Science.gov (United States)

    Rossi, Peter H.

    1990-01-01

    Changes in homelessness since the 1950s and 1960s involve increasing numbers of homeless persons, striking differences in their composition, and marked deterioration in their condition. Beyond similarly high levels of mental illness and substance abuse, the new homeless are younger, poorer, often shelterless, and include more minorities, women,…

  1. South Dakota's 1996 Homeless Report. Homeless, Not Hopeless.

    Science.gov (United States)

    South Dakota State Dept. of Education and Cultural Affairs, Pierre.

    To study the number and status of homeless people in South Dakota, a questionnaire was mailed to approximately 701 persons who were likely to have knowledge of homeless people. Responses were received from 349 people. Estimated numbers of homeless people include those who live with others because they lack adequate resources to maintain a fixed,…

  2. Health care for the homeless: a family medicine perspective.

    Science.gov (United States)

    Usatine, R P; Gelberg, L; Smith, M H; Lesser, J

    1994-01-01

    Many factors contribute to the health problems of homeless persons, including exposure to adverse weather, trauma and crime, overcrowding in shelters, unusual sleeping accommodations, poor hygiene and nutritional status, alcoholism, drug abuse and psychiatric illness. It is common for homeless adults to have skin ailments, respiratory infections, traumatic injuries and chronic gastrointestinal, vascular, dental and neurologic disorders. Homeless children may have respiratory, ear and skin diseases, as well as special problems, including failure to thrive, developmental delay, neglect and abuse. Important questions to ask during history-taking include questions about sleeping conditions, sources of food, past psychiatric problems and substance abuse, and sources of social support. Special attention should be given to examination of the skin, teeth and feet. Supplemental food, immunizations, psychologic counseling and social service referrals should be considered for homeless pediatric patients.

  3. Elder homelessness. A community perspective.

    Science.gov (United States)

    Bissonnette, A; Hijjazi, K H

    1994-09-01

    Elder homelessness is an increasing problem in our society. After presenting demographics of elder homelessness, this article discusses successful Boston-based program models. Nurse-directed community solutions are emphasized.

  4. National Center on Family Homelessness

    Science.gov (United States)

    ... You are here Home National Center on Family Homelessness Center A staggering 2.5 million children are ... raise awareness of the current state of child homelessness in the United States, documents the number of ...

  5. National Coalition for Homeless Veterans

    Science.gov (United States)

    ... Continues Support of National Campaign to End Veteran Homelessness Nov. 14, 2017 This Veterans Day, Harbor Freight ... support of the national campaign to end veteran homelessness through generous contributions to the National Coalition for ...

  6. The homeless in America: adapting your practice.

    Science.gov (United States)

    Montauk, Susan Louisa

    2006-10-01

    In 2004, the National Guidelines Clearinghouse placed eight guidelines from the National Health Care for the Homeless Council on its Web site. Seven of the guidelines are on specific disease processes and one is on general care. In addition to straightforward clinical decision making, the guidelines contain medical information specific to patients who are homeless. These guidelines have been endorsed by dozens of physicians who spend a large part of their clinical time caring for some of the millions of adults and children who find themselves homeless each year in the United States. In one guideline, physicians are prompted to keep in mind that someone living on the street does not always have access to water for taking medication. Another guideline points out the difficulty of eating a special diet when the patient depends on what the local shelter serves. As the number of homeless families and individuals increases, family physicians need to become aware of medically related information specific to this population. This can help ensure that physicians continue to offer patient-centered care with minimal adherence barriers.

  7. Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department.

    Science.gov (United States)

    Gabrielian, Sonya; Chen, Jennifer C; Minhaj, Beena P; Manchanda, Rishi; Altman, Lisa; Koosis, Ella; Gelberg, Lillian

    2017-10-01

    Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population's acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians' attitudes/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit. To study feasibility, we captured (from May to September 2012) the number of patients screened for homelessness, positive screens, unique patients seen, and primary care visits. We focused on acceptability to ED clinicians (physicians, nurses, social workers); we sent a 32-item survey to ED clinicians (n = 57) who worked during clinic hours. Questions derived from an instrument measuring clinician attitudes toward homeless persons; acceptability of homelessness screening and the clinic itself were also explored. Over the 5 months of interest, 281 patients were screened; 172 (61.2%) screened positive for homelessness; 112 (65.1%) of these positive screens were seen over 215 visits. Acceptability data were obtained from 56% (n = 32) of surveyed clinicians. Attitudes toward homeless patients were similar to prior studies of primary care physicians. Most (54.6%) clinicians agreed with the homelessness screening procedures. Nearly all (90.3%) clinicians supported expansion of the homeless-tailored clinic; a minority (42.0%) agreed that ED colocation worked well. Our data suggest the feasibility of recruiting patients to a homeless-tailored primary care clinic colocated with the ED; however, the clinic's acceptability was mixed. Future quality improvement work should focus on tailoring the clinic to increase its acceptability among ED clinicians, while assessing its impact on health, housing, and costs.

  8. Engagement and retention in services among formerly homeless adults with co-occurring mental illness and substance abuse: voices from the margins.

    Science.gov (United States)

    Padgett, Deborah K; Henwood, Ben; Abrams, Courtney; Davis, Andrew

    2008-01-01

    This qualitative study analyzed 72 interviews with 39 formerly homeless psychiatric consumers to develop a grounded theory model of engagement and retention in mental health and substance abuse services. Person-centered themes included severity of mental illness and substance abuse (the latter also conflicting with programmatic abstinence requirements). System-related themes inhibiting service use included program rules and restrictions and a lack of one-on-one therapy. Those promoting service use were acts of kindness by staff, pleasant surroundings, and the promise (or attainment) of independent housing. Implications of these findings are discussed in terms of integrating consumers' opinions about services to enhance treatment engagement and retention.

  9. Prevalence and Correlates of Youth Homelessness in the United States.

    Science.gov (United States)

    Morton, Matthew H; Dworsky, Amy; Matjasko, Jennifer L; Curry, Susanna R; Schlueter, David; Chávez, Raúl; Farrell, Anne F

    2018-01-01

    Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13-17 and young adults aged 18-25, as well as self-reports from young adults aged 18-25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations. Copyright © 2017 The Society for Adolescent Health and Medicine. All rights reserved.

  10. Health Care for the Homeless.

    Science.gov (United States)

    Altman, Drew; And Others

    1989-01-01

    This supplementary statement, prepared by 10 members of the Institute of Medicine's Committee on Health Care for the Homeless, expands upon the Committee's report, "Homelessness, Health and Human Needs." Argues that the only broad, long-term solution to the health problems of the homeless is immediate action to provide decent, affordable…

  11. Homelessness: From the Clients' Perspectives.

    Science.gov (United States)

    Hertzberg, Edwina L.

    Although homelessness is not a new phenomenon, the number of homeless people today has fostered mobilization on their behalf by public and private sectors. Principal factors accepted as contributing to homelessness are inadequate low-cost housing, unemployment, chemical dependency, family violence, and inadequate community services for the…

  12. Homelessness and drug misuse in developing countries: A mathematical approach

    Science.gov (United States)

    Bhunu, C. P.

    2014-06-01

    Homelessness and drug-misuse are known to exist like siamese twins. We present a model to capture the dynamics in the growth in the number of homeless (street kids and street adults) and drug misusers. The reproduction numbers of the model are determined and analyzed. Results from this study suggests that adult peer pressure plays a more significant role in the growth of drug-misuse and the number of street kids. This result suggests that in resource constrained settings intervention strategies should be tailor made to target adults whose behaviour influence others to misuse drugs and abuse children. Furthermore, numerical simulations show that homelessness and drug-misuse positively enhances, the growth of each other. Thus, to effectively control these two social problems require strategies targeting both of them.

  13. Medical care for the homeless elderly.

    Science.gov (United States)

    Horn, Ansell

    2008-01-01

    This is a case study of two elderly, frail women in New York City who were recently rendered homeless. One woman had a massive tumor on her occipital scalp; the other was in renal failure. The obstacles and complexities of providing care to those with double jeopardy--being elderly and homeless--are described. There are enormous difficulties for placement into safe, supportive housing once people become homeless. The process is expensive and labor intensive. This can be complicated by the existence of mental illness. A New York agency that works with mentally ill homeless people is described. There are systemic obstacles as well: One woman loses her Medicaid when she moves from one state to another to be closer to her family. Another, 82 years old, is told to get a job so that she could qualify for Medicare. There are numerous contradictions and unnecessary costs in a fragmented health care system to which the obvious solution is a national single-payer system of care.

  14. The homeless: social isolates.

    Science.gov (United States)

    Malloy, C; Christ, M A; Hohloch, F J

    1990-01-01

    Within the last 10 years, homelessness has emerged as one of the leading social problems in the United States. This article contains the findings of a descriptive study of the characteristics and health status of a homeless population in a southeastern city. The homeless population is of interest to nurses because it is representative of a specific disadvantaged group, seriously at risk for a myriad of physical and mental problems. The theoretical model, Social Disaffiliation, can serve as a basis for intervention with a variety of underserved or unserved population groups and the data presented provide opportunities for designing nursing intervention strategies. The study was conceived as a way to gather empirical evidence about the specific health-care needs of the community's homeless, to generate a data base on which to estimate that need, and to use the findings to support the establishment of an innovative practice model, a nurse-managed clinic. The literature suggests that on-site clinics, located in emergency shelters, are effective approaches to providing acceptable and accessible health care to the homeless. Nurses are well prepared to be a key part of the solution to one of the most serious problems facing health care in the U.S. today.

  15. Healthcare experiences of the homeless.

    Science.gov (United States)

    Nickasch, Bonnie; Marnocha, Suzanne K

    2009-01-01

    To explore the healthcare experiences of homeless individuals and inform providers of the barriers created by the situation of homelessness. This was a qualitative research study using a grounded theory approach. The sample included homeless individuals older than 18 years living in northeastern Wisconsin. This research provided rich insight into the healthcare experiences of the homeless. Five key conclusions were made: (a) the great majority of homeless people have an external locus of control; (b) most homeless individuals lack the necessary resources to meet their physical needs of shelter, air, water, and food; (c) most homeless individuals lack the financial resources to seek adequate health care; (d) access to resources is limited because of poor transportation, telephones, and mail; and (e) all those interviewed felt that healthcare providers lack compassion for the homeless. Healthcare providers can use the concepts discovered in this study to help improve their skills and comfort level when working with homeless individuals. A decrease in acute illnesses and an increase in the effective management of chronic disease resulting in fewer long-term complications and medical costs because of these unnecessary complications could be seen. Healthcare professionals may also volunteer to become more involved with the care of the homeless if they are confident in their skills. Improving the health of the homeless in the community will result in improvements in the overall health of the community.

  16. Day to Day...Parent to Child. The Future of Violence among Homeless Children in America.

    Science.gov (United States)

    Homes for the Homeless, Inc., New York, NY.

    The majority of parents now living in homeless shelters, typically young single mothers with one or two children under the age of six, have spent their lives spiraling downward through a complex and self-perpetuating cycle of family violence, community violence, and poverty. Sixty-three percent of homeless parents, a survey has found, live with…

  17. Migration to the Downtown Eastside neighbourhood of Vancouver and changes in service use in a cohort of mentally ill homeless adults: a 10-year retrospective study.

    Science.gov (United States)

    Somers, Julian M; Moniruzzaman, Akm; Rezansoff, Stefanie N

    2016-01-06

    Little research has investigated the role of migration as a potential contributor to the spatial concentration of homeless people with complex health and social needs. In addition, little is known concerning the relationship between possible migration and changes in levels of service use over time. We hypothesised that homeless, mentally ill individuals living in a concentrated urban setting had migrated from elsewhere over a 10-year period, in association with significant increases in the use of public services. Recruitment was concentrated in the Downtown Eastside neighbourhood of Vancouver, Canada. Participants (n=433) met criteria for chronic homelessness and serious mental illness, and provided consent to access administrative data. Linked administrative data were used to retrospectively examine geographic relocation as well as rates of health, justice, and social welfare service utilisation in each of the 10 years prior to recruitment. Generalised estimating equations were used to estimate the effect of migration on service use. Over a 10-year period there was significant movement into Vancouver's Downtown Eastside neighbourhood (from 17% to 52% of the cohort). During the same period, there were significant annual increases in community medical services (adjusted rate ratio (ARR) per year=1.08; 95% CI 1.06 to 1.10), hospital admissions (ARR=1.08; 95% CI 1.04 to 1.11), criminal convictions (ARR=1.08; 95% CI 1.03 to 1.13), and financial assistance payments (ARR=1.04; 95% CI 1.03 to 1.06). Migration was significantly associated with financial assistance, but not with other types of services. Significant increases in service use over a 10-year period coincided with significant migration into an urban area where relevant services were concentrated. These results highlight opportunities for early intervention in spatially diverse neighbourhoods to interrupt trajectories marked by worsening health and extremely high service involvement. Further research is urgently

  18. Impact of nursing intervention on decreasing substances among homeless youth.

    Science.gov (United States)

    Nyamathi, Adeline; Branson, Catherine; Kennedy, Barbara; Salem, Benissa; Khalilifard, Farinaz; Marfisee, Mary; Getzoff, Daniel; Leake, Barbara

    2012-01-01

    Alcohol use, and in particular, binge drinking, and methamphetamine use is pervasive among homeless youth and remains a social pressure among this vulnerable population. However, there is no compelling evidence that specific interventions for reducing drug and alcohol use are effective for homeless youth. This community-based participatory action pilot study assessed the impact of an intervention study focused on decreasing use of drugs and alcohol among a sample of homeless young adults (N= 154) visiting a drop-in site in Santa Monica, California. The two programs consisted of an HIV/AIDS and Hepatitis Health Promotion (HHP) program led by nurses and an Art Messaging (AM) program led by artists. Six-month follow-up data were obtained from 100 of these individuals. Findings revealed significant reductions in alcohol and marijuana use and binge drinking in both the HHP and AM programs. However, homeless youth in the HHP program reported additional reductions in methamphetamine, cocaine, and hallucinogen use at 6-month follow-up. Reductions in drugs and alcohol are important as these substances are linked to HIV/AIDS, hepatitis, and other health risks in homeless youth. The successful outcomes of the study intervention validate the utility of nurse-led and artistic health promotion strategies to decrease drug and alcohol use and other risky behaviors in homeless youth populations. Copyright © American Academy of Addiction Psychiatry.

  19. Youth Homelessness and Vulnerability: How Does Couch Surfing Fit?

    Science.gov (United States)

    Curry, Susanna R; Morton, Matthew; Matjasko, Jennifer L; Dworsky, Amy; Samuels, Gina M; Schlueter, David

    2017-09-01

    Youth homelessness is a problem characterized by high levels of vulnerability. The extent to which couch surfing - moving from one temporary housing arrangement to another - is part of youth homelessness is not well understood. Chapin Hall's Voices of Youth Count, a national research initiative, involves a multicomponent approach to studying youth homelessness. This study reports emerging findings regarding couch surfing and homelessness primarily from a national survey of 13,113 adults with youth ages 13-25 in their households or who are themselves ages 18-25. Findings suggest that couch surfing is relatively common, particularly among the older age group. Among households with 13- to 17-year-olds and 18- to 25-year-olds, 4.0% and 20.5%, respectively, reported that any of them had couch surfed in the last 12 months. There are notable social, economic, and educational differences, on average, between youth reporting homelessness and those reporting only couch surfing. However, most youth who report experiencing homelessness also report couch surfing, and these youth who experience both circumstances present high levels of socioeconomic vulnerability. Couch surfing encompasses a range of experiences, some of which likely include need for services. Interviews currently in the field, and expanded analysis of data, will contribute more nuanced policy insights. © Society for Community Research and Action 2017.

  20. Universal health insurance and health care access for homeless persons.

    Science.gov (United States)

    Hwang, Stephen W; Ueng, Joanna J M; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A

    2010-08-01

    We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

  1. Challenging Stereotypes: Sexual Functioning of Single Adults with High Functioning Autism Spectrum Disorder

    Science.gov (United States)

    Byers, E. Sandra; Nichols, Shana; Voyer, Susan D.

    2013-01-01

    This study examined the sexual functioning of single adults (61 men, 68 women) with high functioning autism and Asperger syndrome living in the community with and without prior relationship experience. Participants completed an on-line questionnaire assessing autism symptoms, psychological functioning, and various aspects of sexual functioning. In…

  2. Patient-reported outcomes in adult survivors with single-ventricle physiology

    DEFF Research Database (Denmark)

    Overgaard, Dorthe; Schrader, Anne-Marie; Lisby, Karen H

    2011-01-01

    Objectives: Data on patient-reported outcomes (PROs) in patients with single-ventricle physiology (SVP) are scarce. We sought (1) to describe the perceived health status, quality of life, symptoms of anxiety and depression, and sense of coherence in adult survivors with SVP, (2) to compare PROs...

  3. Barriers to Homeless Persons Acquiring Health Insurance Through the Affordable Care Act.

    Science.gov (United States)

    Fryling, Lauren R; Mazanec, Peter; Rodriguez, Robert M

    2015-11-01

    Medicaid expansion under the Affordable Care Act (ACA) is intended to provide a framework for increasing health care access for vulnerable populations, including the 1.2 million who experience homelessness each year in the United States. We sought to characterize homeless persons' knowledge of the ACA, identify barriers to their ACA enrollment, and determine access to various forms of communication that could be used to facilitate enrollment. At an urban county Level I trauma center, we interviewed all noncritically ill adults who presented to the emergency department (ED) during daytime hours and were able to provide consent. We assessed access to communication, awareness of the ACA, insurance status, and barriers preventing subjects from enrolling in health insurance and compared homeless persons' responses with concomitantly enrolled housed individuals. Of the 650 enrolled subjects, 134 (20.2%) were homeless. Homeless subjects were more likely to have never heard of the ACA (26% vs. 10%). "Not being aware if they qualify for Medicaid" was the most common (70%) and most significant (30%) barrier to enrollment reported by uninsured homeless persons. Of homeless subjects who were unsure if they qualified for Medicaid, 91% reported an income homeless subjects reported access. Homeless persons report having less knowledge of the ACA than their housed counterparts, poor understanding of ACA qualification criteria, and limited access to phone and internet. ED-based outreach and education regarding ACA eligibility may increase their enrollment. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Homeless & hungry: the evidence from Liverpool.

    Science.gov (United States)

    Stitt, S; Griffiths, G; Grant, D

    1994-01-01

    Much research has established the link between low incomes and poor nutritional standards. A research team from the Centre for Consumer Education & Research at Liverpool John Moores' University recently found that 30% of all families with children in Britain today are spending less on food than what is required to achieve a dietary which adheres, at minimum cost, to the Department of Health's Dietary Recommended Values (DRVs). But very little, if any, research has investigated the nutritional implications of a particularly extreme form of material deprivation--homelessness. This pilot study therefore sets out to study the dietaries of a number of homeless families in Liverpool--homeless as defined by living in Bed & Breakfast accommodation. Not only do such families have to contend with dependency upon welfare benefits when purchasing their foodstuffs; they also have to labour under inadequate cooking facilities. The study has involved these families keeping a dietary diary of all food and drink consumed. This information has then been analysed for its nutrient composition, using the Microdiet computer programme at Liverpool JMU. The results will show that, in every single case, the dietaries of these homeless families fall substantially short of the government's own nutritional guidelines and are, without doubt, unhealthy in the extreme. This paper is thus an examination of the nature and extent of the problem, using the science of nutrition and dietetics: not a policy prescription (although this is obvious) not a policy analysis. A study of the dietary implications of homelessness for 100 individuals (the largest ever undertaken) on Merseyside will be undertaken between September 1993 and June 1994.

  5. Quality of life of homeless persons with mental illness: results from the course-of-homelessness study.

    Science.gov (United States)

    Sullivan, G; Burnam, A; Koegel, P; Hollenberg, J

    2000-09-01

    The quality of life of homeless persons with mental illness was compared with that of homeless persons without mental illness. Subjective and objective quality-of-life ratings were obtained in face-to-face interviews with 1,533 homeless adults in Los Angeles, who were identified using probability sampling of people on the streets and at shelters and meal facilities; 520 subjects were tracked for 15 months. Ratings of homeless persons with and without mental illness were compared using chi square tests and regression analyses. Mentally ill homeless persons were significantly more likely than those without mental illness to receive Supplemental Security Income, Social Security Disability Insurance, Veterans Affairs disability benefits, or Medicaid. However, those with mental illness still fared significantly worse in terms of physical health, level of subsistence needs met, victimization, and subjective quality of life. Differences between groups in the subjective quality-of-life ratings were accounted for by modifiable factors such as income and symptoms rather than by nonmodifiable demographic characteristics. Interventions most likely to improve the quality of life of homeless persons with mental illness include those that stress maintenance of stable housing and provision of food and clothing and that address physical health problems and train individuals to minimize their risk of victimization. Interventions that decrease depressive symptoms might also improve subjective quality of life.

  6. Increasing Overall Well-Being is Salient in Treating Homelessness.

    Science.gov (United States)

    Coleman, Jennifer

    2017-04-03

    Homeless treatment programs have focused on physical solutions rather than attending to all aspects of well-being. Support services that address overall well-being have demonstrated effectiveness. Previous research suggests that overall well-being is defined as satisfaction within all life spheres. Objective life indices have been the primary evidence of success among various programs, which include food, housing, income, leisure, health, access to psychiatric and medical services, and maintenance of positive support networks. This does not account for other important subjective components, such as psychiatric symptoms and quality of life. This study was designed to assess quality of life and psychiatric symptoms among the people who were chronically and formerly chronically homeless. The people who were formerly chronically homeless are defined as individuals who were chronically homeless in the past but have successfully remained in housing for 6 months or more and have access to intensive case management services. People who are chronically homeless are homeless individuals who have lacked a residence for a year or more or have had four or more episodes in three years, are single, and have a persistent disability. Participants completed the Oxford Happiness Scale, Brief Symptom Inventory, and a brief questionnaire. All participants were disabled in accordance with the definition of chronic homelessness adopted by the U.S. Department of Housing and Urban Development. This researcher hypothesized that high quality-of-life scores, low frequency of psychiatric symptoms, and greater access to basic life indices indicate happiness overall. Additionally, it was hypothesized that people who are chronically homeless have a higher foster care rate than the general population.

  7. Estimating the size of the homeless adolescent population across seven cities in Cambodia.

    Science.gov (United States)

    Stark, Lindsay; Rubenstein, Beth L; Pak, Kimchoeun; Taing, Rosemary; Yu, Gary; Kosal, Sok; Roberts, Leslie

    2017-01-26

    The Government of Cambodia has committed to supporting family care for vulnerable children, including homeless populations. Collecting baseline data on the numbers and characteristics of homeless adolescents was prioritized to illuminate the scope of the issue, mobilize resources and direct the response. Administrative zones across seven cities were purposively selected to cover the main urban areas known to have homeless populations in Cambodia. A complete enumeration of homeless individuals between the ages of 13 and 17 was attempted in the selected areas. In addition, a second independent count was conducted to enable a statistical estimation of completeness based on overlap across counts. This technique is known as capture-recapture. Adolescents were also interviewed about their schooling, health and other circumstances. After adjustment by the capture-recapture corrective multipliers (range: 3.53 -27.08), the study yielded an estimate of 2,697 13-17 year old homeless adolescents across all seven cities. The total number of homeless boys counted was significantly greater than homeless girls, especially in older ages. To the authors' knowledge, this is the first time capture-recapture methods have been applied to a homeless estimation of this scale in a resource-limited setting. Findings suggest the number of homeless adolescents in Cambodia is much greater than one would expect if relying on single count data alone and that this population faces many hardships.

  8. Estimating the size of the homeless adolescent population across seven cities in Cambodia

    Directory of Open Access Journals (Sweden)

    Lindsay Stark

    2017-01-01

    Full Text Available Abstract Background The Government of Cambodia has committed to supporting family care for vulnerable children, including homeless populations. Collecting baseline data on the numbers and characteristics of homeless adolescents was prioritized to illuminate the scope of the issue, mobilize resources and direct the response. Methods Administrative zones across seven cities were purposively selected to cover the main urban areas known to have homeless populations in Cambodia. A complete enumeration of homeless individuals between the ages of 13 and 17 was attempted in the selected areas. In addition, a second independent count was conducted to enable a statistical estimation of completeness based on overlap across counts. This technique is known as capture-recapture. Adolescents were also interviewed about their schooling, health and other circumstances. Results After adjustment by the capture-recapture corrective multipliers (range: 3.53 -27.08, the study yielded an estimate of 2,697 13–17 year old homeless adolescents across all seven cities. The total number of homeless boys counted was significantly greater than homeless girls, especially in older ages. Conclusions To the authors’ knowledge, this is the first time capture-recapture methods have been applied to a homeless estimation of this scale in a resource-limited setting. Findings suggest the number of homeless adolescents in Cambodia is much greater than one would expect if relying on single count data alone and that this population faces many hardships.

  9. Paranoia and maladaptive behaviours in homelessness: The mediating role of emotion regulation.

    Science.gov (United States)

    Powell, Kathryn; Maguire, Nick

    2017-12-22

    Current research has implicated a role for cognitive and emotional processes in the pathways to becoming homeless. Evidence implicates three risk factors, which are often associated with an increased incidence of homelessness: paranoid thinking, emotion regulation, and engaging in maladaptive behaviours. Maladaptive behaviours include deliberate self-harm, substance misuse, and high-risk sexual practices. Currently, no studies have investigated the specific psychological mechanisms, such as difficulty regulating emotions, which underpin the association between paranoia and maladaptive behaviours. A mediational design was employed in a group of homeless individuals. Participants (N = 40), who were homeless at the time of the study, completed a single-session assessment of paranoia, emotion regulation, and maladaptive behaviours. Mediation analyses indicated that individuals scoring high on paranoia were more likely to engage in maladaptive behaviours, particularly substance misuse and aggression, when they had difficulty regulating their emotions. These results demonstrate a novel finding relating to the effect of emotion regulation in maintaining psychopathology and behaviours in vulnerable individuals, which may in turn sustain periods of homelessness. Emotion regulation may therefore be one particular psychological mechanism through which severe mental illness affects engagement in self-destructive behaviours in homelessness. These findings have valuable clinical implications for targeted therapeutic interventions, in this often difficult to treat homeless population. Psychosis is over-represented in the homeless population; the cycle of homelessness may be attenuated by addressing psychotic symptomology. Homeless individuals engage in drug abuse, self-harm, aggression, and high-risk sexual practices due to an inability to regulate distressing emotions effectively. Therapeutic interventions, such as MBT and DBT, which target emotion regulation difficulties, may

  10. [Health of the homeless].

    Science.gov (United States)

    Cha, Olivier

    2013-02-01

    The homeless population is difficult to define and its number difficult to evaluate. In France, it is estimated that almost 4 million people living in substandard accommodation, and 85,000 homeless people. Most homeless people rarely frequent public spaces. One-third have a job, one-quarter live with children, and one-third are between 18 and 29 years old. Shared characteristics include a collapse of social ties and a complete lack of stable accommodation. There are no illnesses specific to homeless people, but their epidemiology differs from the general population: the incidence rate of tuberculosis is 30 times higher, for example. Medical care often arrives far too late. As a result, functional deficits are common, often following serious accidents, and hospitalization is three times more frequent. A chronic disease is present in 45% of cases. Average life expectancy is only 47.6 years-between 30 and 35 years lower than for the general French population. Medical care can only be fully effective if these patients' social and housing issues are dealt with too.

  11. Attributions about homelessness in homeless and domiciled people in Madrid, Spain: "Why are they homeless people?".

    Science.gov (United States)

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2018-01-01

    Causal attributions of homelessness may affect both the design and acceptance of public policies aimed at improving the situation of homeless people and the strategies that homeless people themselves decide to adopt in order to cope with their situation. This article analyzes the differences in causal attributions of homelessness based on gender, age, nationality, educational background, perceived social class, evolution of personal economic situation, and future expectations between the members of 2 groups: (a) "homeless group", consisting of a representative sample of homeless people in Madrid, Spain (n = 188); and (b) "domiciled group", consisting of a sample of people in Madrid at no risk of homelessness (n = 180), matched for sex, age and nationality. Results show that among domiciled population, women, older people, those without university education, those considering themselves to belong to lower income social classes, those who considered their economic situation to have worsened, and those who expressed negative expectations for the future attributed homelessness to individualistic courses to a greater extent. Meanwhile, among homeless group, younger people, those without university education, those considering themselves to belong to higher social classes, those who perceived their economic situation as having improved in recent years, and those who expressed positive expectations for the future generally attributed homelessness to individualistic courses to a greater extent. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  12. A review of homelessness and homelessness services in East Dorset

    OpenAIRE

    Cutts, Wendy; Redmond, Mark; Ricketts, Chris

    2003-01-01

    This report reviews the nature and extent of homelessness in East Dorset. In particular it focuses on:\\ud - Existing levels of homelessness;\\ud - The causes of homelessness within the local authority area;\\ud - Current service provision for homeless people/households;\\ud - Identifying gaps in the provision of current services.\\ud \\ud Reflecting the local authority’s desire to develop a more pro-active and preventative approach to addressing housing need, this report identifies a number of str...

  13. Does the availability of single cigarettes promote or inhibit cigarette consumption? Perceptions, prevalence and correlates of single cigarette use among adult Mexican smokers.

    Science.gov (United States)

    Thrasher, J F; Villalobos, V; Dorantes-Alonso, A; Arillo-Santillán, E; Cummings, K Michael; O'Connor, R; Fong, G T

    2009-12-01

    Single cigarette use and its implications have rarely been studied among adults. To assess perceptions, prevalence and correlates of single cigarette purchase behaviour and its relation to harm reduction. Focus group transcripts and cross-sectional data were analysed. Focus groups among convenience samples of adult smokers in two Mexican cities and a population-based sample of 1079 adult smokers from the International Tobacco Control Policy Evaluation Project in four Mexican cities. Purchase of single cigarettes last time cigarettes were bought, frequency of purchasing single cigarettes in the previous month and intention to quit in the next 6 months. Focus group data indicated that smokers bought single cigarettes as a harm reduction strategy. Survey data indicated that 38% of participants purchased single cigarettes in the last month and 10% purchased them the last time they bought cigarettes, with more frequent consumption among young adults and those with lower income. Purchasing single cigarettes was independently associated with the frequency of using single cigarettes to reduce consumption and, less consistently, with the frequency of being cued to smoke after seeing single cigarettes for sale. Using single cigarettes to reduce consumption was positively associated with quit intention, whereas being cued to smoke by single cigarettes was negatively associated with quit intention. Study results suggest that some adult Mexican smokers purchase single cigarettes as a method to limit, cut down on and even quit smoking. Nevertheless, promotion of the availability of single cigarettes as a harm reduction strategy could provide additional smoking cues that undermine quit attempts and promote youth smoking.

  14. Risk factors for homelessness: evidence from a population-based study.

    Science.gov (United States)

    Shelton, Katherine H; Taylor, Pamela J; Bonner, Adrian; van den Bree, Marianne

    2009-04-01

    This study examined factors associated with lifetime experience of homelessness among young adults. Data were analyzed for 14,888 young adults (mean+/-SD age 21.97+/-1.77; 7,037 men and 7,851 women) who participated in the National Longitudinal Study of Adolescent Health (Add Health), a U.S. nationally representative, population-based sample. Data were collected from young adults through computer-assisted interviews six years after they had enrolled in the study as adolescents. Variables that have been associated with lifetime homelessness in at least one service sample were mapped to Add Health survey items. Data were analyzed by logistic regression. A total of 682 respondents (4.6%) were classified as ever being homeless. Several factors related to childhood experiences of poor family functioning, socioeconomic disadvantage, and separation from parents or caregivers were independently associated with ever being homeless. Other significant independent factors included current socioeconomic difficulty, mental health problems, and addiction problems. Indicators of involvement in crime and addiction problems with gambling and alcohol were not independently associated with homelessness. The findings underscore the relationship between specific indicators of adversity in childhood and risk of homelessness and point to the importance of early intervention efforts. Consistent with the extant research literature, mental health problems also appear to be associated with homelessness, highlighting the potentially complex service needs of this population.

  15. Effectiveness of case management for homeless persons: a systematic review

    NARCIS (Netherlands)

    Vet, R. de; Luijtelaar, M.J.A. van; Brilleslijper-Kater, S.N.; Vanderplasschen, W.; Beijersbergen, M.D.; Wolf, J.R.L.M.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized

  16. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    NARCIS (Netherlands)

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.; Wolf, Judith R. L. M.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized

  17. The Jailing of America's Homeless: Evaluating the Rabble Management Thesis

    Science.gov (United States)

    Fitzpatrick, Kevin M.; Myrstol, Brad

    2011-01-01

    The authors of this article test hypotheses derived from Irwin's rabble management thesis. The analysis uses data from 47,592 interviews conducted with jailed adults in 30 U.S. cities as part of the Arrestee Drug Abuse Monitoring program. Clearly, homeless persons are overrepresented among those arrested and booked into local jails. Bivariate…

  18. [Surgical problems of homeless people].

    Science.gov (United States)

    Witkiewicz, Wojciech; Gnus, Jan Janusz; Stankiewicz, Zuzanna; Kocot, Marta; Rasiewicz, Marcin

    2013-09-01

    Estimated quantity of homeless people in Poland is about 30.000. Health conditions of homeless depends on poor living conditions, alcohol abuse and lack of medical care. The aim of the study was to present surgical problems of homeless people at St. Brother Albert's Aid Society Shelter in Szczodre. In years 2009-2011 in St. Brother Albert's Aid Society Shelter in Szczodre 1053 homeless were provided outpatient surgical care. The frequency of occurrence of diseases rated on the basis of the medical examination, medical history and medical records. The patients were aged 20-82 years (median: 46 years). The most common surgical problem of homeless people was skin infectious such as scabies, lice, tinea and lower limb ulceration due to underlying chronic vanous insufficiency or due to sustained injury. Other problems requiering surgical care were: frostbite, abscesses, phlegmon, unhealed wounds, back pain and pain due to sustained injuries. Most frequent causes of homelessness were family problems, alcohol abuse, conflict with the law, loss of ocupation or loss of home. Surgical diseases of homeless people have multifactorial etiology. The most frequent diseases in our patients were skin infectious and lower limb ulcerations. Medical care oriented on specific needs of homeless people is particulary important because poor health condition is not only consequence but could also be the cause of homelessness.

  19. How did a Housing First intervention improve health and social outcomes among homeless adults with mental illness in Toronto? Two-year outcomes from a randomised trial.

    Science.gov (United States)

    O'Campo, Patricia; Stergiopoulos, Vicky; Nir, Pam; Levy, Matthew; Misir, Vachan; Chum, Antony; Arbach, Bouchra; Nisenbaum, Rosane; To, Matthew J; Hwang, Stephen W

    2016-09-12

    We studied the impact of a Housing First (HF) intervention on housing, contact with the justice system, healthcare usage and health outcomes among At Home/Chez Soi randomised trial participants in Toronto, a city with an extensive service network for social and health services for individuals who are experiencing homelessness and mental illness. Participants identified as high needs were randomised to receive either the intervention which provided them with housing and supports by an assertive community treatment team (HF+ACT) or treatment as usual (TAU). Participants (N=197) had in-person interviews every 3 months for 2 years. The HF+ACT group spent more time stably housed compared to the TAU group with the mean difference between the groups of 45.8% (95% CI 37.1% to 54.4%, phousing stability and selected health and justice outcomes over 2 years in a city with many social and health services. ISRCTN42520374. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The Other America: Homeless Families in the Shadow of the New Economy. Family Homelessness in Kentucky, Tennessee and the Carolinas. A Report of Homes for the Homeless.

    Science.gov (United States)

    Institute for Children and Poverty, New York, NY.

    This report describes a survey of homeless families from shelters in Kentucky, Tennessee, and the Carolinas. The typical family included a 32-year-old single woman with two young children who was more likely to be African American, had a high school education, and had a 50-50 chance of being employed. Most children attended preschool, most were…

  1. Do Place and Time Make a Difference? Examining Quality of Life Among Homeless Persons in Northwest Arkansas and Birmingham.

    Science.gov (United States)

    O'Connor, Gail; Fitzpatrick, Kevin

    2017-04-01

    This study examines the role that life chances and choices play in determining quality of life among homeless people. Given the prominent negative impact of homelessness, this paper specifically examines the impact of length of time homeless and location on adverse quality of life. OLS regression examined quality of life among 264 homeless adults living in Northwest Arkansas and Birmingham, Alabama. Analysis shows no significant impact of life choices on quality of life but a significant impact of life chances including strong social ties and mastery of fate, on adverse quality of life. Length of time homeless was related to adverse quality of life, but location was not, indicating that the homeless experience with regards to subjective quality of life did not vary significantly between Birmingham and Northwest Arkansas.

  2. Ankle muscle activity modulation during single-leg stance differs between children, young adults and seniors.

    Science.gov (United States)

    Kurz, Eduard; Faude, Oliver; Roth, Ralf; Zahner, Lukas; Donath, Lars

    2018-02-01

    Incomplete maturation and aging-induced declines of the neuromuscular system affect postural control both in children and older adults and lead to high fall rates. Age-specific comparisons of the modulation of ankle muscle activation and behavioral center of pressure (COP) indices during upright stance have been rarely conducted. The objective of the present study was to quantify aging effects on a neuromuscular level. Thus, surface electromyography (SEMG) modulation and co-activity of ankle muscles during single-leg standing was compared in healthy children, young adults and seniors. Postural steadiness (velocity and mean sway frequency of COP), relative muscle activation (SEMG modulation) and co-activation of two ankle muscles (tibialis anterior, TA; soleus, SO) were examined during single-leg stance in 19 children [age, 9.7 (SD 0.5) years], 30 adults [23.3 (1.5) years] and 29 seniors [62.7 (6.1) years]. Velocity of COP in medio-lateral and anterior-posterior directions, mean sway frequency in anterior-posterior direction, relative muscle activation (TA and SO) and co-activation revealed large age effects (P  0.14). Post-hoc comparisons indicated higher COP velocities, anterior-posterior frequencies, relative SO activation and co-activation in children and seniors when compared with adults. Relative TA activation was higher in children and adults compared with seniors (P modulation. However, TA modulation is higher in children and adults, whereas seniors' TA modulation capacity is diminished. An aging-induced decline of TA motor units might account for deteriorations of TA modulation in seniors.

  3. Wellbeing for homeless people: a Salutogenic approach.

    Science.gov (United States)

    Dunleavy, Andrew; Kennedy, Lynne Alexandra; Vaandrager, Lenneke

    2014-03-01

    Homelessness affects considerable numbers in the UK and is caused by poverty and social exclusion. Much of the literature on housing and health is disease centric, where the experience of homelessness is described as traumatic, disempowering and socially isolating. Based on the Salutogenic approach, which calls for a positive orientation on health, the aim of this study was to explore the subjective lived experiences of wellbeing in the situated context of homeless people's lives. Nine in-depth qualitative interviews with temporarily housed adults (>25 years) in a socio-economically deprived region of North-west England were held. Accounts of renewed self-confidence, perceived resourcefulness and continual personal participation are said to be supporting wellbeing. A strong belief, or sense of coherence, in internal and external general resistance resources was a critical enabling factor for those living in temporary accommodation. Wellbeing was consistently linked with both social and formal activities; keeping occupied and having a strong sense of purpose were essential to wellbeing. In utilizing a Salutogenic approach we demonstrate how the 'context and meaning' of health actions can improve the understanding about the kinds of factors influencing wellbeing.

  4. Families' Experiences of Doubling Up After Homelessness.

    Science.gov (United States)

    Bush, Hannah; Shinn, Marybeth

    2017-01-01

    This study examined experiences of doubling up among families after episodes of homelessness. Doubling up refers to two or more adults or families residing in the same housing unit, which has been an increasing trend in the United States in recent decades. Within the past 14 years, the number of households containing more than one family, related or unrelated, has more than tripled. Although doubling up is increasingly common among families at all income levels, this study seeks to understand the experiences of doubling up among families who have been homeless. Through qualitative interviews with caregivers of 29 families, we analyzed advantages and disadvantages of doubling up with the caregiver's parent, other family, and nonfamily. Experiences were rated on a four-point scale-(1) mostly negative, (2) negative mixed, (3) positive mixed, and (4) mostly positive-and coded for various positive and negative themes. Overall, we found that doubling up was a generally negative experience for families in our sample, regardless of their relationship to their hosts. Common themes included negative effects on children, undesirable environments, interpersonal tension, and feelings of impermanence and instability. For formerly sheltered families in this study, doubling up after shelter did not resolve their period of housing instability and may be only another stop in an ongoing cycle of homelessness.

  5. Risk factors for failure of a single surgical debridement in adults with acute septic arthritis.

    Science.gov (United States)

    Hunter, Joshua G; Gross, Jonathan M; Dahl, Jason D; Amsdell, Simon L; Gorczyca, John T

    2015-04-01

    Acute septic arthritis in a native joint may require more than one surgical debridement to eradicate the infection. Our objectives were to determine the prevalence of failure of a single surgical debridement for acute septic arthritis, to identify risk factors for failure of a single debridement, and to develop a prognostic probability algorithm to predict failure of a single surgical debridement for acute septic arthritis in adults. We collected initial laboratory and medical comorbidity data of 128 adults (132 native joints) with acute septic arthritis who underwent at least one surgical debridement at our institution between 2000 and 2011. Univariate and logistic regression analyses were used to identify potential risk factors for failure of a single surgical debridement. Stepwise variable selection was used to develop a prediction model and identify probabilities of failure of a single surgical debridement. Of the 128 patients (132 affected joints) who underwent surgical debridement for acute septic arthritis, forty-nine (38%) of the patients (fifty joints) experienced failure of a single debridement and required at least two debridements (range, two to four debridements). Staphylococcus aureus was the most common bacterial isolate (in sixty, or 45%, of the 132 joints). Logistic regression analysis identified five independent clinical predictors for failure of a single surgical debridement: a history of inflammatory arthropathy (odds ratio [OR], 7.3; 95% confidence interval [CI], 2.4 to 22.6; p 85.0 x 10(9) cells/L (OR, 4.7; 95% CI, 1.8 to 17.7; p = 0.002), S. aureus as the bacterial isolate (OR, 4.6; 95% CI, 1.8 to 11.9; p = 0.002), and a history of diabetes (OR, 2.6; 95% CI, 1.1 to 6.2; p = 0.04). Most (62%) of the septic joints were managed effectively with a single surgical debridement. Adults with a history of inflammatory arthropathy, involvement of a large joint, a synovial-fluid nucleated cell count of >85.0 x 10(9) cells/L, an infection with S. aureus

  6. Pastoral care and counseling with the "un-homeless homeless": understanding cultures of homelessness.

    Science.gov (United States)

    Snodgrass, Jill

    2014-01-01

    This article presents a subset of findings from a larger study exploring the lived experiences of 16 former residents of a 90-day emergency family shelter program in Los Angeles County. Interpretative phenomenological analysis serves as a qualitative method for understanding the cultural uniqueness of the "un-homeless homeless." The findings offer implications for culturally competent pastoral care and counseling in the context of family homelessness and attend to both the process and content of caregiving.

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

    Science.gov (United States)

    Slockers, Marcel T; Nusselder, Wilma J; Looman, Caspar W N; Slockers, Colette J T; Krol, Luuk; van Beeck, Ed F

    2015-04-01

    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. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  8. Health and life problems of homeless men and women in the southeast.

    Science.gov (United States)

    Clarke, P N; Williams, C A; Percy, M A; Kim, Y S

    1995-01-01

    Homelessness in America is on the rise. Cities across the United States have been targeted in studies documenting the prevalence, health needs, and socioeconomic status of the "new" homeless. Southern cities have been noticeably underrepresented in these reports. The purpose of this exploratory, descriptive study was to identify the health needs and life situations of the homeless population in Columbia, South Carolina. Adult participants were interviewed at homeless shelters, public parks, and soup kitchens. Quantitative and qualitative methods were used to increase reliability and to portray a comprehensive picture of this diverse population. An interview guide was designed to help interviewers elicit the experience of homelessness including the needs of women and children. Outcomes paralleled findings of previous studies supporting the commonality of the homeless experience across geographic areas. Among the 157 respondents, 41 (26.1%) were women living in shelters or on the street. Minorities were well represented, with 67.5% of the sample composed of African Americans and .6% composed of Spanish Americans. Reasons for homelessness were expressed as a combination of factors such as loss of a job, family problems, or health problems. Of those who disclosed abuse histories (n = 59), 73.8% stated that this had occurred before becoming homeless. Implications for the development of innovative community nursing systems to meet the needs of this population are addressed.

  9. Sheltered versus nonsheltered homeless women differences in health, behavior, victimization, and utilization of care.

    Science.gov (United States)

    Nyamathi, A M; Leake, B; Gelberg, L

    2000-08-01

    To contrast sociodemographic characteristics, physical and mental health status, substance use, sexual behaviors, victimization, and utilization of health services between homeless women residing in sheltered and non-sheltered environments. Cross-sectional survey. A structured scale was used to measure mental health status. Physical health status, substance use, sexual behavior, history of adult victimization, and health services utilization were measured by content-specific items. Shelters (N = 47) and outdoor locations in Los Angeles. One thousand fifty-one homeless women. Homeless women living on the streets were more likely than sheltered women to be white and longer-term homeless. Controlling for sociodemographic characteristics, multiple logistic regression analyses revealed that unsheltered women had over 3 times greater odds of fair or poor physical health, and over 12 times greater odds of poor mental health than sheltered homeless women. They were also more likely than sheltered women to report using alcohol or noninjection drugs, to have multiple sexual partners, and to have a history of physical assault. About half of the overall sample reported utilization of a variety of health services; however, unsheltered homeless women were less likely to utilize all of the health services that were assessed, including drug treatment. There is a critical need for aggressive outreach programs that provide mental health services and substance abuse treatment for homeless women on the streets. Comprehensive services that also include medical care, family planning, violence prevention, and behavioral risk reduction may be particularly valuable for homeless women, especially those living in unsheltered environments.

  10. [Morbidity spectrum and drug therapy of homeless persons in Munich].

    Science.gov (United States)

    Egen, V

    1998-01-01

    In Germany there are currently approx. 200,000 homeless single people, and the trend is rising. As a result of the situation in which they find themselves, many of these persons are ill and in need of medical treatment. A study was performed in Munich/Germany, focussing on a medical practice providing care for the homeless, to investigate their illnesses and pharmacological therapy. The medical practice was located in a municipal shelter. Each year about 350 different destitute homeless men--about 15 per cent of all single homeless people in Munich--were cared for. The men, whose ages ranged from about 17 to 74 years were single and the majority lived in shelters, bed and breakfast accommodations, or shared apartments. About ten per cent lived on the street. For the study, 171 randomly selected medical records were analysed for the period of July 1994 to June 1995. The homeless men suffered principally from the following illnesses: psychiatric illnesses (36%), infectious and parasitic diseases (31%), skin diseases (30%), injuries (29%), diseases of the skeleton, of the muscles and of the connective tissues (28%), diseases of the respiratory organs (27%), cardiovascular diseases (24%), and diseases of the digestive organs (17%). Seventy-five per cent of the patients received drug treatment. In the case of 37% of the patients, wounds were treated and dressed in the medical practice itself. The most frequently prescribed drugs were: analgesics (12%), antibiotics (10%), antihypertensives (10%), gastrointestinal treatments (9%), treatments for colds (9%), and dermatopharmacological preparations (6%). It was surprising that only 16% of the psychic ill patients were treated with drugs, while over 60% of the other illnesses were mostly treated pharmacologically. The interaction with alcohol was the reason for that. The study showed that the practice did not sufficiently reach women and homeless people living on the street. The homeless situation, the personal and social

  11. Cocreating with the homeless?

    DEFF Research Database (Denmark)

    Hansen, Brian Benjamin; Gemal, Carsten Høy

    2014-01-01

    The article is based on the case of a group of homeless people who in the fall of 2013 occupied a central site in the Danish town of Aarhus. The authors argue that this specific case is an ideal object of investigation for casting light on a new situation in the field of public administration....... Public administration has recently moved from the paradigm of New Public Management to a new and still undetermined paradigm, which focuses on activating and engaging citizens, treating them as equal partners in the process of co-creating welfare services and the community itself as a brand. Using...... the case of the homeless, the authors argue that participatory citizenship should not only be viewed as “added value” to the field of public administration, but rather as emerging within a dynamic and conflict-ridden field between citizens and administration where new types of value are potentially created...

  12. Homeless in Galilee

    Directory of Open Access Journals (Sweden)

    Robert L. Brawley

    2011-04-01

    Full Text Available This article has located Jesus’ saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic covenant traditions and the prophetic hope expressed especially in Isaiah, Ezekiel and Psalm 37, Jesus proclaimed God’s kingdom as God’s rule over heaven and earth, which implicates restoration of equitable access to the resources of the earth. The Lord’s Prayer, presumptions about the water of Jacob’s well in John 4 and the parable of the unjust steward in Luke 16 are used to demonstrate understandings of violations of equitable access according to Abrahamic covenant traditions and the hope for the restoration thereof.

  13. Can Better National Policy End Family Homelessness?

    Science.gov (United States)

    Roman, Nan

    2010-01-01

    An understanding of the close link between federal policy and family homelessness is critical for ensuring that one day no child in the United States is homeless. This article discusses the nature of family homelessness, the national policy framework that exists to help vulnerable families, the homeless assistance system that federal policy has…

  14. Homelessness: An Annotated Bibliography of Australian Research.

    Science.gov (United States)

    Loft, Jenny, Comp.; Davis, Mari, Comp.

    This bibliography, compiled for the International Year of Shelter for the Homeless, lists Australian works published since 1974 about homelessness. It includes definitions of homelessness from the literature and an introductory article looking at different perspectives on homelessness. The entries, mainly taken from FAMILY database, are each…

  15. Faces of Homelessness: A Teacher's Guide.

    Science.gov (United States)

    Massachusetts State Dept. of Education, Quincy.

    A brief teacher's guide supplements a videotape of two 15-minute segments on homelessness. The stated objective of the video is to cover the issues of homelessness as they exist today and to dispel the stereotypes of homelessness leftover from earlier eras. A family which has found itself homeless is introduced and then aspects of the phenomenon…

  16. Children Who Are Homeless: Implications for Educators.

    Science.gov (United States)

    Yamaguchi, Barbara J.; Strawser, Sherri; Higgins, Kyle

    1997-01-01

    Reviews the definition and demographics of homeless students; the effects of homelessness on developmental, psychological, behavioral, and academic growth; the legal mandates regarding homeless students; and barriers to education. Recommendations for fostering success for homeless students are offered. (Author/DB)

  17. Homeless Students: A Search for Understanding.

    Science.gov (United States)

    Robertson, Donna Friedman

    1998-01-01

    Describes a qualitative research project examining homelessness's effects on children's schooling, highlighting a South Carolina intervention program's success. Research disclosed an informal homelessness "caste system," the political unpopularity of providing homeless services, homeless kids' high rates of academic failure and problem…

  18. Prognosis for Homeless Children and Adolescents.

    Science.gov (United States)

    Reganick, Karol A.

    1997-01-01

    Notes that children and adolescents appear to suffer the most detrimental effects of homelessness. Discusses the problems faced by homeless youth and the educational systems that must respond to them, including causes and demographics of homelessness, detrimental effects of shelters, the victimization of homeless adolescents, and educational and…

  19. The Educational Rights of Homeless Children.

    Science.gov (United States)

    Schumack, Sharon, Ed.

    1987-01-01

    This newsletter focuses on the educational rights of the homeless. It contains the following articles: (1) Homelessness: A Barrier to Education for Thousands of Children; (2) New Federal Act Protects Education Rights of Homeless Children; (3) Suggested Questions Regarding the Education Provisions of the McKinney Homeless Assistance Act; and (4)…

  20. 34 CFR 300.19 - Homeless children.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Homeless children. 300.19 Section 300.19 Education... DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the meaning given the term homeless children and youths in section 725 (42 U.S.C. 11434a) of the McKinney...

  1. Relationship between attachment and executive dysfunction in the homeless.

    Science.gov (United States)

    Rodríguez-Pellejero, José M; Núñez, Juan L

    2018-02-01

    The executive functions of the homeless may be contributing to the success or failure of social integration processes. The goal of this study was to analyze the relationship between attachment and executive dysfunction in the homeless, specifically, to analyze the prevalence of adult attachment and executive dysfunction patterns, as well as the predictive power of different types of attachment for executive functioning. Participants were 107 homeless. Descriptive analysis revealed the prevalence of insecure attachment, and a high prevalence of clinically significant executive dysfunction. Regression analysis showed that attachment predicts all the executive functions, although the predictive power of attachment decreased when entering the variable drug addiction. People in a situation of chronic social exclusion are characterized by an insecure attachment style and moderate levels of executive dysfunction.

  2. An Investigation of Loneliness and Perceived Social Support Among Single and Partnered Young Adults.

    Science.gov (United States)

    Adamczyk, Katarzyna

    This study investigated the possible differences between single individuals and individuals in nonmarital romantic relationships in the domains of emotional (romantic and family) and social loneliness, and of perceived social support from family, friends and significant others. Based on a Polish university-student sample of 315 participants (167 women and 148 men) aged 19 to 25 years ( M  = 21.90, SD  = 2.15), single relationship status was related to greater romantic and family loneliness, and to less perceived social support from significant others and family. Women reported a lower level of social loneliness and a higher level of perceived social support in comparison to men. Relationship status interacted with gender in predicting perceived social support from significant others and friends. Finally, the duration of remaining single and significant others' support were found to be predictive of single young adults' romantic loneliness. In addition, perceived social support from family and significant others were found to moderate the relationship between the duration of remaining single and romantic loneliness. In particular, high family support and medium-high support from significant others mitigated the negative impact of being single for a long time on romantic loneliness.

  3. A retrospective analysis of episodes of single tooth extraction under general anaesthesia for adults.

    Science.gov (United States)

    Hong, B; Birnie, A

    2016-01-15

    To investigate the provision of adult dental extraction under general anaesthesia (DGA) at the Royal Cornwall Hospitals NHS Trust (RCHT)-- specifically adult single tooth DGA episodes in regards to numbers, demographics, justifications, and appropriateness regarding the use of resources. Data were collected retrospectively from the patient case notes and electronic records for the complete study cohort. This study included all episodes of adult single tooth DGA in all RCHT sites during 2014, except for mandibular third molar and impacted teeth. Each case was tested against the DGA case selection criteria empirically devised for this study. In 2014, 106 episodes of adult single tooth DGA were carried out in RCHT that met the inclusion criteria. Younger females from more socio-economically deprived areas of Cornwall were increasingly likely to have this procedure. Mental disorders were the most prevalent co-morbidity (21.7%) in this cohort. The vast majority of patients (93.4%) had previously tolerated dental treatment without the need for general anaesthesia (GA). Many referrals (46.2%) and listings (30.2%) specifically stated patient demand-driven reasons. None of the cohort had DGA due to failure of sedation. There were potentially 11 episodes that met the DGA case selection criteria. Patients waited for 126 days (median) from the referral date for an operation which took seven minutes (median) to complete. The majority (83%) of the cases were simple exodontia. Twenty patients (18.9%) had previous DGA. Potentially a considerable proportion of GA prescription appeared to be driven by patient demand rather than clinical need. This study poses a fundamental question--what drives the demand for DGA? National data collection and specific DGA case selection criteria are recommended.

  4. Improving the nutritional quality of charitable meals for homeless and vulnerable adults. A case study of food provision by a food aid organisation in the UK.

    Science.gov (United States)

    Pelham-Burn, Sophie E; Frost, Catherine J; Russell, Jean M; Barker, Margo E

    2014-11-01

    The prevalence of homelessness in the UK is rising, and demand for food aid through charitable meal services has increased. Charitable services make a substantial contribution to the food and nutrient intake of vulnerable people, and thus offer a platform for dietary improvement. This study examined food provision by a large charitable organisation in a major UK city. It had several objectives: Firstly to quantify nutritional composition of breakfast and lunch meals, secondly to understand factors that influence the composition of menus and meals, and thirdly to determine whether, within the context of these influences, improvements to the menu would be possible and whether these would be acceptable to clients. Mixed methods of ethnography, semi-structured interviews, quantitative nutrient analysis, recipe adaptation and taste tests were employed. The research team worked as volunteers in the organisation for a 3-week period and interviews were held with the kitchen staff. Food choice was recorded for 189 clients at breakfast and 251 clients at lunch over a 5-day period and nutrient content of these meals was estimated. Meals were weighted towards fat and sugar energy. Energy, potassium, calcium, vitamin C, vitamin A, zinc and magnesium content of meals were below Dietary Reference Value (DRV) targets for at least 20% of breakfast and lunch meals. Such inadequacies may be addressed by the addition of simple foods to the breakfast menu and adaptation of lunchtime recipes. Twelve lunchtime dishes were proposed and eight of these were seemingly acceptable to clients in taste testing. Barriers to provision of healthier meals include budget, food donations and acceptability of meals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Food choice and nutrient intake amongst homeless people.

    Science.gov (United States)

    Sprake, E F; Russell, J M; Barker, M E

    2014-06-01

    Homeless people in the UK and elsewhere have typically been found to consume a nutritionally inadequate diet. There is need for contemporary research to update our understanding within this field. The present study aimed to provide an insight into the nutrient intake and food choice of a sample of homeless adults. In this mixed-methods study, 24 homeless individuals accessing two charitable meal services in Sheffield, UK, participated in up to four 24-h dietary recalls between April and August 2012. Twelve individuals took part in a semi-structured interview focusing on food choice. Energy intake was significantly lower than the estimated average requirement. Median intakes of vitamin A, zinc, magnesium, potassium and selenium were significantly lower than reference nutrient intakes. Contributions of saturated fat and nonmilk extrinsic sugars to total energy intake were significantly higher, whereas dietary fibre was significantly lower, than population average intakes. Charitable meals made an important contribution to intakes of energy and most micronutrients. Thematic analysis of interview transcripts revealed three major themes: food aspirations; constraints over food choice; and food representing survival. The present study reveals risk of dietary inadequacies amongst homeless people alongside a lack of control over food choices. Charitable meal services are suggested as a vehicle for improving the dietary intake and nutritional health of homeless people. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  6. Modeling the mental health effects of victimization among homeless persons.

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F; Pollio, David

    2008-11-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

  7. Modeling the mental health effects of victimization among homeless persons

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F.; Pollio, David

    2014-01-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults. PMID:18703266

  8. A collaborative community approach to homeless care.

    Science.gov (United States)

    Plumb, J D; McManus, P; Carson, L

    1996-03-01

    Homelessness is a social, economic, and public health problem of increasing magnitude in the United States. The past methods and approaches to delivering health care to those without homes have been inadequate because of the many complex problems faced by homeless persons today. To facilitate a discussion of a collaborative community approach to homeless care, it is helpful to include a definition of homelessness, describe the homeless population and the health status of homeless individuals, and explain what is meant by health care for the homeless.

  9. Youth Homelessness and Individualised Subjectivity

    Science.gov (United States)

    Farrugia, David

    2011-01-01

    This article aims to contribute to understandings of youth homelessness and subjectivity by analysing identity construction in terms of young people's negotiation of the structural and institutional environment of youth homelessness. I suggest that while existing literature on this topic concentrates mainly on micro-social encounters, the…

  10. Public Policy and the Homeless.

    Science.gov (United States)

    Gore, Albert, Jr.

    1990-01-01

    Describes regional and federal responses to the homelessness crisis, including the author-sponsored White House Conference on Homelessness Act. Supports legislative measures to accomplish the following goals: (1) increased low-income housing; (2) treatment of mentally ill and alcohol- and drug-dependent individuals; and (3) new approaches to…

  11. Research on Homelessness: An Introduction.

    Science.gov (United States)

    Shinn, Marybeth; Weitzman, Beth C.

    1990-01-01

    Introduces an issue on the causes, consequences, and social response to homelessness, with contributions by scholars in anthropology, history, medicine, sociology, economics, public administration, law, and psychology. Much attention has been given to the problems of homeless individuals; this issue attempts a comprehensive overview of the…

  12. Youth Homelessness: Early Intervention & Prevention.

    Science.gov (United States)

    Chamberlain, Chris; MacKenzie, David

    The issue of youth homelessness in Australia is examined in the context of relevant social and educational policies. The exploration is based on 8 years of research into the situation of homeless youth in Australia involving several studies, including a study of school students in 9 communities and field visits to 100 schools. In 1994, researchers…

  13. The Homeless in Contemporary Society.

    Science.gov (United States)

    Bingham, Richard D.; And Others

    This book consists of 15 chapters on understanding and helping the homeless. The first seven chapters present the "new" homeless in historical context and describe this population and its situation. The remaining eight chapters discuss policy and program options of the government and other organizations in attempting to alleviate the problems of…

  14. Homeless healthcare: raising the standards.

    Science.gov (United States)

    Medcalf, Pippa; Russell, Georgina K

    2014-08-01

    Over the past 3 years the number of homeless people in the UK has increased by 34%. Most will die young, largely due to treatable conditions. Secondary care can, and must, do more for the silent killer that homelessness is. © 2014 Royal College of Physicians.

  15. Care of the Homeless Patient.

    Science.gov (United States)

    Klein, Jared Wilson; Reddy, Simha

    2015-09-01

    This article discusses the unique considerations when caring for patients who lack housing, one of the most essential human needs. Special attention is provided to diseases and conditions that are affected by homelessness as well as to particularly vulnerable populations of homeless patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Needs of Children Experiencing Homelessness who are Living in Shelters: A Qualitative Investigation of Perceptions of Care Workers to Inform Music Therapy Clinical Practice

    OpenAIRE

    Greta Jean Yates; Michael Joseph Silverman

    2016-01-01

    On a single night in January in 2014 there were 194,000 children living with their families in shelters in the United States (National Center on Family Homelessness, 2015). A typical family experiencing homelessness consists of a single mother with two to three children. Children experiencing homelessness are more likely to face academic, social, and emotional problems compared to children in poverty. As there is currently a dearth of peer reviewed publications related to music therapy with c...

  17. Alcoholism in homeless men in the mid-nineties: results from the Bavarian Public Health Study on homelessness.

    Science.gov (United States)

    Fichter, M; Quadflieg, N

    1999-01-01

    Parallel to structural economic changes homelessness has become publicly more visible and has received increased media attention in Western industrialized countries. Most studies on mental illness and homelessness in recent years were carried out in North America but only few studies in Europe have dealt with these issues. The goals of the present study were (1) to assess alcohol abuse and dependence as well as other mental disorders in a representative sample of homeless men in Munich using reliable methods of case identification (Structured Clinical Interview for DSM-IV (SCID)), (2) to compare homeless alcoholics with homeless non-alcoholics in our sample on relevant variables, and (3) to compare our data from the Munich sample with data obtained by others. According to our results, the life-time prevalence of any SCID-DSM-IV Axis I diagnoses was 93.2% and the lifetime prevalence of substance use disorder was 79.6%. The single most prevalent diagnosis among homeless males in Munich was alcohol dependence (life-time 72.7%); alcohol abuse (life-time 5.5%) and drug abuse/dependence were considerably lower in prevalence (life-time 19.1%) (weighted data). A higher rate of psychotic disorders was found for non-alcoholic homeless men. Data show that alcoholism and its consequences were more severe in the Munich as compared to North American samples. Homeless alcohol dependent men showed a high comorbidity with other mental disorders (life-time) such as mood disorders (36.4%), anxiety disorders (16.4%), drug abuse/dependence (18.9%) and psychotic disorders (4.5%). Of those with alcohol dependence at some time during their life 59.1% had experienced at least one other life-time mental disorder. Alcohol-related behavioral patterns and symptoms as well as general social functioning are described. Considering the very high prevalence of alcohol dependence (frequently in combination with other mental disorders), the participation in alcohol rehabilitation and other services

  18. Smoking policy change at a homeless shelter: attitudes and effects.

    Science.gov (United States)

    Businelle, Michael S; Poonawalla, Insiya B; Kendzor, Darla E; Rios, Debra M; Cuate, Erica L; Savoy, Elaine J; Ma, Ping; Baggett, Travis P; Reingle, Jennifer; Reitzel, Lorraine R

    2015-01-01

    Homeless adults are exposed to more smokers and smoke in response to environmental tobacco cues more than other socioeconomically disadvantaged groups. Addressing the culture of smoking in homeless shelters through policy initiatives may support cessation and improve health in this vulnerable and understudied population. This study examined support for and expected/actual effects of a smoking ban at a homeless shelter. A 2-wave cross-sectional study with an embedded cohort was conducted in the summer of 2013 two weeks before (wave 1) and two months after (wave 2) a partial outdoor smoking ban was implemented. A total of 394 homeless adults were surveyed (i.e., wave 1 [n=155]; wave 2 [n=150]; and 89 additional participants completed both waves). On average, participants were 43 years old, primarily African American (63%), male (72%), and had been homeless for the previous 12 months (median). Most participants were smokers (76%) smoking 12 cigarettes per day on average. Most participants supported the creation of a large smoke-free zone on the shelter campus, but there was less support for a shelter-wide smoking ban. Average cigarettes smoked per day did not differ between study waves. However, participants who completed both study waves experienced a reduction in expired carbon monoxide at wave 2 (W1=18.2 vs. W2=15.8 parts per million, p=.02). Expected effects of the partial ban were similar to actual effects. Partial outdoor smoking bans may be well supported by homeless shelter residents and may have a positive impact on shelter resident health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Homelessness predicts attrition but not alcohol abstinence in outpatients experiencing co-occurring alcohol dependence and serious mental illness.

    Science.gov (United States)

    Leickly, Emily; Skalisky, Jordan; Oluwoye, Oladunni; McPherson, Sterling M; Srebnik, Debra; Roll, John M; Ries, Richard K; McDonell, Michael G

    2017-11-21

    Adults experiencing homelessness and serious mental illnesses (SMI) are at an increased risk of poor mental health and treatment outcomes compared with stably housed adults with SMI. The additional issue of alcohol misuse further complicates the difficulties of those living with homelessness and SMI. In this secondary data analysis, the authors investigated the impact of homelessness on attrition and alcohol use in a contingency management (CM) intervention that rewarded alcohol abstinence in outpatients with SMI. The associations between housing status and attrition and alcohol abstinence during treatment, as assessed by ethyl glucuronide (EtG) urine tests, were evaluated in 79 adults diagnosed with alcohol dependence and SMI. Thirty-nine percent (n = 31) of participants reported being homeless at baseline. Individuals who were homeless were more likely to drop out of CM (n = 10, 62.5%) than those who were housed (n = 4, 16.7%), χ 2 (1) = 8.86, P < .05. Homelessness was not associated with attrition in the noncontingent control group. Accounting for treatment group and prerandomization EtG levels, neither the effect of housing status nor the interaction of housing status and group were associated with EtG-assessed alcohol abstinence during treatment. Individuals experiencing homelessness and co-occurring alcohol dependence and SMI receiving CM had higher rates of attrition, relative to those who were housed. Homelessness was not associated with differences in biologically assessed alcohol abstinence.

  20. [Mental health of homeless persons. Critical review of the Anglo-Saxon literature].

    Science.gov (United States)

    Ducq, H; Guesdon, I; Roelandt, J L

    1997-01-01

    Because the visibility of homeless persons congregating in urban areas has increased since the 1980's, the relationship between homelessness and mental illness has caused more and more concern. A multitude of epidemiological surveys have been organized in Great Britain, Australia, Canada, and mainly in United States, and have attempted to evaluate scientifically the psychiatric morbidity of this population. This literature review reveals disparity of epidemiological methods in assessing the type and extent of mental illness among homeless adults. The lack of consensual definition of homelessness, the choice of different settings in which the research is organized (street, health centres, shelters), and the use of diverse instruments of psychiatric evaluation (diagnosis by clinician, by scale or by structured diagnostic interview) lead to a great disparity of the results. Thus, 1/3 of the homeless adults had prior history of psychiatric hospitalisation. Rates of psychosis range to 70% and it is estimated that 4% to 74% of the homeless persons suffer from affective disorders. Substance abuse disorder remains a problem for a significant number of these individuals, with a high frequency of dual diagnosis. Such divergent data highlight the anglo-saxon debate between those who accuse desinstitutionnalisation as a reason of homelessness, and those who blame the socioeconomic background.