Homelessness Among Families, Children, and Adolescents: An Ecological–Developmental Perspective

This paper reviews and evaluates the literatures on children in families that are homeless and on adolescents who are homeless on their own. After presenting several emerging theoretical approaches, we propose a broad ecological-developmental perspective that recognizes that, although persons in these groups often lack resources and experience negative events that can amplify the risk for poor outcomes, they also have resources and adaptive potential. The perspective also recognizes that homelessness may have different meanings and outcomes at different points in development and that we need to consider interactions between individual development and multiple levels of social organization in order to foster new solutions to homelessness. On the basis of this perspective, we discuss directions for treatment and preventive interventions as well as social policy.     

Discrimination and exiting homelessness among homeless adolescents

This article examines how newly homeless adolescents' discrimination experiences were associated with exiting homelessness after 6 months. A sample of 262 homeless adolescents, aged 12 to 20 years, were recruited and followed longitudinally (6-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 families were more likely to exit homelessness than adolescents who did not report such discrimination. Suggestions for future research include focusing on the experiences of LGB homeless adolescents, the role of families in the lives of homeless adolescents, and other aspects of discrimination, including salience, frequency, intensity, and duration.     

At Home with the Homeless:

The tragically increasing incidence of homelessness and the reasons for it have been documented and speculated about extensively in recent years. While having such information is necessary toward understanding the phenomenon in general, it still doesn't assure that one can communicate and empathize adequately with homeless people. More effective, if more discomforting, is to actually experience the world as they experience it. This p aper describes the efforts of one professional person to do this. After sleeping in office building doorways, in mission houses and homeless shelters, visiting welfare and employment offices and begging on the streets for two months, the author reaches some conclusions and recommendations rarely seen in the social science literature.     

‘Fighting’ for survival: A systematic review of physically violent behavior perpetrated and experienced by homeless young people

ObjectivesThis systematic review appraises published studies reporting associations between homelessness, perpetration of physically violent behavior and experience of victimization due to others' physically violent behavior, among young people.MethodsA comprehensive systematic search of psychology, sociology, and health electronic databases, including PsycInfo and SocIndex was conducted. Search terms examined (a) homeless youth, (b) perpetration of physically violent behavior, and (c) experience of victimization due to others' physically violent behavior.ResultsTwenty-nine studies met the inclusion criteria. Findings showed homeless youth report engaging in physically violent behavior including assault, physical fights, and robbery, and commonly describe victimization experiences such as being physically assaulted, threatened with weapons, and robbed. Rates of perpetration of physically violent behavior and experiences of victimization were inconsistent across reviewed studies. It is unclear whether homelessness is a predictor of the perpetration of physically violent behavior and/or victimization. Findings suggest that perpetration of, and being victimized by others' physically violent behavior, may vary for sub-groups of homeless youth.ConclusionsFurther research embedded within theoretical perspectives that consider the influence of situational antecedents is warranted to examine whether homelessness is predictive of engagement in physically violent behavior and the experience of victimization due to others' physically violent behavior.     

Homeless Adults’ Recovery Experiences in Housing First and Traditional Services Programs in Seven European Countries

Across Europe, as governments turn to housing-led strategies in attempts to reverse rising rates of homelessness, increasing numbers of Housing First (HF) programs are being implemented. As HF programs become more widespread, it is important to understand how service users experience them compared to the more prevalent traditional treatment-first approach to addressing long-term homelessness. Although there is a large body of research on service users’ experiences of Housing First compared to treatment-first in North American contexts, comparatively less is known about how these two categories of homeless services are experienced in the European context. In a correlational and cross-sectional study, part of a larger examination of homelessness in Europe, participants (n = 520) engaged with either HF (n = 245) or traditional services (TS; n = 275) programs in seven countries completed measures of their experiences of services (consumer choice, housing quality, and service satisfaction) and recovery (time in independent housing, psychiatric symptoms, and community integration). Across the seven countries, participants engaged with HF programs reported experiencing more consumer choice, better perceived housing quality, and more satisfaction with services than participants engaged in TS programs. Participants in HF programs also reported a greater proportion of time in independent accommodation, fewer psychiatric symptoms, and more community integration. Varying patterns of association between experiences of services and recovery outcomes were observed. Findings indicate HF consistently predicts greater recovery than TS across diverse sociopolitical and economic contexts. Implications of findings for configurations of homeless services and homeless services policy are discussed.     

Decreasing Psychiatric Symptoms by Increasing Choice in Services for Adults with Histories of Homelessness

Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven “Housing First” program or “treatment as usual” requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choice, mastery, and psychiatric symptoms were measured at six time points. Results indicate a direct relationship between Housing First and decreased homelessness and increased perceived choice; the effect of choice on psychiatric symptoms was partially mediated by mastery. The strong and inverse relationship between perceived choice and psychiatric symptoms supports expansion of programs that increase consumer choice, thereby enhancing mastery and decreasing psychiatric symptoms.     

What about the babies? A critical review of infants’ and toddlers’ absence in homelessness scholarship

Rates of family homelessness continue to reach unprecedented levels. As many as two million young children experience family homelessness each year, with an estimated one in 10 younger than one year old. Yet, despite their high prevalence, a dearth of studies have specifically investigated infants’ and toddlers’ experiences of homelessness. Overall, the available literature suggests homeless infants and toddlers experience increased risk to physical health, development, and well-being at an individual- and family-level. This presents a severely limited understanding of homeless infants’ and toddlers’ experiences, with substantial gaps remaining. This review documents the scant existing literature on infant and toddler development within the context of homelessness at both the individual and family-system levels, and proposes next steps for research, practice, and policy.     

Ending homelessness. Policy challenges.

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.     

Homeless women with children. The role of alcohol and other drug abuse.

For some women with children, alcohol and other drug use may be an important risk factor for homelessness because it may interfere with a woman's capacity to compete for scarce resources such as housing, employment, or services. The impact of various policy decisions on homeless women, their dependent children, and the family unit is considered, including women's right to privacy, criminalization of drug use, and scarcity of appropriate treatment programs for homeless women.     

Peer support critical elements and experiences in supporting the homeless: A qualitative study

Peer supporters are individuals with lived experience and are an integral part of health care systems, providing support to those affected by various phenomena such as homelessness and addictions. However, little is known about the critical elements that underpin peer support interventions. This qualitative study sought to understand the critical elements of intentional peer support with a homeless population, voiced by those who provide and/or receive this support. Twenty‐nine participants from 4 different homeless charities in England were interviewed about their experiences of providing/receiving peer support and what they felt were critical factors to its success. Participants defined peer support as an experience‐based relationship, built upon mutual understanding, empathy, and support. Thematic analysis was utilised to in developing 6 themes. Results identified peers' persistence in developing unique experience‐based relationships, providing social support, role modelling recovery, and peers' motivations were perceived as important factors involved in peer support. It was also found that peers described benefitting from helping, such as, undergoing transformative identity developments that helped them to escape homelessness. Through the retelling of their stories, they create meaning and restructure their autobiography, attributing experiences of homelessness as a catalyst for positive changes in their lives. Limitations and future research are discussed.     

Utilizing Participatory Mapping and GIS to Examine the Activity Spaces of Homeless Youth

Although previous studies have informed our understanding of certain aspects of youth homelessness, few studies have critically examined the spatial and social environments utilized by youth as they navigate life on the streets. This study employed participatory mapping and Geographic Information Systems (GIS) to examine the activity spaces of homeless youth as they relate to sense of community and psychological well‐being. Participants were 28 youth experiencing homelessness in Portland, Oregon, USA. Results suggest that youth engage most frequently in service‐related activities, and their activity participation is significantly associated with sense of community and psychological well‐being. The utility of innovative participatory methods for better understanding the diverse experiences of homeless youth is discussed alongside examination of their practical implications.     

Trauma Among Unaccompanied Homeless Youth: The Integration of Street Culture into a Model of Intervention

Homeless adolescents comprise a population particularly vulnerable to developing symptoms of post-traumatic stress. Research has shown that prevalence of trauma-related symptoms among homeless youth living in shelters and on the streets without families is approximately 18%. The detrimental effects of traumatic experiences often inhibit homeless youths' ability to employ the psychosocial skills necessary to a transition out of homelessness. Consequently, interventions targeting the mitigation of post-traumatic stress symptoms among this population are crucial. This article aims to address the symptoms and needs of unaccompanied homeless youth who experience post-traumatic stress disorder symptomatology and offers a strength-based intervention framework for understanding, identifying, and beginning to address trauma-related mental health needs within the cultural context and experience of youth homelessness.     

Voices from the Street: How Structural and Individual Factors Influence Homelessness

This study compared structural and individual factors related to persons who are homeless and how these factors affected their ability to utilize and benefit from available services. A qualitative case study design was used to conduct in-depth interviews with two participants receiving hospice care in a residence for the homeless. Results support previous findings that chronic homelessness is the result of multiple structural and individual factors that occur over time. Contrary to the literature on chronic homelessness, however, both participants were unique in their history of employment and strong desire to work, despite having limited work skills. Responses from both participants underscored the value of daily structure and meaningful occupation in residential addiction treatment.     

What Happens After the Demonstration Phase? The Sustainability of Canada's At Home/Chez Soi Housing First Programs for Homeless Persons with Mental Illness

This research examined the sustainability of Canada's At Home/Chez Soi Housing First (HF) programs for homeless persons with mental illness 2 years after the end of the demonstration phase of a large (more than 2000 participants enrolled), five‐site, randomized controlled trial. Qualitative interviews were conducted with 142 participants (key informants, HF staff, and persons with lived experience) to understand sustainability outcomes and factors that influenced those outcomes. Also, a self‐report HF fidelity measure was completed for nine HF programs that continued after the demonstration project. A cross‐site analysis was performed, using the five sites as case studies. The findings revealed that nine of the 12 HF programs (75%) were sustained, and that seven of the nine programs reported a high level of fidelity (achieving an overall score of 3.5 or higher on a 4‐point scale). The sites varied in terms of the level of systems integration and expansion of HF that were achieved. Factors that promoted or impeded sustainability were observed at multiple ecological levels: broad contextual (i.e., dissemination of research evidence, the policy context), community (i.e., partnerships, the presence of HF champions), organizational (i.e., leadership, ongoing training, and technical assistance), and individual (i.e., staff turnover, changes, and capacity). The findings are discussed in terms of the implementation science literature and their implications for how evidence‐based programs like HF can be sustained.     

Homelessness and strategies of identity maintenance: a participant observation study

In order to investigate identity maintenance strategies used by a low status group, a covert participant observation study was conducted in a shelter for the homeless. From Social Identity Theory and previous research on the homeless, it was hypothesized that the identity maintenance strategies used would differ as a function of longevity of homelessness: the short‐term homeless (<2 years) would be less likely to identify themselves as homeless (social mobility), while the longer‐term homeless (>2 years) would identify themselves as homeless but engage in various types of social creativity to mitigate their situation. In addition to the strategies described in SIT, it was conjectured that some of the longest‐term homeless would have given up making any intergroup or other social comparisons. Of the various strategies found, some were beyond SIT. The pattern of strategy use was best interpreted mainly as a function of longevity of homelessness, but this was moderated by both experience and personality. A trajectory of change in identity strategies with longevity of homelessness was offered as a plausible frame of reference for further research. Methodological limitations, implications for Social Identity Theory and recommendations for improving the situation of the homeless were discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

Homelessness in the mind

In this article, I am going to present several related, themes, based on data gathered from years of consulting to homelessness services, particularly staff and management working in the voluntary sector, who are responsible for the teams that deliver care to some of the most vulnerable and challenging individuals in society. The three concepts that I will put forward are as follows: firstly, the idea that there is a fundamental human concern, or state, regarding homelessness. What I will refer to as 'homelessness in the mind'. I will consider this from psychoanalytic and systems-psychodynamic viewpoints and explore the idea of an internalised homeless state and the structures which attempt to contain it. Second, is an almost universal hatred and repulsion of this state and a need for its expulsion and relocation, in phantasy, into individuals and services associated with the homeless population. Next, I will link the concept of homelessness in the mind with Bion’s idea of sophisticated/specialised basic assumption groups; groups, budded off from mainstream society to contain specific psychological aspects of the population. I will suggest that the associated psychological stressors and pressures of homelessness, and ‘homelessness in the mind’ and its subdivisions, dependency and shame, relate to aggressive and violent elements associated with the inability to correctly process, engage with, or contain, specific internal states related to homelessness. Throughout, I will refer to my practice as an organisational consultant, and my experience of working with managers and teams who work with the homeless population.     

The epidemiology of alcohol, drug, and mental disorders among homeless persons.

This article describes recent research on the prevalence of alcohol, drug, and mental (ADM) disorders and the characteristics of homeless substance abusers and persons with mental illness. Methodological problems in homelessness research are reviewed, particularly in relation to definitions of homelessness and sampling- and case-ascertainment methods. Prevalence rates of ADM disorders are much higher in homeless groups than in the general population. As is true of homeless people in general, homeless substance abusers and mentally ill persons are characterized by extreme poverty; underutilization of public entitlements; isolation from family, friends, and other support networks; frequent contact with correctional agencies; and poor general health. Knowledge of these disadvantages should be used to advocate for better services to prevent homelessness and support homeless people.     

Enhancing Well‐being of Homeless Individuals by Building Group Memberships

There is growing recognition that social isolation and a lack of connectedness with social groups is one of the reasons why the subjective well‐being of homeless individuals is generally worse than the rest of the population. Past research amongst a range of populations suggests that the ability of an individual to take on new group memberships and/or their ability to maintain their memberships in meaningful groups is an important predictor of well‐being. In a mixed method study (N = 119), we examined the extent to which experiences at homeless accommodation form building blocks for the formation of multiple group memberships and to what extent this predicts positive well‐being. Qualitative analysis reveals the importance of feeling connected to the homeless service and supported by homeless accommodation staff. Linking these data to quantitative data from a second wave, we found that these experiences predicted well‐being. These findings provide further support for a strength‐based approach to homelessness, by providing insights into the ways that experiences at homeless accommodation can contribute to the development of multiple group memberships (i.e. social capital), and enhance the well‐being of those experiencing, and exiting, homelessness. Copyright © 2016 John Wiley & Sons, Ltd.     

How Does Homelessness Affect Parenting Behaviour? A Systematic Critical Review and Thematic Synthesis of Qualitative Research

The adverse social and physical conditions of homelessness pose significant developmental risks for children, which may be compounded or buffered by the quality of parenting behaviour they are exposed to. There is currently a limited understanding of how parents approach their care-giving role and responsibilities while adjusting to the experience of homelessness. Advancing knowledge in this area is essential for developing acceptable, appropriate and effective interventions to support highly marginalised and vulnerable homeless families. This review explored homeless parents’ perceptions of how homelessness affects their parenting behaviour and identified adaptive strategies that parents may use to mitigate the potentially negative impacts of homelessness on the quality of care-giving. A systematic search of four electronic databases (ASSIA, PsycINFO, Web of Science and MEDLINE) identified 13 published qualitative studies, all originating from the USA, which explored parenting behaviour in homeless contexts. The studies were critically appraised using the CASP qualitative assessment tool. Thematic synthesis identified the following determinants of parenting behaviour; negative self-concept in the parental role, parental mental health, material resources, challenges to autonomy and self-efficacy, daily hassles, physical environment and service context, stigma, child characteristics and lack of support. These were synthesised thematically using existing models of parenting determinants and positive parenting. Findings indicate substantive impacts of homelessness on parental mental health, parenting authority, material resources, parenting environments and social support. Parents developed a number of adaptive methods to negotiate the challenges of homeless parenting such as maintaining a positive mindset, cherishing the parental role and developing practical strategies. We conclude with recommendations that service providers should tailor parenting support to resource-constrained circumstances and that further research is required in order to better understand experiences of homeless parents in other international contexts.     

Peer Substance Use and Homelessness Predicting Substance Abuse from Adolescence Through Early Adulthood

Adolescents who experience homelessness are at higher risk for abusing substances, and for being exposed to substance-using peers. The current study used a longitudinal design to track substance abuse, affiliation with substance-using peers, and episodes of homelessness among a sample of 223 adolescents who were housed at the baseline data collection and 148 adolescents who were housed at baseline. Participants were interviewed at six waves over 6.5 years, covering an age range from 13 to 25. Many participants experienced a recurrence of homelessness during follow-up, with 64.6 % of the baseline homeless group and 22.6 % of the baseline housed group reporting an additional episode of homelessness. Both alcohol abuse and other drug abuse symptoms showed an increase in adolescence followed by slowing in early adulthood. Recent homelessness and friend alcohol use predicted alcohol abuse symptoms, and the strength of the influence of friend use decreased over time. Recent homelessness and friend drug use predicted other drug abuse symptoms. Duration of the initial episode of adolescent homelessness showed no influence on substance abuse over time, or the effects of other predictors, highlighting the importance of conceptualizing the experience of homelessness as a recent stressor rather than an enduring personal characteristic.