Homelessness in the United States: Assessing Changes in Prevalence and Public Opinion, 1993–2001

A national survey was administered in 1993-1994 (N = 360) and repeated in 2001 (N = 435) to assess the prevalence of homelessness as well as attitudes, opinions and knowledge regarding homelessness. No significant changes in prevalence were found, despite a strong US economy during most of the 7-8 year period. Respondents in 2001 had less stereotyped views of homeless people and were more supportive of services, but came to see homelessness as a less serious problem that was less often due to economic factors. This "mixed" set of findings may reflect both beliefs on the benefits of a good economy and an increased awareness of the complexity of homelessness. Across the surveys, younger, female, liberal, and less wealthy respondents demonstrated more sympathetic attitudes towards homeless people.     

Public knowledge,attitudes, and beliefs about homeless people: Evidence for compassion fatigue?

Media reports suggest that the public is becoming impatient with the homeless—that so-called “compassion fatigue” has gripped the nation. This characterization of public sentiment could have important policy consequences—restrictive measures can be justified by growing public impatience, and progressive housing policies seem infeasible within a hostile climate of opinion. But evidence to support the compassion fatigue notion is anecdotal. We examine the issue by tracking the results of public opinion polls and by reporting detailed evidence from a nationwide random-digit dial telephone survey (N=1,507) concerning knowledge attitudes and beliefs about homeless people. To be sure, the public sees homelessness as an undesirable social problem and wants something done about it. However, although the homeless are clearly stigmatized, there is little evidence to suggest that the public has lost compassion and is unwilling to support policies to help homeless people.     

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.     

Changes in Public Attitudes and Perceptions about Homelessness Between 1990 and 2016

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.     

Cognitive-affective preparation for homelessness: quantitative and qualitative analyses of childhood out-of-home placement and child abuse in a sample of homeless men

Patterns of homelessness were examined against histories of childhood out-of-home placement and abuse in a sample of 146 homeless men. It was speculated that out-of-home placement and abuse influenced needs for love and belonging and were related to preparation for adult homelessness. Main effects of a 2 x 2 (placement by abuse) multivariate analysis of variance were significant with longer periods of time since first homeless and greater lengths of a current episode of homelessness associated with childhood out-of-home placement. Homeless men who had experienced abuse as a child had more episodes of homelessness than those who had not experienced abuse. Mean Brief Index of Self-actualization scores were not different for those with out-of-home placement or abuse; however, self-actualization scores were minimally lower with greater number of homeless episodes but not with total time homeless. Case histories supported the quantitative findings that loss of feelings of belonging in childhood were preparatory for chronic homelessness.     

Homelessness and the problem of containment

Homelessness is a problem that is hardly spared to any society in our modern world. Usually discussed by people concerned with social policy, sociology, public health and politics, homelessness has only quite recently begun to command the attention of professionals concerned with psychological and psychotherapeutic processes. Following from the author's experience of working therapeutically with homeless people, as well as in discussions with homeless services, the paper follows a line of thinking around homelessness that is explicitly psychodynamic in orientation. The central argument here is that homelessness is an experience that is, so to speak, waiting to happen. Homelessness is portrayed as a natural extension of an underlying experience of the sister states of uncontainment and alienation. I argue that the homeless person not only experienced a lack of containment in his earliest interactions, but has grown through life with significant difficulties in this area. Homelessness then is an extreme response to a deeper psychological reality that projects into a part of the person's life the agonies associated with uncontainment. Homelessness is the realization of an internal situation –a shifting of a personal struggle into a new and more visible stage. This view of homelessness is designed to provide an amendment to current views that privilege the roles of poverty and social exclusion in the origins of homelessness rather than as an alternative account of the origins of homelessness.     

The old homeless and the new homelessness in historical perspective

In the 1950s and 1960s homelessness declined to the point that researchers were predicting its virtual disappearance in the 1970s. Instead, in the 1980s, homelessness increased rapidly and drastically changed in composition. The "old homeless" of the 1950s were mainly old men living in cheap hotels on skid rows. The new homeless were much younger, more likely to be minority group members, suffering from greater poverty, and with access to poorer sleeping quarters. In addition, homeless women and families appeared in significant numbers. However, there were also points of similarity, especially high levels of mental illness and substance abuse.     

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

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.     

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.     

Cross-National Variations in Behavioral Profiles Among Homeless Youth

Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness.     

Five Dimensions of Faith and Spiritually of Older African American Women Transitioning Out of Homelessness

Background Homelessness among older African American women is emerging as a serious social problem. The increasing cost of living, diminishing community resources, and shrinking retirement benefits, as well as reduced social services are resulting in greater numbers of older minority women becoming homeless. Aims This investigation explores the relevance of faith and spirituality to an advocacy assessment designed to help participants resolve issues that operate as barriers to their leaving and staying out of homelessness. Methods A substudy of a larger research and development project was undertaken, in which qualitative interview methods were used to illuminate the role of faith and spirituality resources in the lives of 84 older homeless African American women. Comparative thematic analysis of illustrative cases was undertaken to better understand the role of faith and spirituality in the women’s lives and in how they used faith and spirituality in coping with homelessness. Findings Five dimensions of faith and spirituality, (a) identity and beliefs; (b) affiliation and membership; (c) involvement; (d) practices; and (e) benefits, served as promising resources in understanding life spaces of homeless minority women and identified promising advocacy strategies. Two cases describe the realities of homelessness for older minority women endeavoring to transition out of homelessness and illustrate how faith and spirituality can buffer stress, facilitate coping, and sustain motivation. Conclusions How older homeless African American women use their faith and spiritual resources to cope with demands of homelessness, challenges of transition, and recovery from the multiple traumas resulting from being homeless makes the assessment of faith and spirituality an important part of the advocacy process.     

The association between homelessness and suicidal ideation and behaviors: results of a cross-sectional survey

This study was carried out with three goals: (1) to determine the prevalence of suicidal ideation and suicide attempts among the homeless; (2) to determine what aspects of homelessness predict suicidality, and (3) to determine which aspects remain predictive after controlling for key covariates, such as mental illness. A sample of 330 homeless adults were interviewed. Sixty-one percent of the study sample reported suicidal ideation and 34% had attempted suicide. Fifty-six percent of the men and 78% of the women reported prior suicidal ideation, while 28 percent of the men and 57% of the women had attempted suicide. Childhood homelessness of at least 1 week without family members and periods of homelessness longer than 6 months were found to be associated with suicidal ideation. Psychiatric diagnoses were also associated with suicidality in this sample.     

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.     

Homelessness as psychological trauma. Broadening perspectives.

Most mental health literature on homelessness has focused on characteristics that may be risk factors for homelessness. The authors of this article argue that homelessness itself is a risk factor for emotional disorder and use the construct of psychological trauma--focusing on social disaffiliation and learned helplessness--to understand the potential effects of homelessness. Psychological trauma is likely among homeless individuals and families for three reasons. (a) The sudden or gradual loss of one's home can be a stressor of sufficient severity to produce symptoms of psychological trauma. (b) The conditions of shelter life may produce trauma symptoms. (c) Many homeless people--particularly women--become homeless after experiencing physical and sexual abuse and consequent psychological trauma. Research suggests that negative psychological responses to traumatic events can be prevented or mitigated by a supportive and empowering posttrauma environment. The implications of trauma theory for improving the psychosocial conditions of homeless people are discussed.     

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.     

Applying a Time‐Patterned Typology of Homelessness Among Individuals with Mental Illness

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.     

Family Homelessness: State or Trait?

Compares conceptualizations of homelessness as a temporary state through which people pass or a permanent trait that emanates from individual characteristics. Evidence from a longitudinal study of 564 homeless families in New York City and additional secondary sources supports the view that for families, homelessness is a temporary state that is resolved by the provision of subsidized housing. Even for single individuals with severe mental disturbances, housing is a key factor in ending homelessness, although here there is more evidence that social services also contribute. Policy implications are that governments should take a more active role in reducing homelessness by providing access to subsidized housing.     

Applying Cluster Analysis to Test a Typology of Homelessness by Pattern of Shelter Utilization: Results from the Analysis of Administrative Data

This study tests a typology of homelessness using administrative data on public shelter use in New York City (1988–1995) and Philadelphia (1991–1995). Cluster analysis is used to produce three groups (transitionally, episodically, and chronically homeless) by number of shelter days and number of shelter episodes. Results show that the transitionally homeless, who constitute approximately 80% of shelter users in both cities, are younger, less likely to have mental health, substance abuse, or medical problems, and to overrepresent Whites relative to the other clusters. The episodically homeless, who constitute 10% of shelter users, are also comparatively young, but are more likely to be non-White, and to have mental health, substance abuse, and medical problems. The chronically homeless, who account for 10% of shelter users, tend to be older, non-White, and to have higher levels of mental health, substance abuse, and medical problems. Differences in health status between the episodically and chronically homeless are smaller, and in some cases the chronically homeless have lower rates (substance abuse in New York; serious mental illness in Philadelphia). Despite their relatively small number, the chronically homeless consume half of the total shelter days. Results suggest that program planning would benefit from application of this typology, possibly targeting the transitionally homeless with preventive and resettlement assistance, the episodically homeless with transitional housing and residential treatment, and the chronically homeless with supported housing and long-term care programs.     

Suicidal Self‐Directed Violence Among Homeless US Veterans: A Systematic Review

A systematic review of the literature was conducted to investigate suicidal self‐directed violence and homelessness among US military veterans, and identify existing suicide prevention strategies. In November 2015, MEDLINE, EMBASE, PsycInfo, CINAHL, Web of Science, Cochrane Library, Google, and Google Scholar were searched. Articles published since 1990 investigating self‐directed violence among homeless veterans were identified. Data were extracted and synthesized qualitatively. Nineteen observational studies were included. Suicide ideation rates were 1.3% (current), 7.0% (past week), 12.1%–18% (past 30 days), and 74% (lifetime). Suicide attempt rates were 0%–6% (past 30 days), 30.7%–31.5% (past 5 years), and 15%–46.6% (lifetime). Death by suicide rate was 81.0 per 100,000. No interventional studies to prevent self‐directed violence among homeless veterans were identified. Homeless veterans are at risk for self‐directed violence, suggesting the need for research to examine preventive strategies. A comprehensive public health approach to suicide prevention needs to focus on vulnerable populations, including homeless veterans.     

Mother-child separations among homeless and housed families receiving public assistance in New York City

We examined the incidence, characteristics, and predictors of separations of children from mothers in 543 poor families receiving public assistance, 251 of whom had experienced homelessness during the previous 5 years. Forty-four percent of the homeless mothers and 8% of housed mothers were separated from one or more children. A total of 249 children were separated from 110 homeless families and 34 children from 23 housed families. Children were placed with relatives and in foster care but were rarely returned to their mothers. Maternal drug dependence, domestic violence, and institutionalization predicted separations, but homelessness was the most important predictor, equivalent in size to 1.9 other risk factors. We infer that policies regarding child welfare and substance abuse treatment should be changed to reduce unnecessary placements. Studies of homeless children who remain with families may be biased if separated children are excluded.