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.     

Comparing the Housing Trajectories of Different Classes Within a Diverse Homeless Population

The paper presents findings from a longitudinal study identifying different classes of homeless individuals in a mid‐size Canadian city based on health‐related characteristics and comparing the housing trajectories of these classes 2 years later. Using data collected through in‐person interviews with a sample of 329 single persons who have experienced homelessness, the paper presents results of a latent class analysis. Results found four distinct latent classes characterized by different levels of severity of health problems—i.e., a class of individuals who are “Higher Functioning” (28.7%), a second class with “Substance Abuse Problems” (27.1%), a third class with “Mental Health Substance Abuse Problems” (22.6%), and a fourth class with “Complex Physical and Mental Health Problems” (21.6%) that included having diminished physical functioning, multiple chronic physical health conditions, mental health difficulties, and in some cases substance abuse problems. Follow‐up interviews with 197 of these individuals (59.9%) 2 years later showed the class of individuals with substance abuse problems experiencing the greatest difficulty in exiting homelessness and achieving housing stability. Implications of these findings for social policy development and program planning are discussed.     

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.     

Predicting Homelessness among Emerging Adults Aging Out of Foster Care

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.     

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.     

Gender differences in victimized homeless adolescents

Most of what we know about sexual abuse comes from efforts to examine female children victimized by men. Although some researchers have identified similarities between male and female victims of sexual abuse, few studies have examined gender-specific factors associated with sexual health practices among homeless adolescents. The aim of this study was to explore how gender and history of sexual abuse influence cognitive-perceptual and behavioral factors associated with sexual health practices of homeless adolescents. This study was a secondary analysis of data collected for a cross-sectional study of the sexual health practices of homeless adolescents. The sample consisted of 414 youths (104 males who reported sexual abuse and 124 who did not; and 95 females who reported sexual abuse and 75 who did not; 16 did not provide these data). Homeless adolescent females with a history of sexual abuse scored higher (indicating a shorter perspective) on a measure of future time perspective than females with no sexual abuse. Males who reported no sexual abuse scored higher than abused females on perceived health status and higher than abused males on assertive communication. With respect to perceived health status, males who reported no sexual abuse scored significantly higher than females who reported sexual abuse (p = .04). Males with no sexual abuse had significantly higher assertive communication scores than did males who had experienced sexual abuse (p = .015). We found that male and female abuse victims differ in terms of their cognitive-perceptual and behavioral factors associated with sexual health practices. Early identification of those who have been abused is critical so that interventions can be developed. Effective short-term interventions are needed for the adolescent victims of Child Sexual Abuse (CSA), particularly those who are homeless and prone to further sexual victimization.     

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.     

A latent class analysis of self‐identified reasons for experiencing homelessness: Opportunities for prevention

Individuals experience homelessness due to a vast number of factors. Therefore, the methods used to prevent individuals from experiencing homelessness should match their diverse needs. This study utilized survey data obtained from 577 adults experiencing homelessness to identify self‐reported causes of homelessness. A latent class analysis was conducted in order to identify classes or subgroups of respondents with distinct patterns of reported causes of homelessness. A latent class analysis is a person‐centred statistical approach that is used to determine groups of individuals who share similar characteristics. Findings from this analysis identified 5 distinct classes based on individuals' responses to 19 potential vulnerabilities or events that contributed to experiencing homelessness. Individuals tended to cluster around issues associated with (a) disability or physical health issues (4%), (b) substance abuse or mental health issues (30%), (c) report major life changes (3%), (d) financial crises (7%), or (e) employment difficulties (55%). Significant group differences occurred across military veteran status, history of homelessness, depression, and health‐related quality of life. Results for these analyses suggest that individuals report notable differences in their reasons for becoming homeless and therefore require unique preventative solutions.     

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.     

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.     

Homeless mothers: is there a relationship between coping strategies,mental health and goal achievement?

This study examined the relationship between coping, mental health and goal achievement among homeless mothers. Seventy-two women took part and 44 were re-interviewed 4 months later. The Family Crisis Oriented Personal Evaluation Scales (F-COPES) were used to identify their coping strategies at the time of homelessness; the General Health Questionnaire (GHQ) measured mental health problems; and a semi-structured questionnaire identified their goals. Outcome measures at follow-up were goal achievement and mental health. A variety of coping strategies were used, with some differences ascertained according to reason for homelessness and age of respondent. Lower use of problem-focussed coping was associated with poorer mental health at the time of homelessness. Mental health problems improved over time, but levels of psychopathology remained high at follow-up. Most women had achieved their primary goal of resettlement, and this was associated with use of problem-focussed coping. Lower use of problem-focussed coping, in particular, acquiring social support, was associated with continuation of mental health problems at follow-up, however the greatest predictor of mental health at follow-up was mental health status whilst homeless. Despite exposure to major stressors and poor mental health, mothers experiencing homelessness can maintain their ability to cope effectively, in order to achieve their goals. Copyright © 2007 John Wiley & Sons, Ltd.     

Homeless Youths and Young Adults in Los Angeles: Prevalence of Mental Health Problems and the Relationship Between Mental Health and Substance Abuse Disorders

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults is increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems, as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorder included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.     

What role does substance use play in the social world of Australian people who have experienced homelessness? A critical realist mixed‐methods exploration

Substance use is prevalent amongst Australians who have experienced homelessness, but the social impacts of using substances amongst this group are poorly understood. This study uses a relational and critical realist approach to understand the role of substance use on the social lives of people with lived experience of homelessness. A mixed‐methods design was used to explore this question and assess the experiences of people who have exited homelessness. Recruiting across services catering to marginalised populations, 110 participants completed a cross‐sectional survey. Findings showed substance use both socially connected and disconnected participants, and that attempting abstinence required participants to negotiate and alter their social networks. To participants, being a substance “user,” or “non‐user,” was a social identity that they actively negotiated to facilitate competing social, psychological and material/embodied needs. Participants chose to engage and not engage with others to craft a social identity they valued, which had the sometimes‐negative side‐effect of limiting potential relationships, leaving users feeling isolated from their non‐users and a continued imperative to keep using. The impacts of substance use on social networks were similar for currently and formerly homeless participants, suggesting transitioning into housing may not immediately prompt a reduction in substance use or influence from substance‐using peers. Interventions with substance users with lived experience of homelessness would benefit from taking a social identity approach that incorporates an understanding of the material/embodied aspects of addiction to provide a holistic model of care that best supports the relational needs of the client.     

WOMEN, HOMELESSNESS, AND SUBSTANCE ABUSE Moving Beyond the Stereotypes

This study examined the characteristics of homeless women with sub stance abuse problems. Data were collected on a sample of 323 home less substance abusers. First, 49 women and 274 men were compared to demonstrate distinct problems and treatment needs of the women. Results showed that the women were more likely than the men to abuse drugs, but less likely to receive substance abuse treatment. In addition, women spent more time in doubled-up living arrangements, and were more likely to receive outpatient psychiatric treatment. Second, two subgroups of women were compared: those who had been homeless for 6 months or less, and those who had been homeless longer than 6 months during their lifetime. The women who had been homeless longer were less educated, younger when they first became homeless, and were more likely to abuse alcohol, to have been assaulted, and to have attempted suicide. Implications for research and treatment are discussed.     

Homeless women and their families: Characteristics,life circumstances,and needs

This study investigated the needs of a sample of 100 women from shelters for the homeless in Richmond, Virginia. The women's responses to a 117-item interview were used to obtain information regarding their domicilary status, work history, educational background, family and health history, social support, reasons for homelessness, and social service needs. The results indicated that a significant number of the women had moved as many as six times within the past five years for various reasons, including domestic violence, interpersonal conflict, overcrowding, and eviction. Many women were high school graduates and had job skills in the health care, educational, and clerical fields. Most women were raised by their natural or extended family and the majority of them had a friend or family member who provided social support. Identified needs included housing, food, clothing, and transportation. The needs of homeless women and their children were different from the needs of the homeless chronically mentally ill and require specialized services as well as an increase in the available number of low-income housing units.     

Homelessness Is Traumatic: Abuse,Victimization, and Trauma Histories of Homeless Men

Homelessness is traumatic, and trauma-informed care is an emerging best practice. Using structured interviews with day shelter clients (N = 152), this study examined trauma among homeless men. The PTSD Checklist (PCL–C) was used to assess for posttraumatic stress disorder (PTSD). Participants’ pattern of PCL–C responses suggested that 23% to 30% screened positive for PTSD. Those with positive PTSD screens had been homeless longer and were more likely to have met time criteria for chronic homelessness. They were significantly more likely to be veterans and to report violent attacks, abuse histories, and mental health problems. Importantly, only 69% of those with positive PTSD screens acknowledged current mental health problems. These individuals were much less likely to report mental health counseling in the prior year.     

Spirituality and Homelessness: Implications for Pastoral Counseling

This article presents a limited number of findings from a larger research project that explores spiritual themes related to the experience of homelessness as reported by 16 research participants following their residence in a 90-day emergency shelter program in Los Angeles County, California. By utilizing interpretive phenomenological analysis, the study focuses solely on three spiritual themes present in the experience of homelessness. Participants noted experiencing the presence of hope and motivation while homeless, the challenges of coping with the homeless stigma, and times in which they felt (and did not feel) “human.” Implications for pastoral counselors and others offering spiritually-integrated counsel in the context of homelessness are discussed.     

Comparing suicide attempters, suicide ideators, and nonsuicidal homeless and runaway adolescents.

This study considers variables that best distinguish among attempters, ideators, and nonsuicidal youth in a sample of 527 homeless and runaway adolescents from four Midwestern states. Univariate results indicate that attempters are significantly more likely than ideators and nonsuicidal youth to have experienced physical or sexual abuse by an adult caretaker, to have experienced sexual victimization while on their own, and to have a friend who attempted suicide. Multivariate analyses reveal five variables that best distinguish among the three groups: self-esteem, depression, physical abuse, sexual abuse, and having a friend who attempted suicide. Further analysis suggests that the accumulation of these risk factors greatly increases the chance that these youth will engage in suicidal behavior.     

Academic achievement among formerly homeless adolescents and their continuously housed peers

This study examined the school experiences and academic achievement of 46 adolescents in families who experienced homelessness and 87 permanently housed adolescents whose families received public assistance. Measures taken after the homeless students were rehoused showed that both groups valued school highly and were similar in cognitive abilities assessed with the similarities subtest of the Wechsler Intelligence Scale for Children—Revised (WISC-R). Formerly homeless students had more school mobility, more grade retention, and worse school experiences by mother report and lower plans for post-secondary education by self-report. Both groups scored poorly on standardized tests of academic achievement. Homelessness was associated with further declines in achievement during the period of maximal residential disruption, but did not have effects 5 years later.     

Self-perceived strengths among people who are homeless

This study examined self-perceived strengths among 116 people who were homeless. Those who had experienced a longer period of current homelessness tended to report fewer personal strengths (r?=??0.23). Nonetheless, in spite of their marginalized position in society, the vast majority of participants (114 out of 116) perceived personal strengths. A prior diagnosis with mental illness was not associated with the number of strengths reported, but self-perception of strengths was associated with altruistic orientation. The Values in Action (VIA) taxonomy of character strengths captured many of the responses generated by this population. The most frequently mentioned character categories included social intelligence, kindness, persistence, authenticity and humour. The most frequently mentioned other strengths included personal skills (e.g. music, sports), job skills, intelligence and education. The results have relevance for efforts to build self-perceptions that facilitate escape from homelessness.