Revealing the Cues Within Community Places: Storiesof Identity, History, and Possibility

Place-based approaches to community change have become increasingly popular strategies for addressing significant social problems. With their intentional focus on 'place,' most efforts have sought to gain greater understanding into how neighborhood contexts affect people. However, while both aggregate characteristics and social dynamics of neighborhoods have been subject to scrutiny in the literature, less attention has been paid to understanding how the environmental characteristics of neighborhoods and communities as places have meaning for residents. The present study used an innovative methodology called Photovoice to obtain a greater understanding of the meanings residents ascribe to the salient characteristics of their neighborhoods and communities. As part of a place-based initiative, 29 adult and youth residents in seven distressed urban neighborhoods photographed and dialogued about the meaningful physical attributes of their community. According to participants, place characteristics provided cues about their personal histories as members of the community; communicated messages about the value and character of the community and its residents; defined social norms and behavior within the community; and provided markers that could remind residents of who they are and inspire a sense of possibility for who they could become. Implications for practice 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.     

The splitting between separate and symbiotic stätes of the self in the psychodynamic of schizophrenia

Abstract

We explore the problematic dynamics in the relationship between societal systems of care and the chronically excluded, with particular reference to severe personality disorder and the “difficult-to-reach” patient. The individual who “refuses” is often met with a violent response: yet his violence must be understood as related to an experience of being violently excluded. We reformulate personality disorder as a disturbance of “groupishness” and suggest, as a paradigm for the problem of refusal, the story of Diogenes the Cynic, who “holed himself up” in a barrel; and of his legendary encounter with Alexander the Great, who tried unsuccessfully to persuade him to “come in from the cold.” We suggest it may be as important to focus on Alexander's violence as on that of Diogenes, and we examine modes of violence deployed by society against the excluded outsider, with particular reference to the hostile attribution of intentionality to the personality disordered individual's acts of violence and self-harm. We conclude by considering both the merits of the democratic therapeutic community model as a response to severe personality disorder and the dangers, inherent in this model among others, in an unconscious identification with Diogenes in his barrel.     

Addiction in Maternity: Prevalence of Mental Illness,Substance Use,and Trauma

Women living in vulnerable neighborhoods experience higher rates of poverty, homelessness, psychiatric issues, illicit substance use, rates of HIV, and a lowered life expectancy. The aim of the study was to further explore the history of mental illness and trauma in a sample of women (N?=?31) who had recently given birth and had a substance use problem while pregnant. We investigated sociodemographic characteristics, history of trauma and post-traumatic stress disorder (PTSD), rates of substance use and dependence, and psychiatric symptoms. Childhood and adult traumatic experiences were found in the majority of the sample, and one-third presented with suspected PTSD diagnosis at the time of the interview. Women-centered services are in great demand, as well as trauma informed care, and further research on appropriate treatment for substance using, traumatized, women with a mental illness.     

Social entrepreneurship: understanding consumer motives for buying The Big Issue

This paper examines consumer response to a particular social entrepreneurship initiative, The Big Issue. Focusing on consumer motivation, the research explores the utilitarian value of the product as compared to the desire to help the homeless as the primary motivation for purchase. The research found that, although the utilitarian value partly motivated purchase, consumers widely perceived there to be a helping dimension to the exchange. Consumers valued the empowerment goals espoused by The Big Issue and found it rewarding to play a part in the empowerment process. The appearance and manner of The Big Issue vendors influenced consumer reactions to the initiative, indicating a need for careful management of ‘beneficiary portrayal’ in this context.     

Let's Ask the Homeless People Themselves: A Needs Assessment Based on a Probability Sample of Adults

A probability sample of 301 homeless adults from Buffalo, NY, was followed over 6 months to document the utilization of a variety of community services, examine services desired, and identify factors associated with service utilization, preference, and satisfaction. The following needs were all rated as at least equally important as the need for affordable housing: safety, education, transportation, medical/dental treatment, and job training/placement (most of these needs were also rated as difficult to obtain). Needs for formal mental health and substance abuse services were rated as relatively unimportant and easy to obtain, and for those who actually used them, respondents were often dissatisfied with them. Of 16 predictor variables examined in multivariate analyses, several showed consistent relationships with subsequent service use, preference, and satisfaction. Younger adults, persons of color, those with dependent children, and persons having fewer social supports reported less service utilization, less satisfaction with services received, different perceived needs for particular services, and/or greater difficulty obtaining services.     

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.     

Companion Animals and Vulnerable Youth: Promoting Engagement between Youth and Professional Service Providers

Vulnerable youth have fewer social ties as a result of inadequate housing and a lack of social support. It is well established that many of these youth tend to underutilize mental health, medical, and social services. Among marginalized and stigmatized populations, the affirming and nonjudgmental presence of companion animals appears to be important for developing collaborative relationships between youth and professional service providers. This paper reviews literature on the benefits of companion animals for assisting providers in their attempts to help youth find a stable living environment. Recommendations are made for providers considering incorporating therapy animals into their existing services.     

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.     

Perceived strengths of urban girls and boys experiencing homelessness

Homelessness, with concomitant poverty and mobility, is often associated with multiple negative outcomes for school‐aged children; less is known about the positive characteristics of children experiencing homelessness. This study focused on understanding the mother‐perceived strengths of 50 elementary school‐aged children experiencing homelessness. Mothers typically identified multiple child strengths, even among children experiencing emotional or behavioural difficulties. These strengths included positive personality and behavioural characteristics, intelligence and academic achievement and positive physical attributes. Implications for intervention and further research are discussed. Copyright © 2008 John Wiley & Sons, Ltd.