Content Analysis of Health Concerns among Housing First Residents with a History of Alcohol Use Disorder

Mackelprang, Jessica L.; Clifasefi, Seema L.; Grazioli, Ronique S; Collins, Susan E.

doi:10.1353/hpu.2021.0035

Cited by 9 publications

(4 citation statements)

References 60 publications

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“…One recommended response would be to create space and opportunity for memorial services within housing services or public settings to reduce social exclusion and disenfranchised grief, and provide a form of advocacy [44]. In Seattle, Homeless Housing First residents recommend integrating grief counselling into single-site or shelter settings where residents who live in close proximity and share communal spaces may be deeply affected by the death of a fellow resident [45].…”

Section: Discussionmentioning

confidence: 99%

“Just a knife wound this week, nothing too painful”:an ethnographic exploration of how homeless clients attending an urban primary care and addiction service view their own health and healthcare

Ingram,

Buggy,

MacNamara

et al. 2024

Preprint

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This study used an ethnographic approach grounded in a social constructivist research paradigm to explore the perspectives of people in homelessness attending a primary care and addiction service on their priority health and healthcare needs. Participant observations and informal interviews were conducted with homeless clients attending the service for three hours every Monday morning between October 2022 and April 2023. Field note data from active participant observation and informal conversations were collected, anonymised, and analysed using inductive thematic analysis in accordance with the Declaration of Helsinki and the researchers’ institutional Research Ethics Committee. Three main themes emerged from the analysis: self-identified priorities, satisfaction with services, and migrant health. Clients’ priority concerns relate to their mental health, maintaining ties with children and families, navigating complex romantic relationships, finding meaningful activities, and feeling better physically. These challenges differ from those of the general population in terms of their severity observed both prior to and during experiences of homelessness, coupled with disproportionately high levels of loss, fear, injury, pain, disability, fatigue, and isolation. In terms of services, clients are satisfied with their ability to access primary care and harm reduction in a social environment where positive exchanges with friends and providers take place. Conversely, barriers to accessing mental health and addiction services persist including the internalised belief that one is beyond help, lack of access to information on available services and their entry requirements, and lingering stigma within a health system that treats addiction as separate to health. Moving forward, health practitioners may consider holding more regular and open conversations with homeless clients about the care they are receiving, its rationale, and whether or not changes are desired that can be safely made. The health needs of migrants and asylum seekers entering homelessness in Ireland are urgent and should be prioritised in future research.

show abstract

Section: Discussionmentioning

confidence: 99%

“Just a knife wound this week, nothing too painful”:an ethnographic exploration of how homeless clients attending an urban primary care and addiction service view their own health and healthcare

Ingram,

Buggy,

MacNamara

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…One recommended response would be to create space and opportunity for memorial services within housing services or public settings to reduce social exclusion and disenfranchised grief, and provide a form of advocacy [ 59 ]. In Seattle, homeless Housing First residents recommend integrating grief counselling into single-site or shelter settings where residents who live in close proximity and share communal spaces may be deeply affected by the death of a fellow resident [ 60 ]. Requirements that PEH reduce their substance use in order to access mental healthcare should be reconsidered in light of overwhelming evidence that this is detrimental to health [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

“Just a knife wound this week, nothing too painful”: An ethnographic exploration of how primary care patients experiencing homelessness view their own health and healthcare

Ingram,

Buggy,

MacNamara

et al. 2024

PLoS ONE

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Community health needs assessments (CHNA) involving qualitative techniques help tailor health services to the specific needs of the population groups for whom they are designed. In light of increasing health disparities amongst people experiencing homelessness (PEH)—and to ensure the integration of their voices into a larger CHNA—this study used an ethnographic approach grounded in a social constructivist research paradigm to explore the perspectives of PEH attending a primary care and addiction service in Ireland on their priority health and healthcare needs. Participant observations and informal interviews were conducted with clients experiencing homelessness attending the service for three hours every Monday morning between October 2022 and April 2023. Field note data from active participant observation and informal conversations were collected, anonymised, and analysed using inductive thematic analysis in accordance with the Declaration of Helsinki and the researchers’ institutional Research Ethics Committee. Three main themes emerged from the analysis: self-identified priorities, satisfaction with health services, and migrant health. Clients’ priority concerns relate to their mental health and personal safety, strengthening ties with children and families, finding a sense of purpose, and feeling better physically. These challenges differ from those of the general population in terms of their severity observed both prior to and during experiences of homelessness, coupled with disproportionately high levels of loss, fear, pain, fatigue, social stigma and other barriers to accessing satisfactory housing. In terms of services, clients are satisfied with their ability to access primary care and harm reduction in a social environment where positive exchanges with friends and providers take place. Conversely, barriers to accessing mental health and addiction services persist including the internalised belief that one is beyond help, lack of access to information on available services and their entry requirements, and lingering stigma within a health system that treats addiction as separate to health. Moving forward, health practitioners may consider holding more regular and open conversations with clients experiencing homelessness about the care they are receiving, its rationale, and whether or not changes are desired that can be safely made. The health needs of migrants and asylum seekers entering homelessness in Ireland are urgent and should be prioritised in future research.

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“…Permanent supportive housing interventions have been shown to keep people housed longer, decrease acute care utilization, and increase outpatient utilization. 38 , 82 , 83 , 84 , 85 , 86 The US federal government has been partnering with local housing agencies for several years to provide permanent supportive housing for specific populations, including individuals with HIV/AIDS, persons with mental illness, and also Veterans. 38 Given the impact of housing on health outcomes, several medical institutions across the country have also invested in housing for specific patient populations.…”

Section: Housing Definitions and Prevalencementioning

confidence: 99%

Unstable Housing and Kidney Disease: A Primer

Novick

Kushel²,

Crews³

2022

Kidney Medicine

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Content Analysis of Health Concerns among Housing First Residents with a History of Alcohol Use Disorder

Cited by 9 publications

References 60 publications

“Just a knife wound this week, nothing too painful”:an ethnographic exploration of how homeless clients attending an urban primary care and addiction service view their own health and healthcare

“Just a knife wound this week, nothing too painful”:an ethnographic exploration of how homeless clients attending an urban primary care and addiction service view their own health and healthcare

“Just a knife wound this week, nothing too painful”: An ethnographic exploration of how primary care patients experiencing homelessness view their own health and healthcare

Unstable Housing and Kidney Disease: A Primer

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