Recognizing and responding to women experiencing homelessness with gendered and trauma-informed care

Abstract

Background: The purpose of this study is to highlight the experiences of women who are often hidden in what we know and understand about homelessness, and to make policy and practice recommendations for womencentred services including adaptations to current housing interventions. Methods: Three hundred survey interviews were conducted with people experiencing homelessness in Calgary, Alberta, Canada. The survey instrument measured socio-demographics, adverse childhood experiences, mental and physical health, and perceived accessibility to resources. Eighty-one women participants were identified as a subsample to be examined in greater depth. Descriptive statistics and logistic regressions were calculated to provide insight into women respondents' characteristics and experiences of homelessness and how they differed from men's experiences. Results: Women's experiences of homelessness are different from their male counterparts. Women have greater mental health concerns, higher rates of diagnosed mental health issues, suicidal thoughts and attempts, and adverse childhood trauma. The results should not be considered in isolation, as the literature suggests, because they are highly interconnected. Conclusion: In order to ensure that women who are less visible in their experiences of homelessness are able to access appropriate services, it is important that service provision is both gender specific and trauma-informed. Current Housing First interventions should be adapted to ensure women's safety is protected and their unique needs are addressed.

Overall and Gender-specific Associations between Dimensions of Adverse Childhood Experiences and Mental Health Outcomes among Homeless Adults: Associations Générales et Sexospécifiques Entre les Dimensions des Expériences Défavorables de L’enfance et les Résultats de Santé Mentale Chez les Adultes Sans Abri

“…The results from this study reveal gendered vulnerability to early adversities for homeless men and women that should be considered by service providers. 21…”

“…18 –20 The experiences of early adversities and homelessness have also been shown to be distinct across gender groups in small qualitative studies, but they have rarely been studied in quantitative research with large samples. 21,22 Further gendered analysis of ACEs is crucial for informing practice and policy to better address the unique needs of homeless men, women, and individuals of other gender identities.…”

A qualitative exploration of women's resilience in the face of homelessness

“…At the most basic level, homelessness is defined as '(of a person) without a home, and therefore, typically living on the streets' (Oxford University Press, 2017). Although important for understanding contributors to and problems of homelessness, research has tended to adopt a deficit approach focused on pathology and difficulties associated with becoming and being homeless (Aubry et al, 2016;Cronley et al, 2019;Gilroy et al, 2016;Milaney et al, 2020). These pragmatic frameworks are limited for examining women's unique experiences of becoming and being homeless.…”

“…Women and families are one of the fastest-growing groups of people experiencing homelessness across the United States (Committee on Health Care for Underserved Women, 2013), Australia (Australian Bureau of Statistics, 2018), Canada (Homeless Hub, 2019) and the United Kingdom (Bretherton & Pleace, 2018). For women, the experience of homelessness is complex and multidimensional (Phipps et al, 2019), involving health needs (Evans & Forsyth, 2004), victimisation (Christensen & Vinther, 2005), mortality (Montgomery et al, 2017) and mental health problems (Milaney et al, 2020;Montgomery et al, 2017).…”

Adverse childhood experiences and related outcomes among adults experiencing homelessness: a systematic review and meta-analysis

“…The 29 included studies encompass samples of adults experiencing homelessness in three countries: 16 (55%) studies in the USA, 12 (41%) studies in Canada, and one (3%) study in the UK. The main recruitment sites were homeless shelters (18 studies),[29][30][31][32]35,36,[39][40][41][42][44][45][46][47]51,52,56,57 clinics and facilities that provide services to people experiencing homelessness (20 studies),29,30,33,34,36,37,39,40,42-45,48, 49,51-54,56,57 and street or outdoor encampments (14 studies). 29-32,36,40,41,44,46,47,51,55-57 Included studies recruited homeless young adults (ten [34%] studies), homeless adults (nine [31%] studies), homeless adults with mental illness (five [17%] studies), older homeless adults (one [3%] study), homeless mothers (one [3%] study), homeless adults with a dual diagnosis of mental illness and substance use disorder (one [3%] study), homeless young adults with psychosis (one [3%] study), and homeless young adults involved in commercial sex (one [3%] study).…”