Service use and recovery among currently and formerly homeless adults with mental illness

Abstract

Background: A range of health and social services exist to address the many life adversities experienced by people with mental illness. However, the effects of services on their recovery in the context of ongoing homelessness and poverty have been minimally examined. Aims: This qualitative study sought to better understand the role of health and social services in the recovery processes of people with mental illness and histories of homelessness. Similarities and differences in the perceived impacts of services on recovery between currently and formerly homeless participants were also explored. Method: In-depth interviews were conducted with 52 currently and formerly homeless people with mental illness. Informed by a recovery framework, qualitative data were analyzed using two cycles of coding. Results: Services were perceived to affect recovery by (1) finding ways to cope and get by, (2) feeling less alone, (3) giving back, (4) being dehumanized or seen as someone and (5) encountering restrictions when getting help. Experiences of discrimination, fewer opportunities to give back and limited service options were heightened among participants experiencing homelessness compared to the housed group. Conclusion: Health and social services can promote and hinder recovery among currently and formerly homeless people with mental illness. Despite several differences between the two groups, the relationship between recovery and service use was similar for currently and formerly homeless participants, suggesting that both groups access services to address needs related to social connection, health and functioning and meaningful activities.

Autonomy and authority: Homeless service users' empowering experiences in housing first and staircase services

“…To mitigate this, the moderator emphasised the importance of protecting the group's privacy and directed the discussion so that all participants were given equal the opportunity to speak. Our findings are consistent with studies that used individual interviews to understand the experiences of homeless service users (Kerman & Sylvestre, 2020), which suggests that our choice to use group discussions had minimal impact on what participants were willing to share.…”

“…For homeless adults, their ability to realise their capabilities largely depends on the type, range, and quality of homeless services they can access. Indeed, the CA has value for understanding the challenges faced by the homeless population (Shinn, 2015), and researchers have successfully applied the CA to examine the experiences of adult homeless services users in HF and SS (Kerman & Sylvestre, 2020; Nicholls, 2010; O'Shaughnessy et al, 2020).…”

A Multilevel Intervention Framework for Supporting People Experiencing Homelessness with Pets

“…Advocating for the needs of pet owners experiencing homelessness with other service providers is also essential. Given the power imbalance between service users and providers, people experiencing homelessness can feel like they are unable to effectively advocate for their needs at times, which can leave them feeling powerless [ 103 , 104 ]. Accordingly, service providers can be a key ally in these efforts by advocating with other community programs for the accommodation of pets—not only emotional support and service animals—in service delivery.…”

Cycles of instability: Proximal and distal influences on residential instability among people with histories of homelessness in three Canadian cities

“…Further, some of the proximal factors that were identified in this study as leading to housing loss (e.g., inability to pay rent after a sudden increase, a violation of residential rules that forbade drug use and possession) are consistent with findings from Tsai and Huang (2019) review of the factors associated with eviction. Similarly, and extending past research on service bans among people experiencing homelessness (Kerman & Sylvestre, 2020; Kerman et al, 2019), substance use could lead to participants being barred from emergency accommodations, triggering a transition and continuing the cycle of instability. Our study illustrated the complex and interrelated nature between factors and their proximal and distal levels.…”