The promise of recovery: narratives of hope among homeless individuals with mental illness participating in a Housing First randomised controlled trial in Toronto, Canada

Abstract

ObjectivesHope is widely embraced as an important factor in the recovery process. The role of housing in inspiring hope and facilitating recovery has been explored with homeless populations but is not well understood. This study explores perspectives on hopes for recovery and the role of housing on these hopes from the perspective of homeless adults experiencing mental illness participating in a multisite Housing First randomised controlled trial in Canada. The study draws on data from in-depth qualitative interviews with participants from the Toronto, Ontario site of the ‘At Home/Chez Soi’ Project.DesignIn-depth interviews were conducted with a subsample of participants from a larger Housing First randomised controlled trial.SettingThe research took place in Toronto, Canada.Participants60 participants in the larger trial (36 from the Housing First group and 24 from the Treatment as Usual group) took part in in-depth interviews.MethodParticipants for the in-depth interviews were purposively selected from the larger trial sample in Toronto and participated in an interview at the beginning of the study (baseline). Data from the baseline interviews were analysed using the constant comparative method derived from grounded theory methods.ResultsParticipants’ narratives show clear visualisation of goals for recovery, and emphasise that housing is an integral factor that can facilitate hope and support dimensions of recovery. However, some participants had difficulty adjusting to housing, and were concerned about feeling socially isolated, which could have negative implications for hopefulness and recovery.ConclusionsHousing First interventions should explicitly incorporate hope-inspiring, recovery-oriented approaches and support participants while adjusting to housing in order to sustain hopefulness.

Youth Homelessness: The Impact of Supportive Relationships on Recovery

“…The inability for youth to take preventative steps and recover from illness(es), is a reflection of limited social supports and social exclusion . Supports that enable homeless youth to perceive recovery as an attainable goal facilitates resilience, hope, and the forward movement of health (Kirst, Zerger, Wise Harris, Plenert, & Stergiopoulos, 2014;. Perceiving recovery as a realistic outcome encourages youth to adhere to treatment plans and remove themselves from the cycle of homelessness.…”

“…This analysis will utilize the ideology of recovery grounded in the subjective experiences and aspirations of those directly affected by the illness itself (Deegan, 1988;Anthony, 1993;Barbic, Krupa, & Armstrong, 2009 Quality of life (QoL) is often associated with health and a key indicator of recovery Corrigan, Giffort, Rashid, Leary, & Okeke, 1999). Other conceptualizations of recovery emphasize various concepts including self-agency (Abbott, 2008;Rogers, Chamberlin, Ellison, & Crean, 1997;Mancini, 2008), self-esteem and self-respect (Jacobson & Greenley, 2001;, and hope and optimism about the future (Kirst, Zerger, Wise Harris, Plenert, & Stergiopoulos, 2014). Therefore, it is clear that the capacity for growth and recovery is a multifaceted, innate ability to human beings .…”

“…Similarly, the personal confidence and hope (M=3.84, SD=0.670) also had high scores. Hope, seen as a maintaining factor and trigger in the process of recovery has been identified in the literature as a crucial component in an youth's ability to recover (Kirst et al, 2014;Padgett, Henwood, Abrams, & Drake, 2008;Padgett & Henwood, 2011, 2012Henwood et al, 2013;. Personal confidence has been associated with one's ability to define purpose and meaning in their life (Jacobson & Greenley, 2001;Mancini, 2008;Resnick et al, 2005;.…”

“…Therefore, there are other factors that contribute to the recovery of homeless youth and must be considered when designing and implementing interventions. Housing has been identified as an integral factor that can facilitate and support dimensions of recovery (Kirst et al, 2014;Tsemberis, Gulcur, & Nakae, 2004;Forchuk et al, 2013;Tsemberis, Kent, & Respress, 2012).…”

“…Housing has been seen by homeless youth as a preliminary step in rebuilding their lives (Kirst et al, 2014). Substance use treatment and mental health programs are also important in the recovery of homeless youth as it assists them in exiting a cycle that leads many back into homelessness (Tsemberis et al, 2004;Forchuk et al, 2013).…”