Working with people experiencing homelessness in Europe

In Europe, the widespread transition from the Traditional Staircase (TS) model to the Housing First (HF) model is transforming the way social service providers work with people experiencing homelessness. This study examined social service providers’ perspectives in both models regarding factors that facilitate or hinder their work. Data were collected through 17 photovoice projects involving 81 social service providers from eight European countries. The results show factors affecting social service providers’ work at three levels: systemic, organizational, and individual. Professionals in TS and HF identified similar topics; however, TS providers discussed more obstacles to work. Implications for practice are discussed.Comissão Européiainfo:eu-repo/semantics/publishedVersio

Recovery in homelessness: the influence of choice and mastery on physical health, psychiatric symptoms, alcohol and drug use, and community integration.

OBJECTIVE: Recovery is the process through which one learns to overcome, manage, or live with the negative consequences of physical illness, mental illness, alcohol or drug misuse, or trauma. Homeless individuals endure many, or all, of these experiences. Previous research has shown that characteristics of homeless services, particularly the amount of choice they afford to service users, can influence recovery experiences, potentially by increasing a sense of mastery. The purpose of this study was to test the hypothesis that choice in housing and services would predict recovery in a number of domains, and that these relationships would be mediated by mastery. METHOD: Using survey data collected from a sample of homeless services users (n = 160) in Ireland, we conducted a series of cross-sectional mediation analyses to predict recovery in domains of physical health, psychiatric symptoms, alcohol and drug use, and community integration. RESULTS: We observed the hypothesized mediational relationship for each recovery domain except alcohol use. That is, personal mastery mediated the relationship of perceived choice to self-appraised physical health, psychiatric symptoms, drug use, and physical and psychological aspects of community integration, but not alcohol use. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Findings add further support to the growing body of evidence that suggests choice is centrally important to recovery experiences among individuals in homelessness. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

Mastery matters: consumer choice, psychiatric symptoms and problematic substance use among adults with histories of homelessness.

Previous research demonstrated the importance of consumer choice and mastery to residential stability and psychiatric functioning for adults with histories of homelessness. In the present study, we investigated whether these relationships hold, even in the context of problem-related substance misuse. Questionnaire data were collected in Ireland from 101 residents of long-term homeless accommodation in 2010. Hayes' PROCESS macro for mediation and moderation analysis in SPSS was employed to test our hypotheses. Findings demonstrated that the indirect effect of choice through mastery on psychiatric functioning was stronger for individuals with more recent problem-related substance use than for those with no or distant histories of problem-related substance use. Our findings confirm that consumer choice in housing and services is important to homeless services users' recovery experiences. Because of its relationship with mastery, consumer choice in housing and services protects homeless services users' psychiatric functioning, especially when substance use-related choices have had negative consequences. Our findings suggest that if homeless services take away consumer choice when substance use causes problems, they may actually undermine, rather than foster, service users' psychiatric functioning

Microsystems of recovery in homeless services: The influence of service provider values on service users' recovery experiences.

There is still much to learn about how aspects of the ecology of homelessness shape homeless adults' recovery experiences. In the present mixed-methods study, the relationship of service providers' work-related values to their service users' recovery experiences in the microsystem of homelessness were examined. Service providers completed semi-structured qualitative interviews about their service users, daily work activities, and work-related goals. At three time points, their service users completed quantitative measures of choice, mastery, and recovery in four life domains: physical health, psychiatric symptoms, substance use, and community integration. Service providers' interview transcripts were coded for three indicators of values: assumptions, actions, and end-states. Summative Content Analysis was used to transform qualitative codes into numeric data so they could be used to predict service users' recovery. In a series of growth curve models, the extent to which service providers' end-state values, as an indicator of consumer-led values, was shown to indirectly predict service users' recovery experiences, through their perceived choice and mastery. Findings confirm that providers' values are an important influence on service users' recovery. Results are discussed in terms of their implications for recovery-oriented theory and practice

Older adults’ social capital and generative activity in rural Ireland

For ageing adults, rural areas present challenges to social and psychological well-being that are qualitatively different from those encountered in urban and suburban areas. Because of its importance to well-being, we explored the ways in which older adults in rural Ireland operate on and experience their social environment. Qualitative interviews were conducted with a sample (n = 10) of active older adults living in a sparsely populated, rural, and geographically isolated area of Ireland. Transcripts were thematically analyzed to gain insight into the ways these older adults reciprocally build informal social capital and engage in generative activity. Findings challenge commonplace notions of rural life as socially isolating and lonely for older adults and suggest that these older adults enact valuable roles in their rural community that are important to social and psychological well-bein

Understanding innovation in homeless service provision: a study of frontline providers' values-readiness for change.

Service innovation for adults experiencing mental illness and homelessness typically involves shifting from treatment-led, staircase models toward recovery-oriented, Housing-First models. Aligning frontline service providers' values to those embedded within newer models is an important, but under-investigated, influence on the innovation process. To assess values alignment in this context, we conducted semi-structured qualitative interviews with frontline providers in staircase services in Ireland (n = 50). Data showed that, while their values mostly aligned to the treatment-led model, there was meaningful evidence of more recovery-oriented values, too. Strategies to enhance innovation through values-alignment are discussed

“You get to understand we are all human beings”: community solidarity initiatives as spaces of recognition, resistance, and change

In Ireland the Direct Provision system segregates and excludes displaced people from the host community, and informal community solidarity initiatives (CSIs) were established nationwide to address this issue. We examined experiences of intergroup contact in CSIs and related contexts to identify how solidarity is produced, and for whom, through photovoice workshops (Study 1: n = 13) with displaced participants of two CSIs, and interviews (Study 2: n = 5) with resident/ national stakeholders of four CSIs. In Study 1, we identified three themes: “Orienting to future and collective identities in Direct Provision,” “Negotiating intersectional identities in public settings,” and “Recognition of valued collective identities in the CSI.” In Study 2, we identified two themes: “Negotiating privileged identities and power asymmetries,” and “Facilitating change through social connections.” CSIs offered temporary respite from the oppression and discrimination displaced people experienced in other contexts and enabled them to resist dehumanizing representations through expression and recognition of valued identities. Connections within and across groups fostered relational solidarity, shifted intergroup norms, and opened opportunities for displaced people to access resources. Accordingly, our findings have implications for public policy, community research, and action to create just and equitable conditions for displaced people in receiving countries