The emergence and dissemination of Housing First in Sweden

The development and dissemination of Housing First programmes have been slow and without nationalinfo:eu-repo/semantics/publishedVersio

Factors associated with providers’ work engagement and burnout in homeless services: A cross‐national study

The complexity of homeless service users' characteristics and the contextual challenges faced by services can make the experience of working with people in homelessness stressful and can put providers' well-being at risk. In the current study, we investigated the association between service characteristics (i.e., the availability of training and supervision and the capability-fostering approach) and social service providers' work engagement and burnout. The study involved 497 social service providers working in homeless services in eight different European countries (62% women; mean age = 40.73, SD = 10.45) and was part of the Horizon 2020 European study "Homelessness as Unfairness (HOME_EU)." Using hierarchical linear modeling (HLM), findings showed that the availability of training and supervision were positively associated with providers' work engagement and negatively associated with burnout. However, results varied based on the perceived usefulness of the training and supervision provided within the service and the specific outcome considered. The most consistent finding was the association between the degree to which a service promotes users' capabilities and all the aspects of providers' well-being analyzed. Results are discussed in relation to their implications for how configuration of homeless services can promote social service providers' well-being and high-quality care.info:eu-repo/semantics/publishedVersio

Psychometric properties of the measure of achieved capabilities in homeless services

Background Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.info:eu-repo/semantics/publishedVersio

Kan man förstå socialt arbete?

Recension av boken "Förstå socialt arbete" författad avMalmö: Liber AB, 2008 Bengt Börjeson

Stockholms hemlösa kvinnors hälsa 1960-2001

Syftet med denna artikel är att i korthet presentera svenska studier som gjorts om hemlösa kvinnor och deras hälsa under perioden 1960-2001 samt att försöka jämföra studierna och därmed utröna om hemlösa kvinnors hälsa under den senare perioden förbättrats eller försämrats. Gruppen hemlösa kvinnor har ändrats i sammansättning, deras sjuklighet verkar inte ha minskat utan snarare ökat

Homelessness and health : analysis of mortality and morbidity from a gender perspective

In this thesis, results from epidemiological cohort studies of morbidity and mortality among homeless men and women are presented. Comparisons were made with the general population concerning hospital care for somatic diseases, injury and mental disorders, and concerning mortality. The thesis contains also the results from a five-year follow-up study of 82 homeless men with mental problems. Results from Paper I shows that the mortality among the 82 homeless men was higher than expected (SMR 4.7). Surprisingly, among men with severe psychiatric disorders, such as schizophrenia, none had died at the follow-up. Among the survivors, 75% were still homeless, and the mental health problems combined with substance use problems had increased. Paper II, shows that among 1 364 homeless men and 340 homeless women, the relative risk of being hospitalised for physical diseases was double that of men and women in the general population. When age was considered, younger homeless women had the highest risk compared to homeless men (RR 1.6). The highest prevalence was found in the diagnosis group injury/poisoning (22% men, and 20% women). The highest risk was found for skin diseases (RR 36.9) and concerned homeless women. Paper III shows that among 1 364 homeless men and 340 homeless women, the relative risk of having mental disorders, including alcohol and drugs, was 13-21 times higher that of the general population. The homeless women ran a higher risk compared with homeless men (RR 1.2), where younger homeless women had the highest risk (RR 2.2). Alcohol use disorders were equally common among homeless men and women, but women had more drug use disorders (RR 1.3). Women had a higher risk of schizophrenia (RR 2.8), and personality disorders (RR 2.7). When adjustment was made for substance use disorders, no increased risk for mental disorder was found in the homeless group. Paper IV reports a relative risk of 3.1 for death among 1 758 homeless men compared with men in the population, and a relative risk of 2.5 for 527 homeless women compared to women in the population. No difference in mortality was found between homeless men and women. The mortality among men was principally related to alcohol, and among women to drug abuse. For homeless men with long homelessness and mental problems including substance misuse, the life and housing situation had not improved at the 5-year follow-up, and substance misuse problems and mental problems had increased among them. There was no connection between mortality and mental illness. Among homeless men and women the risk of having diseases that requires hospitalisation was very high, compared with the general population. Younger homeless women were particularly at risk. There were a number of gender specific somatic and psychiatric diagnoses that are important to take into account when planning services for homeless people. The excess risk for mental illness found among the homeless was entirely related to alcohol and drug misuse, as was their excess mortality

Dödlighet bland hemlösa i Sverige

Denna artikel sammanfattar tidigare och aktuella studier av dödlighet bland hemlösa i Sverige. Gruppen hemlösa har en överdödlighet totalt sett jämfört med övriga befolkningen. Denna överdödlighet har snarast ökat över tid. Kvinnorna har högre överdödlighet än män. Dödsorsaksmönstret har ändrats över tid, från tuberkulos under 1960-tal, till alkoholrelaterade dödsfall och senare narkotikarelaterade dödsfall och yttre våld