This article examines how people experiencing homelessness view their interactions with service providers. Drawing on a database of more than 500 transcribed interviews with people experiencing homelessness we find that descriptions of interactions with staff and providers were predominantly expressed in sharply negative terms, with experiences of objectification and infantilization being commonplace. In response to these experiences, nearly all were angry, and many simply opted out of the social service system in order to maintain a sense of dignity and self-respect. We argue that these responses should not simply be analysed as an individual psychological or cognitive response, but rather as a result of the power relations and social inequities in the provider-client relationship. This suggests that the perpetuation of homelessness is not internal to the homeless individual as many claim, but rather may be embedded in the service industry itself, which subjects both clients and providers to bureaucratic forms of authority and experiences of disrespect. These negative descriptions are juxtaposed with positive comments, which offer potential solutions from homeless individuals themselves. We conclude that qualitative research, in contrast to a reliance on statistics and best practice assessments, is an important tool in developing socially just policies and programs serving those in need.
Understanding mental health issues faced by young homeless persons is instrumental to the development of successful targeted interventions. No systematic review of recent published literature on psychopathology in this group has been completed.We conducted a systematic review of published research examining the prevalence of psychiatric problems among young homeless people. We examined the temporal relationship between homelessness and psychopathology. We collated 46 articles according to the PRISMA Statement.All studies that used a full psychiatric assessment consistently reported a prevalence of any psychiatric disorder from 48% to 98%. Although there was a lack of longitudinal studies of the temporal relationship between psychiatric disorders and homelessness, findings suggested a reciprocal link. Supporting young people at risk for homelessness could reduce homelessness incidence and improve mental health.
Negative perceptions of homelessness contribute to deficit models of practice, false notions of homogeneity, and marginalization. Wellbeing is a state of satisfaction with material, social, and human aspects of life and can be measured both objectively and subjectively. The study explored the meaning and experience of wellbeing in the everyday lives of 20 homeless participants through fieldwork and interviews. This study revealed that health contributed little to their overall perception of wellbeing. Keeping safe, being positive and feeling good, connecting with others, and the ability to participate in “normal” life were the key contributors of subjective wellbeing. The authors demonstrate that social exclusion experienced in homelessness has a negative effect on subjective wellbeing. Services that provide opportunities to experience social inclusion and develop community and cultural connections will improve the wellbeing of homeless persons.
People who are homeless are at risk of COVID-19.
Homeless services are often provided in congregate settings, which could facilitate the spread of infection. Because many people who are homeless are older adults or have underlying medical conditions, they may also be at higher risk for severe disease.
Health departments and healthcare facilities should be aware that people who are homeless are a particularly vulnerable group. If possible, identifying non-congregate settings where those at highest risk can stay may help protect them from COVID-19.
How people experiencing homelessness can protect themselves
Many of the recommendations to prevent COVID-19 may be difficult for a person experiencing homelessness to do. Although it may not be possible to avoid certain crowded locations (such as shelters), people who are homeless should:
- Try to avoid other crowded public settings.
- If using public transportation, follow the CDC guidance on how to protect yourself when using transportation, try to travel during less busy times, and clean your hands as soon as possible after their trip.
- If possible, use take-away options for food.
- Maintain a distance of 6 feet (about two arms’ length) from other people.
- Wash their hands with soap and water for at least 20 seconds as often as possible, and cover their coughs and sneezes.
Donations of food and clothing to homeless service providers
Homeless service providers can accept donations of food and clothing during community spread of COVID-19, but general infection control precautions should be taken. Request that donors not donate if they are sick.
- Set up donation drop-off points to encourage social distancing between shelter workers and those donating.
- Launder donated clothing, sheets, towels, or other fabrics on high heat settings, and disinfect items that are nonporous, such as items made of plastic.
- Food donations should be shelf-stable, and shelter staff should take usual food-related infection prevention precautions.