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This discussion paper focuses on “reflective practice” as conceptualized by Donald Schön with its particular application in homelessness research and practice. Reflective practices are slowly gaining ground among scholars and practitioners engaged in the homelessness sector since the onset of the pandemic where increasing reliance on tele-mediated communication has transformed the ways in which research and practice take place. This paper starts by revisiting the concept of reflection as propounded by John Dewey and later recalibrated by Donald Schön, followed by a discussion of how two specific reflective practices, namely reflection-in-action and reflection-on-action, can be leveraged in homelessness research and practice. The paper concludes by discussing some implications of such practices for researchers and practitioners involved in the homelessness sector in the pandemic era. These implications focus on issues such as housing affordability and affordable housing, case management and support services, and barriers caused by the pandemic to homelessness research.

Built for Zero (BFZ) is a new data-driven approach to allocating housing assistance to homeless households. BFZ implementation includes the production/maintenance of a “by-name list” (BNL). The BNL is a regularly updated spreadsheet with personalised data about everyone who enters and exits a local homeless system (i.e., flow). Local administrators use the BNL to produce “by-name data” (BND). BND lets administrators monitor and manipulate system flow in “real time.” Scholars have not analysed how administrators manage their BNL and produce BND. This paper starts that conservation by answering three questions with interview data that was collected from administrators at 28 “BFZ communities” (i.e., homeless systems implementing BFZ): How do administrators manage their BNL? What factors influence BNL management? How does BNL management affect BND accuracy? Using thematic analysis, the author provides evidence that administrators manage the length of their BNL by removing “inactive” clients who have disengaged from service providers. Administrators try to verify housing status before deeming someone inactive. The verification process is shaped by social policies, network ties, virtual interactions, and administrative discretion. Because those things vary across homeless systems, administrators face different constraints and enablers whilst verifying someone’s housing status. The intersection of contextual factors and subjective processes biases the BND administrators produce from their BNL.

Background: Homelessness is a global challenge affecting both high-income and lower-income countries. While survival is a priority, when assessing rehousing programs, thriving should be a goal. There is, however, a lack of clarity around the concept of thriving in existing literature, as for example it is used interchangeably across a number of professions. Aim: This paper provides an in-depth concept analysis of thriving, with a specific focus on thriving post-homelessness. Method: Walker and Avant’s (2011) concept analysis method was utilized. Results: As a result of this concept analysis, eight defining attributes were identified, including bio-psycho-social-spiritual improvement, adaptive coping styles, a sense of accomplishment, satisfaction across multiple life domains, functional well-being, improving or achieving a high level of performance, finding meaning in life or life activities, and having the necessities of daily living. It was found that thriving is a multidimensional process with subjective and objective components as well as an outcome, which all contribute to an individual's well-being and satisfaction. As a consequence of thriving, one feels more secure and confident and an enhanced sense of belonging. Conclusion: This concept analysis includes an updated definition of an individual's thriving post-homelessness in order to allow for comprehensive measurement in the context of housing research, including a positive assessment of one's life situation across multiple domains, as well as access to basic necessities such as shelter, food, and clothing. Future research can utilize the results of this concept analysis to explore thriving within the context of housing, especially to establish a well-structured housing program for persons exiting homelessness.

This paper presents outcomes for a Housing First (HF) cohort in Aotearoa, New Zealand. Using integrated governmental administrative data, we analysed outcomes for a cohort of 357 people, comparing health, justice, income, and social welfare indicators the year prior to HF and five years after being housed. In the fifth year after being housed, improved outcomes across each of these sectors were noted, with particularly impressive improvements found in income levels (+38%) and mental health. These results demonstrate the efficacy of this HF programme in improving well-being. Despite such notable improvements, there is room for HF to have a greater impact in the context of wider system changes that support overall well-being, as well as the goal of making homelessness rare, brief, and non-recurring.

The intersection between health and homelessness is well documented and has been made more explicit since the onset of the coronavirus disease of 2019 (COVID-19). In the Global North, COVID-19 related public health responses targeting homeless populations have varied across countries, including greater national-level financial investment, temporarily housing those in congregate facilities in ‘self-contained’ accommodation, time-limited eviction moratoriums and dedicated health system interventions across homelessness and addiction services to enable social distancing and self-isolation. Yet questions remain about the immediate and longer-term outcomes of these newly implemented responses and whether they will be sustained. Such considerations are critical and timely in countries such as Ireland, where significant health reform is underway. In this paper, we use Ireland as a case study to explore whether and how public health responses to homelessness during COVID-19 hold important insights for the development of more effective health policy. Drawing on publicly available Irish data, we present a secondary analysis of COVID-19 infection rates amongst homelessness service users as well as trends in emergency accommodation usage between 2020 and 2021. Focusing specifically on public health measures implemented during the pandemic via the health and housing systems, respectively, we discuss how such interventions may have impacted on these homelessness figures in both intended and unexpected ways. We conclude by teasing out and unpacking relevant lessons for health reform.

Living on the streets is a global public health problem that is institutionalized in different local contexts. After the coronavirus disease of 2019 (COVID-19) pandemic was declared in the Autonomous City of Buenos Aires (CABA), the care coverage for Persons Experiencing Homelessness (PEH) was reduced to a few social and community organizations. This paper presents the preliminary results of participatory research using a network research design. We worked with referents from community organizations and PEH, combining synchronous and asynchronous actions through digital media and face-to-face strategies. The COVID-19 pandemic scenario generates challenges for interventions with PEH by revaluating narratives of risk. The relationship between self-care and collective care is problematized in the responses generated by civil society to ensure continuity of care in this socio-health emergency.

While the right to housing is a fundamental right per article 25 of the 1948 Universal Declaration of Human Rights, ‘homelessness’ is still generally a Western concept and not comprehensively recognized or addressed as a social issue in many countries, including many within the Middle East and North Africa. This paper looked at the literature on homelessness in the Middle East and North Africa (MENA) region to document the meaning and scope of homelessness within this region. After identifying and screening the relevant articles, 103 eligible articles were included in the final data synthesis stage. What we have learned from the review is organized in three categories: 1) conceptualizations of homelessness, 2) proposed responses to homelessness, and 3) research gaps. Studies addressing homelessness experienced by women, elderly, and family were underrepresented or did not exist. Homelessness among children dominates the literature in this review with 62% studies investigated the issue of homelessness in childhood. In a way, children are prioritized yet their adult relatives are often left invisible. Responding to the issue of homelessness on a global scale first involves having effective definitions that both properly enumerate and contextualize the issue. Without establishing a comprehensive definition of homelessness, efforts to address housing precarity can be ineffective.

Under what conditions will the public accept homeless-serving housing and social service facilities in their neighborhood? In this paper, we answer this question through a basic descriptive statistical analysis of a brief survey (respondent n=251) and a thematic analysis of seven focus groups with residents of San Diego, California (participant n=34). We find that although residents were not categorically opposed to such facilities, their support was contingent on a particular approach to addressing homelessness, often rooted in misperceptions of the causes of homelessness. Participants classified people experiencing homelessness (PEH) into “deserving” and “undeserving” groups based on these perceptions. Attitudes towards homeless-serving facilities were also shaped by a belief that what is needed most are services such as substance abuse treatment, mental health services, or job training; they focused less on the need to house people who are currently unsheltered. Study participants also took a paternalistic approach to policy design, focusing on rules and regulations to force PEH to make “good” decisions. Participants recognized homelessness as a pressing social problem and were willing to consider homeless-serving facilities in their community. However, their attitudes and beliefs limited which facilities they would support, and under what circumstances.

For people experiencing homelessness, the ability to move between and within communities is an important aspect of achieving stability and improving overall well-being. However, people experiencing homelessness are often transportation disadvantaged, which creates barriers to health management, housing, employment, and social service connections. This paper draws on qualitative interviews with frontline homeless service providers (N=21) in a large, geographically diverse region of New York State to explore the impact of transportation disadvantage on mobility, service use, and exiting homelessness. Findings center on how the housing process often necessitates significant mobility (e.g., moving between communities or counties) and how a lack of transportation access limits the mobility necessary for gaining stability. The findings illustrate the insurmountable nature of transportation disadvantage in many communities and how this disadvantage continues and even worsens once a person is housed. Implications for practice, policy, and research are discussed.

Homelessness is a serious public health concern with devastating consequences for health and wellbeing of homeless people. Visible signs of homelessness often appear in the form of encampments or tent cities. Such sites often raise controversies about public health and safety without attention to the structural, systemic and individual factors that contribute to their existence, including deficits in basic determinants of health and a failure to protect human rights to housing. The purpose of this paper is to explore the conditions that contribute to homeless encampments and ongoing issues of precarity, and right to housing from the perspective of residents of one encampment. The data set was comprised of 47 affidavits taken from 33 people from one tent city in Victoria, British Columbia (BC) in anticipation of legal action to remove residents and their belongings in 2016. We used Braun and Clarke’s (2006) approach to thematic analysis to identify, analyze and report patterns within the data. Residents spoke to systemic failures within the homeless sector itself as a factor in decisions to live in an encampment. Participants highlighted the challenges of ‘being chained to a backpack’ with nowhere to go and the impact of bylaws and policing on their health and well being. They acknowledged that while living in an encampment is a last resort it is often a better option than the streets or shelters with the benefits of a community, albeit a forced one with ongoing precarity. Public health responses to encampments should focus on centring human rights to adequate housing including self-determination and access to determinants of health. Such responses are aligned with public health commitments to health equity and social justice and require public health infrastructure.

In this paper, I offer a unique lens through which to theorize neoliberal governance from the perspective of the politics of space and everyday surveillance in Akash Sadan, a Delhi homeless shelter. Drawing from interview data and over two years of ethnographic research with children (boys and girls), their families, and civil society and state representatives, I bring theories of homelessness, surveillance, and spatialized control as they connect to scholarship on governance, regulation, and stigmatization into conversation with Miraftab’s (2004) framework on the mutually constitutive concepts of “invited” and “invented” spaces of participation. Extending this framework, I conceptualize the Aakash Sadan shelter as an “invited,” state-sanctioned space supported by a state-legitimized non- governmental organization (NGO). I argue that regulatory power operates through spatial territorialism and stigmatized surveillance exercised by an NGO primarily in league with the state. This stigmatization is inseparable from the community’s historically enforced precarity and state-induced dispossession. The empirical case of the Aakash Sadan shelter thus demonstrates how the convergence of these spatial features in a state-sanctioned community can leave residents with reduced access to basic and urgently needed services, heightening experiences of poverty and precarity.

A focus on access to mental health care is critical for beneficent and just care of individuals experiencing homelessness. The delivery of this care is strengthened through building longitudinal relationships between clinicians and persons experiencing homelessness—relationships that are best understood, perhaps, through the lens of attachment theory. In this paper, we look at the prevalence of mental illness among individuals experiencing homelessness and the history of deinstitutionalization of the mentally ill. We then evaluate how three modern-day interventions—street medicine, community health clinics, and supportive housing programs—play integral roles in providing mental health care and constructing a trusting relationship. We conclude with a call for increased funding to support the expansion of these essential mental health care interventions, especially in the aftermath of COVID-19.

This paper aims to demonstrate the efficacy of a five-level homelessness prevention typology, encompassing universal, targeted, crisis, emergency, and recovery categories. We argue that this typology can be deployed to illuminate key comparisons in homelessness prevention policy and practice between different jurisdictions and over time. Meanwhile, it avoids the confusions and overlaps that occur in extant categorisations. Using the UK jurisdictions as an empirical testbed for this analytical framework, four key lessons emerge which we contend have resonance across much of the global north. First, though there is growing evidence of the importance of both universal prevention measures (particularly the delivery of affordable housing and poverty reduction), and targeted preventative interventions (focused on high risk groups and transitions), practical action on both fronts has been deeply deficient to date. Second, and more encouragingly, there is a nascent shift in homelessness practice from an overwhelming focus on basic, emergency interventions, towards more upstream attempts to avert the kind of crisis situations that can lead to homelessness arising in the first place. Third, and also welcome, is a trend within recovery interventions from treatment-led to more housing-led models, albeit that this shift has been frustratingly slow to materialise in many countries. Fourth, across all of these categories of homelessness prevention, there remain substantial evidence gaps, especially outside of the US.