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This Photovoice research is situated within a larger study and part of a community-based participatory research (CBPR) partnership, Project Lotus, Hope Together. Project Lotus is a collaboration that began in early 2021 with a network of women’s shelters, women with lived experience of homelessness, and academic scholars in Montreal, Quebec, working towards a broad goal of co-creating supports for women post-shelter stay. Underpinned by a critical feminist lens, the aim of this research was to uncover what helps and what hinders women in their transition from shelter to housing. Using Photovoice as the participatory research method, seven women in Montreal with lived experience of a shelter stay and post-shelter transition to their own housing were interviewed over a 6-month period in 2021. Five key and interrelated themes emerged as central to their experience and process in their transition from shelter to home: 1) Shelter as a safety net; 2) Living with trauma; 3) Moving beyond survival to find meaning in everyday life; 4) Connecting and contributing; and 5) A home. Our findings demonstrated that, while moving into their own living space post-shelter marked a new beginning for the women, it was a beginning filled with various systemic and structural barriers. Our findings also suggest and align with recent literature reviews that there are broad systemic inequalities for women related to housing, gender roles, and poverty. Sustainable wrap-around supports and policy changes using rights-based, systems, and trauma-informed approaches to support women post-shelter are urgently required.

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.

Why do some cities provide many emergency shelter beds while others do not? We interpret differences with respect to the supply of shelter beds as originating from alternative choices concerning a series of policy trade-offs. These trade-offs arise because of climate effects, prejudice, levels of poverty, and housing and labour market conditions affecting the rates of homelessness. Governments have policy levers they can adjust to respond to changes in most, if not all these conditions. One of these policy levers is the number of emergency shelter beds that are made available. But other policy responses are also possible. These include efforts to reduce poverty, policies designed to increase the stock of affordable housing, and policies to increase income support payments. Choosing to supply shelter beds over other policy responses reveals a preference for one set of societal outcomes over another. Using data describing conditions in 52 Canadian cities, we test six hypotheses describing why some communities choose to provide more homeless shelter beds than others.

Although Takatāpui/ lesbian, gay, bisexual, transgender, intersex, questioning, plus (LGBTIQ+) people are over-represented in homelessness statistics, there is limited qualitative research that explores the enduring effects of homelessness once they have attained housing stability. Using data from eight semi-structured interviews, we explore life after homelessness for Takatāpui/LGBTIQ+ people in Aotearoa, New Zealand. Results show the long-term ramifications of homelessness, stigma, and shame about having experienced homelessness, participants’ desire to “turn their lives around,” and their experiences of supporting others. These findings show that experiencing homelessness influences people’s lives long after they are housed.

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 review presents and explores "Homelessness: A Critical Introduction" by Cameron Parsell.

To receive federal homelessness funding, cities in Canada must adhere to federal policy directives associated with the government of Canada’s Reaching Home program. These directives include the implementation of a homelessness management information system (HMIS) and a Coordinated Access process. In this article, we draw on 90 in-depth interviews and extensive policy and institutional analysis to assess the implementation of Coordinated Access in one Ontario city. Our findings suggest that none of the four pillars of Coordinated Access (access, assessment, prioritization, matching, and referral) work as intended. Structural and systemic challenges (e.g., related to housing stock, staff turnover, inaccessibility of shelters, criminalizing municipal bylaws, and the reliability of the assessment tool) undermine the efficacy of the process as a means of improving transparency, service coordination, and housing outcomes. Despite being an early adopter of the Coordinated Access process, this Ontario municipality continues to struggle with a growing housing affordability crisis and an unhoused population.

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.

Regardless of age, transportation determines access to necessary services and supports, including food, healthcare, shelter, and social connection for persons experiencing homelessness (PEH). This study compared experiences and perceptions of transportation among PEH aged

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While homelessness is a global phenomenon, research on homelessness skews heavily towards high-income nations such as those in North America, Europe, and Australia. The academic publishing sector also highly privileges articles written in English. Therefore, homelessness in the global south or non-English as a first language countries is less understood and less recognized. In this article, we explore homelessness as a phenomenon in the Middle East and North African (MENA) region. In particular, we use a gender-based analysis to understand the highly gendered nature of homelessness in this region, presenting an argument that while homelessness is gendered globally, in regions where gender inequality is greater, women and gender-diverse people will be more disproportionately impacted by homelessness. Therefore, obtaining Sustainable Development Goal 5 of ‘Gender Equality’ and efforts to prevent homelessness will go hand-in-hand within the MENA region.

The 2019 Coronavirus (COVID-19) pandemic severely limited the availability of community resources within the Regional Municipality of Durham, Ontario, Canada. It disrupted the lives of persons experiencing homelessness and other vulnerable populations. To address the gaps in resources, community stakeholders developed two pilot community hubs to respond to the unmet health, housing, and support needs of those impacted. This research utilized a mixed-methods research design to determine the effectiveness of the community hubs in responding to the unmet needs of patrons utilizing the services and the scalability of the community hub model as a viable regional service approach. Surveys were administered in person with seventy-five community hub patrons. Fifteen direct service staff completed self-administered online surveys. Interviews were conducted with five community hub managerial staff and two subject-matter experts who collaborated with one of the community hubs. Results from the study showed that the needs of patrons were deep and entrenched and required a progressive, co-located, integrated health and social service response model. Staff described the services as critical and lifesaving for the patrons. The descriptive statistical analysis revealed that 93% of patrons indicated that services offered by the community hubs met their needs. The main challenge for the community hubs was the lack of core funding. Implications of this study include establishing a regional, evidence-informed, integrated system of care that addresses the healthcare, social service, and housing needs of populations experiencing homelessness.

Visible homelessness is on the rise in Nuuk, Greenland. Since the early 2000s, the number of people staying at the municipal shelter, accessing support programs, and registering as homeless in the community has, by a qualitative estimate grown. Attention has also been given to the growing number of Greenlanders living homeless in Danish cities. However, the literature on Greenlandic homelessness remains sparse, and very little literature conceptualizes homelessness in Greenland within its specific geographical, cultural, or social context. To better understand the emergence of visible homelessness, this article explores the social dimensions of homelessness and asks how homelessness can be understood within the dynamics of urbanization in Greenland. Drawing on four years of participant observation in Nuuk with homelessness outreach organizations, and 20 in-depth interviews with both service providers and men and women experiencing homelessness, and four lived experience focus groups, we find that the emergence of homelessness in Greenland is part and parcel of a trajectory of welfare colonialism, resettlement, and contemporary urbanization. We highlight four specific policy issues: 1) an existing housing stock in Nuuk inappropriate for diverse needs; 2) urbanization in the absence of a national housing or homelessness strategy; 3) a lack of integrated supports and reliance on the non-profit sector; 4) and an increasingly punitive approach to managing the limited housing supply. Stepping back, we argue that the emergence of visible northern homelessness is an important lens through which to understand the dynamics of northern urbanization, social marginalization and exclusion, and the continuation of colonial relations in the era of self-governance.

Recently, the logic of public health prevention has found a foothold in research and advocacy about homelessness. From a commonsense perspective, the prevention of a social problem like homelessness is an objectively positive aim. However, in the realm of social and health policy, the concept of prevention is not simply a common-sense word. It is part of a wider set of rationalities and technologies of governance which operate in and through the institution of public health. Research demonstrates that state-driven interventions designed to advance the health of a population often pose problems for particular groups. Prevention efforts, and their differential effects, thus have the potential to illuminate how state-interventions pursued with the objective of safe-guarding the public in general may simultaneously exacerbate specific structural and systemic forms of inequality. In this article, we probe the ethical, empirical, and political dimensions of state-driven responses to the coronavirus disease of 2019 (COVID-19) public health crisis, surfacing some of the ways these interventions posed problems for people who are homeless and experience intersecting health and socio-political disparities. From this vantage point, we then look critically at moves to frame homelessness as a public health crisis, as well as government efforts to prevent homelessness by drawing on public health rationalities. Although our focus is homelessness prevention, as constructed and pursued by governments, our analysis is inspired by critical public health scholarship that challenges the apparent impartiality of prevention as a central logic and set of practices in public health contexts.

While the coronavirus disease of 2019 (COVID-19) pandemic exerted a devastating impact on all members of society, it highlighted the worsening inequalities experienced by marginalised groups such as people experiencing poverty and homelessness in South Africa. The pandemic also exacerbated the multiple demands and stressors of service providers working in homeless shelters. Hence, the study examined the experiences of service providers in terms of challenges and opportunities derived from working at homeless shelters in Tshwane, South Africa, during the hard lockdown from 27 March to 30 April 2020. Guided by a qualitative approach, five service providers were interviewed online. Thematic analysis revealed organizational challenges, such as a lack of knowledge and preparedness regarding disaster management, while client challenges included getting service users to adapt to living with rules. Organizational opportunities included the opportunity for the organization to conduct research, while personal opportunities included the learning experience of working with a vulnerable population during an unprecedented pandemic. Findings highlight the need for programmes to support the wellness needs of service providers and the development of a national policy on homelessness.

Individuals facing Severe and Multiple Disadvantage (SMD) have experience of at least three of the following: homelessness, substance use, mental illness, offending, and domestic violence. There is a push towards providing better support for people facing SMD and yet little research on what the “best” support looks like. Values motivate behaviour across various contexts, and helping an individual identify their values can lead to greater enactment of positive behavioural change. This study aimed to identify and explore the values of people facing SMD, the barriers and facilitators to enacting these values, and the perceived helpfulness of service provision in encouraging values-based behaviour or change. Twelve participants took part in semi-structured interviews. Reflexive thematic analysis resulted in four themes: values are idiosyncratic and interconnected; the benefits of value identification and enactment; the risks and challenges of value identification and enactment; and the relationship between values and support. Results offer preliminary evidence for the potential use of values in providing helpful, person-centered support for people facing SMD. Values work could arguably be integrated into any level of support for those facing SMD to support values-based living and change. Further research on the use and efficacy of values-focused interventions in SMD is needed.

Defining homelessness clearly without reducing the problem's complexity helps governments frame effective and conscious policies. There is a growing need for a theoretical framework that explores the common ground and generative structure among broad narratives about homelessness. In this article, we propose that Bakhtin’s (1981) concept of chronotope has excellent potential to achieve this goal. Chronotopes help us understand how time, space, and body configurations are represented in language and discourse for recognizing various situations and personas. Chronotope also enables us to reveal the assumptions and perspectives behind the narrative. Using a chronotopic lens, we analyzed narrations of homelessness from national governments and international organizations of 38 Organization for Economic Co-operation and Development (OECD) member countries. The findings reveal the dynamism, diversity, and assortment of dimensions related to time, space, and body in the analyzed narratives and highlight five main perspectives viewing homelessness as an issue of security, vulnerability, quantification, inclusivity, and human rights. The results of this analysis will guide upcoming research in two primary areas: investigating varied measurement methodologies for assessing different aspects of time, space, and body and scrutinizing how distinct attitudes towards homelessness impact policymaking and development processes.

This article offers a thick, rich, multidimensional, and situational look into a Housing First (HF) program in Charlotte, North Carolina, called HousingWorks. This study focuses on individuals who have experienced chronic homelessness and who exited permanent supportive housing (PSH) programs that employ a HF model and return to homelessness. In January 2022, there were 582,500 people experiencing homelessness in the United States (The U.S Department of Housing and Urban Development [HUD], 2023). One-third of these individuals had patterns of chronic homelessness, which has doubled since 2016 (HUD, 2023). Additionally, one-third of unsheltered individuals are at a high risk of being unsheltered again. To address issues of chronic homelessness, emphasis has been placed on increasing supportive housing, which combines permanent affordable housing with supportive services (permanent supportive housing), commonly called a housing first, or the rapid rehousing approach. Participants exited HousingWorks for multiple individual and programmatic reasons. All exits in this study were tied to relationships individuals had with friends, family (of choice and biological), romantic partners, case managers, and neighbors. Consumers, providers, and former residents describe their experiences and offer insights for improving housing retention in PSH programs. Implications for implementation and housing first fidelity criteria are also discussed.

The identified prevalence of cognitive impairment in people experiencing homelessness has placed a focus on the use of measures of cognition to predict functioning and ability to move successfully into housing. Functional cognition is the cognitive ability to perform daily life tasks, incorporating cognitive functioning, performance skills, and patterns. Given the increased research on cognitive status and functional skills within people experiencing homelessness, a scoping review was conducted to synthesize the existing literature and identify how functional cognition is evaluated in this population, and identify implications for homeless and housing services. This scoping review was conducted using the Joanna Briggs Institute protocol. Included studies assessed functional cognition, or assessed a component of cognition and related it to functional performance. Of 8,848 articles retrieved from the initial search, thirty-seven articles were determined to meet the inclusion criteria for data extraction. Categories for data extraction included functional domain addressed, tools used for assessment of cognition and/or function, and how reported outcomes were interpreted. Narrative analysis identified domains of cognition and function assessed, and relationships between cognition and function domains. Only the functional domain of Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) were found to have a consistent relationship between cognition and performance and primarily when performance-based assessments were used. Challenges with generalizing study findings broadly include: study populations do not reflect demographics of those experiencing homelessness; a variety of assessment tools for cognition and function are utilized; and the broad use of the term function encompasses several different areas of independent living in the community. Several studies identified that even with the presence of decreased cognition, those with the experience of homelessness are able to maintain housing when given individualized and appropriate supports. This scoping review indicates inconsistent methods to assess cognition and functional cognition within people experiencing homelessness. Performance-based assessments of ADL/IADL are more likely to identify the impact of cognition on function, while neurocognitive assessments are more beneficial to assess social/community integration. Findings indicate that to support the transition from homelessness to housing and increase the likelihood of housing stability; assessments should focus on identifying strengths and necessary/individualized ongoing supports.

Background: The health challenges faced by the homeless are widely unaccounted for in the global south. In India, the lack of a primary healthcare sector in urban areas has led informal healthcare providers, such as Street Medicine, to step in. Methods: By compiling data collected by the Centre for Equity Studies’ Street Medicine teams from June 2016 to October 2018 (n =16,635), this study provides the first empirical assessment of the homeless disease burden in a global south country, while limited to only the people experiencing homelessness that the teams treat, hence being a burden of treatment. Our analysis quantifies this burden among those who seek care from Street Medicine teams and identifies variations in this burden’s distribution across demography and time. Results: The majority (n = 13,557; 81.5%) of Street Medicine cases can be attributed to 19 diagnoses or symptoms, which are mostly therapeutically-simple conditions. The distribution of disease seems to be affected by different configurations of three characteristics: demographics (age and sex), urban geography (where homeless reside), and season. Conclusion: The Street Medicine teams must reflect on the balance they wish to achieve by addressing the relatively common and mild conditions documented in the dataset, and more severe and established diseases within homeless communities. Rapid diagnostic tests for resource-constrained settings could be integrated into Street Medicine practice in order to strengthen the data on which resource allocation decisions are made and improve assessments of homeless disease burden.

Homelessness and mental illness frequently occur together. Individuals who have a mental illness and are homeless may experience a range of challenges and are often underserved by behavioral health professionals. This study used Participatory Action Research to form a working group (n=6), which met at a homeless shelter located in a small city in the United States (U.S) mid-Atlantic region, to generate insights and responses to the challenges they had encountered. The authors posed several research questions in the context of lived experiences of individuals who experience homelessness and mental illness. The researchers used Interpretive Phenomenological Analysis to interpret the data in light of these questions. We generated four key themes: the trauma of homelessness and mental illness, the power of personal connection, personal agency, and achievement, and meaning through action. For mental health counselors, suggestions include incorporating a trauma-informed framework, minimal turnover in counselor coverage, and a client-centered approach.

This article addresses the broad research aim of understanding migrants’ experiences of homelessness during the Coronavirus Disease of (COVID-19) pandemic through a novel combination of linguistic and sociological analysis. In our analysis of life story interviews, we find that the United Kingdom (UK) Government’s Everyone In initiative, which suspended eligibility criteria to provide support and accommodation to those experiencing homelessness or deemed to be at risk of rough sleeping, was hugely beneficial for migrants. This indicates what is possible when there is the political will to end rough sleeping. In its analysis of life stories gathered during the pandemic, the article proceeds to identify deeper-rooted problems relating to the weak and restricted structural position of migrants experiencing homelessness. Having spent time in the UK with an ‘inferior status’, with limited access to work and welfare, economic and social capital, and often with experiences of trauma in the UK and/or in their countries of origin, many of our research participants express a lack of control and a sense of being controlled in their conditions of existence. Further, their isolation and loneliness in the individual rooms provided in the emergency accommodation is indicative of a deeper-rooted sense of separation deriving from years spent sleeping rough or living in temporary and insecure accommodation. Experiences of isolation and the sense of a lack of control are corrosive to mental health, and during the pandemic, mental health problems were also exacerbated by welfare checks and other rule-based practices that are potentially re-traumatising.

Homelessness remains a significant public health issue across the United States, particularly in urban areas. Individuals become and remain homeless for multifaceted and complex reasons that are linked to well-being. The aim of this study was to understand the well-being of persons experiencing homelessness (PEH) and living in tent camps using Aaron Antonovsky’s salutogenic model of health (SMH). To address well-being, we conducted a basic qualitative study with thirty adults over age 18 who self-identified as homeless and living in tent camps within the city of Minneapolis. With a semi-structured interview guide that centered on the SMH, we analyzed data using Johnny Saldaña’s qualitative coding method. Sources of stress themes, including (1) “family trauma” (depression/trauma related to the death of a loved one and drugs, imprisonment, and abuse), (2) “mental health” (depression/trauma related to the death of a loved one, loneliness living in tent camps, substance use, mental illness), and (3) “change and threats” (constant fear of aggression, lack of stability of the tent camp, bad people causing problems, cliques in the camp). Themes of general resistance (GRRs) resources (coping with stress), or GRRs emerged, including (1) “systems knowledge,” (2) “coping strategies,” (3) “sense of community,” (4) “camp stability,” and (5) “human dignity” emerged during data collection and analysis. These findings can inform policy decisions related to increasing services to exit homelessness, funding for sustainable tent camps, and sweeps of tent camps in the city of Minneapolis and beyond.

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.

In response to the predicted increase in homelessness in Edinburgh, Scotland, following the Coronavirus disease of 2019 (COVID-19) pandemic, a ‘live’ digital resource, Street Support Edinburgh (SSE), was launched in the city in January 2021. SSE is a website and smartphone application run by Street Support Network (SSN), a registered charity, working online and offline, connecting and supporting local people and organisations to tackle homelessness. The resource is the first of its kind to be implemented in Scotland. This study aimed to assess the implementation of SSE in response to the predicted increase in homelessness in Edinburgh following the COVID-19 pandemic. A qualitative approach was taken to understand users’ experiences of SSE. The evaluation found a generally positive response to SSE from organisations in the homelessness field. We report on nine themes developed through analysis of the qualitative data: positive feedback on SSE; need for SSE resources; uses of SSE; joined up-working; user-friendliness of SSE; suggestions for alterations to SSE; COVID-19 and other implementation challenges; need/opportunities for promotion and engagement; potential wider rollout across Scotland. In conclusion, initial responses to the launch of SSE have been generally positive, but further awareness raising is likely required to increase SSE reach as in-person services and COVID-19-related protections reduce. Ongoing evaluation is required to track progress over time.

To address the ongoing supply-demand gap for permanent supportive housing (PSH), Moving On initiatives (MOIs) provide linkage to affordable housing without embedded support services and rental subsidies, as well as short-term transitional case management to support transitions to independent housing. PSH providers mediate outcomes for individuals moving on from PSH by providing appropriate supports and assistance. Yet, little is known about how providers view these moves. This study explores how providers perceive moves from PSH. Individual interviews were completed with PSH providers from seven U.S. agencies. Data was analyzed via a modified grounded theory approach. The data show that organizational support and prior experience with moving on shape providers’ perceptions of resident capacity. These perceptions were associated with gatekeeping and recovery-oriented approaches, which informed providers’ self-perceived role as following or leading residents towards moving on. System-level support and pressure to adopt a moving on mindset may lead more providers to promote independence and autonomy among individuals with histories of homelessness.

Homelessness was already a well-known risk factor contributing to premature death, morbidity, mental illness, and substance use disorder. The coronavirus disease for 2019 (COVID-19) pandemic has amplified disparities in Canada’s public health system, disproportionately impacting people experiencing homelessness. The present study aimed to investigate the impact of the COVID-19 pandemic on the homelessness situation in Canada from community stakeholders’ perceptions. The study used qualitative research approaches underlain by focused ethnography tenets. The sample includes 200 service providers from 28 communities across Canada (at least one site in each province and territory) to participate in virtual focus groups. Data analysis followed a four-step ethnographic approach for thematic analysis in qualitative research. Six main themes emerged: (a) system changes precipitated by the COVID-19 pandemic; (b) personal changes in life circumstances; (c) previous strategies no longer working; (e) opportunities; (d) some things getting better; (f) an overall increase in first time and recurrent homelessness in Canada. The study findings underscored mechanisms required to help ‘tip the scale’ in affording people experiencing homelessness the opportunity to avoid or exit homelessness.

It is difficult to overstate the degree of uncertainty during the early days of the coronavirus disease of 2019 (COVID-19) pandemic, as government advice largely emphasized self-quarantine and isolation, stringent hygienic and sanitation practices, implementation of regulations around face masks and shields, and closure of congregate public spaces. This uncertainty was especially true for homelessness service providers, as homelessness is a phenomenon which has historically taken place primarily in public and communal spaces. It is important to consider that data collection among people experiencing homelessness (PEH) has always been a complex endeavor, as these populations can be transient, hard-to-reach, and reluctant to engage with researchers. COVID-19 testing was also severely limited throughout 2020, prior to the development of readily available self-administered tests. Understanding the complete picture of COVID-19 transmission within homeless populations during the early days of the outbreak, is therefore immensely challenging. For these reasons, this study, undertaken in August 2020, seeks to record the impact of the early pandemic period on homelessness service systems from a policy perspective. The value of this perspective is twofold: first, it documents how systems in a wide array of contexts responded to a critical public health crisis and can stand as a record of how systems operated prior to and immediately after the outbreak occurred, providing important historical context for future research; and second, it helps contextualize new and emerging data around the experience of PEH during COVID-19 and its lingering impacts.

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.

Homelessness has re-emerged as a significant issue in Aotearoa, New Zealand (Aotearoa/NZ) in recent decades, with Māori (Indigenous peoples of New Zealand) being impacted disproportionately due to ongoing processes of colonisation and impoverishment. Whether living on the streets of an urban centre, small city, or rural district, the lifeworlds of homeless people are frequently textured by social, material, and spatial exclusions, uncertainties, insecurities, and stigma. This article explores how the Open Arms Day Centre (OADC), a drop-in day centre for homeless people in Whangārei (a small city in Northland), functions as a dependable Pou Whirinaki (pillar of strength and support) in the everyday lives of Māori experiencing homelessness. Employing a Māori-centred, case-based approach, we explored the experiences of a small group of local service users, volunteers, and staff through interviews, photographic exercises, and regular casual conversations. This culturally informed mode of inquiry resulted in a deeper understanding of the OADC’s operation as what health geographers have also referred to as a space of care. Such spaces offer those frequenting them opportunities for respite, inclusion, belonging, and routine. They become Pou Whirinaki through enactments of Māori relational values and practices that foster a sense of ontological security, cultural continuity, and shared humanity

Copyright of Cities, Communities & Territories / Cidades, Comunidades e Territórios is the property of Instituto Universitario de Lisboa, DINAMIA-CET and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of O Social em Questão is the property of Faculdades Catolicas - Pontificia Universidade Catolica do Rio de Janeiro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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.

This study sought to clarify the lifestyle and physical and mental health status of homeless people in a cold region of Japan. 28 participants who visited a soup kitchen completed the physical health check-up and questionnaire surveys in 2017. Five were invited to participate in semi-structured interviews in 2018. Mental health was evaluated using the General Health Questionnaire-28 (GHQ-28). The results revealed that a high proportion of homeless people did not consume enough food. Their meat, fish, and vegetables intake were limited, indicating that inappropriate eating habits may affect physical health. Furthermore, four people consumed meals once or less every two days, and all of them were living on the street. In addition, 18% (n = 5) answered that they often consumed alcohol in the daytime, and 68% (n = 19) had a total GHQ-28 score above the cut-off point (>5). In this regard, among those with a GHQ-28 score of >5, seven drank in the daytime even though they consumed meals once or less a day. Indeed, qualitative results revealed physical and psychosocial distress experienced, including limited access to food, anxiety for the future, lack of social support, and erosion of self-esteem. These findings suggest that restrictions on food selection due to financial insecurity, alcohol issues, and mental disorders may impact the food intake and subsequently lead to deteriorating physical health and living on the street may also significantly impact mental health among the homeless. which are helpful for health and social workers to develop necessary interventions targeted at this population.

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.

Displaced people from Afghanistan comprise the largest protracted refugee population in Asia and the second-largest refugee population in the world. For nearly 40 years, most Afghan refugees have been received in neighboring Iran and Pakistan. In Iran, they have been provided with such provisions as healthcare, education, housing, employment, food, visas, and continuing residence. However, many Afghan refugees face significant barriers in accessing services, particularly when it comes to undocumented persons. This study identifies the factors affecting homelessness among refugees, drawing on interviews with eight Afghan men. We explore a four key elements (4Es) construct for supporting the empowerment of refugee people in Iran through education, employment, economic, and emotional support. The study argues that the 4Es approach can alleviate homelessness among refugees.

This article examines the gendered and classed dynamics of homelessness and displacements in Portugal. I use the lens of displaced survival to bring light to the complex web of relations that promote the housing exclusion of low-wage single mothers. I show how these families, expelled from housing programmes and unable to afford housing in the private rental sector, are left to suffer from a cycle of displacements, leading to accentuated poverty and dispossession, which also leads to over-generational perpetuation of poverty. Methodologically the study draws from life-history interviews and policy analysis, conducted from 2017 to 2019 in Lisbon. In addition to being exploited within paid and unpaid labour and having to pay an unaffordable rent, displacements and evictions exacerbate the dispossession and poverty of these families, given that their specific conditions as low-income single mothers are not recognised within the policy responses.

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Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Couchsurfing, or temporarily staying with friends, extended family, acquaintances, or strangers, is a growing form of homelessness within Australia, and particularly concentrated among youth. System involvement with child welfare and its link to youth homelessness has previously been well-established, but not within the context of couchsurfing. In interviews with 19 young people with both couchsurfing and a history of system-involvement, we identify and describe six different pathways into couchsurfing. These pathways extended from the beginning to the end of their child safety involvement, and demonstrate how fear of reprisal for reporting, fear of out-of-home-care, and lack of transition planning pushed-or-pulled young people into couchsurfing. These findings indicate the link between couchsurfing and child safety involvement began very early in the investigative process, suggesting multidisciplinary service teams that include housing support should be involved in initial contact. We also echo the recommendations of other researchers to prioritise Housing First programming and risk assessment for evaluating young people’s living spaces.

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.

This article summarizes findings from a scan of COVID-19 policies in Ontario that impact individuals experiencing homelessness. We collected and analyzed policy data between March 2020 and August 2020, from 10 cities, including all municipal-level restrictions and public health measures implemented in response to COVID-19. From our scan, we found that 161 policies had direct or indirect implications for people living in homelessness. These policies were organized into categories that describe ‘where’ effects were seen – which most often relate to requirements for physical distancing. Some of the most obvious impacts relate to reduced access to needed services and supports in light of non-essential business closures and other service disruptions. Other key impacts relate to the use of public spaces during the pandemic - including access to sanitation facilities, encampment bylaws, changes to public transit services, quarantine and isolation mandates, and the impact of a province-wide stay-at-home order. Overall, in reviewing local responses to the pandemic, it is critical to consider the disproportionate impacts of restrictive public health measures on already marginalized groups and continue to learn about strategies that aim to protect all members of society.

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.

Context: People experiencing homelessness and alcohol dependence are highly marginalized as they struggle to access various health and social services. This study is part of a broader feasibility study on the implementation of "wet services" in Montréal, Canada. Methods: Four focus groups were conducted with 20 participants working in the field of homelessness. The objectives of this study were to gather their perspectives on the need for wet services in Montréal, define the main purpose of such services, and identify the key factors promoting their success. Results: All participants felt that wet services could meet several critical needs of many people experiencing homelessness in Montréal, and most argued that they should also be implemented without delay. According to most participants, these services should be grounded in a harm reduction philosophy, take a low-threshold approach and be accessible to the target population at all times. Participants argued that wet services should primarily aim to offer a safe place to consume alcohol whilst also serving as a place where people experiencing homelessness could meet their basic needs, reconnect socially, and access various health and social services. However, participants cited a number of financial, logistical, and organizational constraints, such as control-related mechanisms (e.g., eligibility criteria, rigid bylaws, or the institutionalization and medicalization of services), which they feared could stand in the way of achieving the objectives of wet services or perpetuate the exclusion of people experiencing homelessness. To avoid these potential problems, most participants felt that wet services should be delivered by well-established and well-funded community-based organizations, accompanied by a variety of partnership arrangements, including those with health services. Conclusion: This qualitative study contributes to the growing body of evidence on alcohol-related harm reduction services. Its findings may serve to inform the eventual implementation of wet services in Montréal and in other locations.

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.

This systematic review describes the international grey literature addressing housing stabilization support models for youth. The review yielded 15 reports with a range of information on preventative activities that focus on well-being embedded within the various form of housing stabilization. These approaches build on the premise that housing alone does not provide an effective solution to youth homelessness. Analyses of the content of these reports revealed both cross-cutting, process-oriented themes, alongside descriptions of the outcomes associated with specific intervention models. These findings emphasized the importance of intersectoral collaboration, early intervention coupled with intensive case management, and applying an attachment-oriented theoretical framework in guiding model implementation. Other highlighted results include specific models of housing stabilization with a particular concentration on housing intervention programs that address the interdependency between housing, income, and education. These stabilization supports, practices, and policies offered by organizations were associated with improved outcomes. This review, however, was limited by a lack of controlled studies amongst the reports and, in many instances, a lack of clarity regarding the service models delivered. Despite these limitations, this review provides an overall view of the grey literature evidence regarding the strategies to support young people in transition out of homelessness that complements and expands upon the academic literature in this area. Further research is needed with clearer and more rigorous methods, more detailed intervention descriptions, as well as data on applicability for visible minorities and specific employment interventions tied with housing supports.

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.

Canadian homeless service providers (HSPs) serve individuals with complex needs. COVID-19 has introduced additional challenges to service provision leading to increased pressure on the organizations and the staff they employ. Little is known about how Canadian HSPs were affected by the global pandemic. The current research sought to address this knowledge gap by using qualitative research methodology to assess leaders’ perception of staff well-being and identify specific organizational challenges associated with the COVID-19 pandemic. 42 semi-structured interviews were conducted with senior leadership in Canadian HSPs, including Program Directors, Executive Directors, CEOs, key department managers and program coordinators. Although unanticipated, themes relating to positive outcomes and growth were also identified. Qualitative analysis revealed four overarching themes within the data: Organizational Challenges, Individual Challenges, Organizational Opportunities and Individual Opportunities. Implications of this study include informing pandemic preparedness in the homelessness sector and reducing occupational risks for staff.

The coronavirus disease 2019 (COVID-19) pandemic affected the homeless serving sector in significant ways, including impacts on service users and service providers. In this qualitative case study from Ottawa, Canada, we conducted 28 semi-structured interviews with service providers and key informants from the homeless serving sector to learn more about responses to the pandemic. We argue that, as it is currently designed, the homeless serving sector had limited opportunity to respond to the combined crises in housing, overdose, and COVID-19 with a transformative agenda. The article draws on Dej’s (2020) concept of the homelessness industrial complex, which argues that current systems manage and sustain rather than end homelessness. And we use Lipsky’s (1969; 1980) notion of street-level bureaucracy to explore the role of service providers as they translated shifting public health guidelines into action on the ground within contexts of ambiguity and constraint. Service providers were tasked with keeping people safe from COVID-19 while managing broader social issues such as homelessness, food insecurity, mental health challenges, and an increasingly poisoned illicit drug supply. They described challenges such as narrowly directed funding and short-term and temporary solutions to homelessness. Staff faced significant occupational stress and burnout within demoralizing contexts (Kerman & Kidd, 2021; Kerman et al., 2022). Despite new partnerships and innovative approaches that emerged, responses to the pandemic in Ottawa were shaped by the homelessness industrial complex and did not significantly contribute to ending homelessness. Even so, public health measures were able to disrupt business as usual in the sector, sparking the question: what might be possible if homelessness comes to be understood as a public health crisis?

The Coronavirus Disease 2019 (COVID-19) pandemic has placed a magnifying glass on what we have been seeing for a long time. With large-scale impacts across the globe, an increased burden has been placed on people experiencing homelessness who already face barriers to necessities such as housing, food, and quality health care. This qualitative descriptive study explored the experiences of people experiencing homelessness during the COVID-19 pandemic and of those working for supporting organizations in the Greater Boston Area between July-November 2020. Additionally, the study identified key recommendations for policymakers or service providers to use in creating inclusive policies and emergency response plans that consider the needs of the homeless community. The study comprised individual interviews and focus group discussions from two groups: 1) employees from supporting organizations (medical organizations, shelters, universities, and housing organizations) and 2) people experiencing homelessness. An inductive content analysis of interview transcripts was conducted to identify emerging themes and recommendations. Community dialogues were held with participants to confirm results and explore any new potential topics or recommendations. Four key themes were identified from interviews: 1) Social inclusion, 2) Services and resources, 3) Community support and collaboration, and 4) Government response and policy. Overall, the COVID-19 pandemic has highlighted major gaps in existing support for people experiencing homelessness on the state and federal levels while also emphasizing the importance of community support and collaboration for this vulnerable population. Further work must be conducted to develop and implement more inclusive policies and regulations to support this community.