Search

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

Although Housing First (HF) has gained widespread support as a service model to end homelessness, staircase services (SS) continue to proliferate. Critics have argued that SS contribute to institutionalisation and neglect the structural causes of homelessness. However, HF employs an empowerment‐orientated approach which can reduce institutionalisation and enable service users to achieve their potential. In this study, we combined a conceptual framework of empowering service features with the capabilities approach to compare the experiences of service users in HF and SS in Ireland. We carried out four focus group discussions with service users in HF (n = 7) and SS (n = 8). Using thematic analysis, we identified three themes that represented participants' descriptions of services: support orientation, home is more than shelter and organisational and political participation. Autonomy‐orientated support and an emphasis on service user choice and housing afforded HF service users' empowering experiences. The authoritarian approach, and emphasis on housing readiness and provider expertise undermined SS service users' empowering experiences. Findings suggest how HF and SS service features shape service users' lived experiences and perceptions of services. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

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. Highlights: The complexity of users' characteristics can make working with homeless people very stressful.Some features of homeless services are likely to be associated with providers' well‐being.Useful training was associated with higher levels of work engagement and lower levels of burnout.Non useful supervision was positively associated with providers' burnout.Capability‐fostering approach was positively associated with providers' well‐being. [ABSTRACT FROM AUTHOR]

Highlights: Housing First reports more service user recovery but little is known about how this is achieved.Certain features of homeless services are likely to promote service users' recovery.Housing First service users reported more choice, better housing quality, and more satisfaction.Service features predicted independent housing, psychiatric symptoms, and community integration.Across socio‐political and economic contexts, Housing First predicts greater recovery than traditional services. Across Europe, as governments turn to housing‐led strategies in attempts to reverse rising rates of homelessness, increasing numbers of Housing First (HF) programs are being implemented. As HF programs become more widespread, it is important to understand how service users experience them compared to the more prevalent traditional treatment‐first approach to addressing long‐term homelessness. Although there is a large body of research on service users' experiences of Housing First compared to treatment‐first in North American contexts, comparatively less is known about how these two categories of homeless services are experienced in the European context. In a correlational and cross‐sectional study, part of a larger examination of homelessness in Europe, participants (n = 520) engaged with either HF (n = 245) or traditional services (TS; n = 275) programs in seven countries completed measures of their experiences of services (consumer choice, housing quality, and service satisfaction) and recovery (time in independent housing, psychiatric symptoms, and community integration). Across the seven countries, participants engaged with HF programs reported experiencing more consumer choice, better perceived housing quality, and more satisfaction with services than participants engaged in TS programs. Participants in HF programs also reported a greater proportion of time in independent accommodation, fewer psychiatric symptoms, and more community integration. Varying patterns of association between experiences of services and recovery outcomes were observed. Findings indicate HF consistently predicts greater recovery than TS across diverse sociopolitical and economic contexts. Implications of findings for configurations of homeless services and homeless services policy are discussed. [ABSTRACT FROM AUTHOR]

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

Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven “Housing First” program or “treatment as usual” requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choice, mastery, and psychiatric symptoms were measured at six time points. Results indicate a direct relationship between Housing First and decreased homelessness and increased perceived choice; the effect of choice on psychiatric symptoms was partially mediated by mastery. The strong and inverse relationship between perceived choice and psychiatric symptoms supports expansion of programs that increase consumer choice, thereby enhancing mastery and decreasing psychiatric symptoms. [ABSTRACT FROM AUTHOR]