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1. 'I can’t remember the last time I was comfortable about being home': lived experience perspectives on thriving following homelessness

Author

Carrie Anne Marshall, Brooke Phillips, Julia Holmes, Eric Todd, River Hill, George Panter, Corinna Easton, Terry Landry, Sarah Collins, Tom Greening, Ashley O’Brien, Marlo Jastak, Rebecca Ridge, Rebecca Goldszmidt, Chelsea Shanoff, Debbie Laliberte Rudman, Alexandra Carlsson, Suliman Aryobi, Jessica Szlapinski, Rozelen Carrillo-Beck, Nicole Pacheco, Shauna Perez, and Abe Oudshoorn

Subjects
social justice, health equity, housing, health systems, poverty, community integration, meaningful activity, mental health, substance use, Medicine (General), R5-920
Abstract

Purpose Strategies for preventing and ending homelessness are frequently measured by their effectiveness on indices of tenancy sustainment. To shift this narrative, we conducted research to identify what is needed to “thrive” following homelessness from the perspectives of persons with lived experience in Ontario, Canada. Methods Conducted in the context of a community-based participatory research study aimed at informing the development of intervention strategies, we interviewed 46 persons living with mental illness and/or substance use disorder [n = 25 (54.3%) unhoused; n = 21 (45.7%) housed following homelessness] using qualitative interviews. A subsample of 14 participants agreed to engage in photovoice interviews. We analysed these data abductively using thematic analysis informed by health equity and social justice. Results Participants described experiences of “living in a state of lack” following homelessness. This essence was expressed through four themes: 1) housing as part one of the journey to home; 2) finding and keeping “my people”; 3) meaningful activity as critical for thriving following homelessness; and 4) struggling to access mental health supports in the context of challenging circumstances. Conclusions Individuals struggle to thrive following homelessness in the context of insufficient resources. There is a need to build on existing interventions to address outcomes beyond tenancy sustainment.

Published
2023
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2. ‘We stick people in a house and say okay, you're housed. The problem is solved’: A qualitative study of service provider and organisational leader perspectives on thriving following homelessness

Author

Carrie Anne Marshall, Brooke Phillips, Julia Holmes, Eric Todd, River Hill, George Panter, Corinna Easton, Terry Landry, Sarah Collins, Tom Greening, Ashley O'Brien, Marlo Jastak, Rebecca Ridge, Rebecca Goldszmidt, Chelsea Shanoff, Debbie Laliberte Rudman, Alexandra Carlsson, Suliman Aryobi, Shauna Perez, and Abe Oudshoorn

Subjects
Sociology and Political Science, Health Policy, Public Health, Environmental and Occupational Health, Social Sciences (miscellaneous)
Abstract

Research aimed at identifying and evaluating approaches to homelessness has predominately focused on strategies for supporting tenancy sustainment. Fewer studies focus on strategies for enabling thriving following homelessness, and the perspectives of service providers and organisational leaders (SPOL) on this topic are rare. We conducted this study in the context of a community-based participatory research project in two cities in Ontario, Canada. This research was aimed at identifying the strengths and challenges of existing supports in enabling thriving following homelessness, followed by co-designing a novel intervention alongside persons with lived experience of homelessness (PWLEH) and SPOL. The current study presents the findings of interviews conducted in 2020-2021 with SPOL in organisations serving PWLEH. We interviewed 60 individuals including service providers (n = 38; 63.3%) and organisational leaders (n = 22; 36.7%) using semi-structured qualitative interviews. Interviews were conducted and recorded on Zoom to align with physical distancing protocols associated with the COVID-19 pandemic. Recordings were transcribed verbatim and analysed abductively informed by the lenses of social justice and health equity. The essence of our findings is represented by a quote from a research participant: 'We stick people in a house and say okay, you're housed. The problem is solved'. This essence was expressed through five themes: (1) stuck in a system that prevents thriving, (2) substance use as an important coping strategy that prevents tenancy sustainment and thriving, (3) the critical importance of targeting community integration following homelessness, (4) incorporating peer expertise as imperative and (5) people need to be afforded options in selecting housing and services following homelessness. Our findings indicate that SPOL envision possibilities of thriving following homelessness yet are embedded within a system that often prevents them from supporting individuals who are leaving homelessness to do so. Research, practice and policy implications are discussed.

Published
2022
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