Archard P J, Murphy D
Centre for Social Work, School of Sociology and Social Policy, University of Nottingham, Nottingham, UK.
School of Education, University of Nottingham, Nottingham, UK.
J Psychiatr Ment Health Nurs. 2015 Aug;22(6):360-70. doi: 10.1111/jpm.12229.
Homeless persons are known to be highly vulnerable to psychological trauma, in events triggering periods of homelessness and the considerable social isolation and adversity suffered when homeless. This study provides an account of how mental health support work is experienced by homeless service users when it is informed by a person-centred, non-directive approach and implemented by trainee health and social care professionals under the auspices of a specialized psychological trauma service. The study draws upon material gathered from interviews with service users domiciled in supported housing for homeless persons and support workers who practiced on the programme. The service users who participated in the study valued support work that combined practical and relational elements, but would have preferred a longer-term involvement. They also spoke of feelings of disconnection and estrangement from others including their peers in supported housing. The support worker participants valued the flexibility they had when working on the programme to tailor their intervention to service users' individual needs. Practice implications of the study are discussed. These include the need to minimize barriers to accessing support, facilitate informal time between professionals and homeless service users, and manage intervention endings sensitively when temporary staffing arrangements are in place.
Homeless people are a population known to be highly vulnerable to trauma, in triggering events to becoming homeless and the considerable social isolation, discrimination, and adversity suffered when homeless. Currently, there is a paucity of research into mental health service delivery to homeless persons and the influence it imparts in individual lives. This article presents a qualitative 'practice research' study into a pilot programme of social support work delivered in a specialized psychological trauma service to homeless service users. The programme was grounded in a non-directive, person-centred approach and staffed by student social workers. The study aim was to explore the support work programme as it was received by service users domiciled in supported housing for homeless persons, encompassing experiencing the programme, worker-service user engagement and contextual influences bearing upon positive outcomes. Narrative interviews gathered the impressions of service users and support workers and the data arising from these interviews was analysed thematically. Service user participants valued support work that combined practical and relational elements, but would have preferred a longer-term involvement. They also spoke of feelings of disconnection and estrangement from their peers in the supported accommodation and their families. The worker participants valued the flexibility of person-centred work tailored to service users' individual needs and echoed service user concerns around the short-term nature of their involvement. Psychiatric nurses carrying out, or supervising, mental health support work with homeless service users should be mindful of the potential impact of temporary staffing arrangements on continuity of care. They should also consider how working from a person-centred perspective and addressing client's practical needs may aid in developing rapport and trust with homeless service users.
Accessible总结:众所周知,无家可归者极易受到心理创伤,无论是在导致无家可归的事件中,还是在无家可归时遭受的严重社会隔离和困境中。本研究描述了以个人为中心、非指导性方法为指导,并由实习健康和社会护理专业人员在专门的心理创伤服务机构的支持下实施的心理健康支持工作,无家可归服务使用者对此有何体验。该研究借鉴了对居住在无家可归者支持性住房中的服务使用者以及参与该项目的支持工作者进行访谈所收集的资料。参与研究的服务使用者重视结合实际和关系要素的支持工作,但更希望有长期的参与。他们还谈到与他人,包括在支持性住房中的同龄人,有脱节和疏离的感觉。参与研究的支持工作者重视在项目工作中根据服务使用者的个人需求调整干预措施的灵活性。讨论了该研究对实践的启示。这些启示包括需要尽量减少获得支持的障碍,促进专业人员与无家可归服务使用者之间的非正式交流时间,以及在临时人员安排到位时敏感地处理干预的结束。
无家可归者人群极易受到创伤,无论是在导致无家可归的触发事件中,还是在无家可归时遭受的严重社会隔离、歧视和困境中。目前,对为无家可归者提供心理健康服务及其对个人生活的影响的研究很少。本文对在专门的心理创伤服务机构中为无家可归服务使用者提供的社会支持工作试点项目进行了定性的“实践研究”。该项目以非指导性、以个人为中心的方法为基础,由学生社会工作者提供服务。研究目的是探索居住在无家可归者支持性住房中的服务使用者所接受的支持工作计划,包括体验该项目、工作者与服务使用者的互动以及对积极成果产生影响的背景因素。叙事访谈收集了服务使用者和支持工作者的印象,并对这些访谈产生的数据进行了主题分析。参与研究的服务使用者重视结合实际和关系要素的支持工作,但更希望有长期的参与。他们还谈到在支持性住所中与同龄人以及家人有脱节和疏离的感觉。参与研究的工作者重视以个人为中心的工作的灵活性,这种灵活性是根据服务使用者的个人需求进行调整的,并回应了服务使用者对其参与的短期性质的担忧。为无家可归服务使用者提供或监督心理健康支持工作的精神科护士应注意临时人员安排对护理连续性的潜在影响。他们还应考虑从以个人为中心的角度开展工作并满足客户的实际需求如何有助于与无家可归服务使用者建立融洽关系和信任。