The University of Queensland, St Lucia, QLD, Australia.
Health Soc Care Community. 2020 Jan;28(1):34-41. doi: 10.1111/hsc.12835. Epub 2019 Aug 26.
People who sleep rough/experience unsheltered homelessness face barriers accessing mainstream healthcare and psychosocial services. The barriers to service access exacerbate poor health, which in turn create additional challenges for rough sleepers to access health and psychosocial services, including stable housing. The study presents descriptive statistics to identify housing outcomes of people working with a Multidisciplinary Model that comprises integrated healthcare and psychosocial support, and qualitative data with clients and service providers to investigate how the Model is experienced and delivered in practice. Fieldwork was conducted between December 2016 and March 2018 with the Multidisciplinary Team operating in Cairns, in the far north of Australia. Qualitative data are drawn from in-depth interviews with 26 rough sleepers and 33 health and psychosocial service providers from the Multidisciplinary Team and the wider service system. Descriptive statistics show that 67% of clients who were sleeping rough were supported to immediately access stable housing, and at the end of the program, all clients remained housed. The qualitative findings illustrated how integrated healthcare and psychosocial outreach enabled people sleeping rough to overcome barriers they experienced accessing mainstream healthcare and other services. With the benefit of healthcare, people felt sufficiently well to engage with the psychosocial service providers to have their housing and other psychosocial needs addressed. This article demonstrates how individual responsibility for and control over healthcare is not only a matter of the individual, but also a matter requiring systems change and the active provision of resources to cater for the constraints and opportunities present in people's immediate environments.
无家可归者/露宿街头者在获得主流医疗保健和心理社会服务方面面临障碍。服务获取障碍加剧了健康状况不佳，反过来又给无家可归者获得健康和心理社会服务带来了额外的挑战，包括稳定的住房。该研究提供了描述性统计数据，以确定与多学科模式合作的人的住房结果，该模式包括综合医疗保健和心理社会支持，以及与客户和服务提供者的定性数据，以调查该模式在实践中的体验和实施方式。实地工作于 2016 年 12 月至 2018 年 3 月在澳大利亚最北部的凯恩斯的多学科团队进行。定性数据来自 26 名露宿街头者和 33 名来自多学科团队和更广泛服务系统的卫生和心理社会服务提供者的深入访谈。描述性统计数据显示，67%的露宿街头者得到支持，立即获得稳定的住房，在项目结束时，所有客户都有住房。定性研究结果表明，综合医疗保健和心理社会外展服务使露宿街头者能够克服他们在获得主流医疗保健和其他服务方面遇到的障碍。在医疗保健的帮助下，人们感觉身体足够好，可以与心理社会服务提供者接触，以满足他们的住房和其他心理社会需求。本文表明，个人对医疗保健的责任和控制不仅是个人的问题，也是需要系统变革和积极提供资源的问题，以满足人们直接环境中存在的限制和机会。
