School of Psychology, University of Ottawa, Ottawa, ON, Canada.
Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, Canada.
Int J Soc Psychiatry. 2020 Jun;66(4):389-396. doi: 10.1177/0020764020913324. Epub 2020 Mar 24.
A range of health and social services exist to address the many life adversities experienced by people with mental illness. However, the effects of services on their recovery in the context of ongoing homelessness and poverty have been minimally examined.
This qualitative study sought to better understand the role of health and social services in the recovery processes of people with mental illness and histories of homelessness. Similarities and differences in the perceived impacts of services on recovery between currently and formerly homeless participants were also explored.
In-depth interviews were conducted with 52 currently and formerly homeless people with mental illness. Informed by a recovery framework, qualitative data were analyzed using two cycles of coding.
Services were perceived to affect recovery by (1) finding ways to cope and get by, (2) feeling less alone, (3) giving back, (4) being dehumanized or seen as someone and (5) encountering restrictions when getting help. Experiences of discrimination, fewer opportunities to give back and limited service options were heightened among participants experiencing homelessness compared to the housed group.
Health and social services can promote and hinder recovery among currently and formerly homeless people with mental illness. Despite several differences between the two groups, the relationship between recovery and service use was similar for currently and formerly homeless participants, suggesting that both groups access services to address needs related to social connection, health and functioning and meaningful activities.
存在一系列卫生和社会服务,以应对患有精神疾病的人所经历的许多生活逆境。然而,在持续无家可归和贫困的情况下,服务对他们康复的影响很少被研究过。
这项定性研究旨在更好地了解卫生和社会服务在有精神病史和无家可归经历的人的康复过程中的作用。本研究还探讨了目前和以前无家可归的参与者对服务对康复的影响的相似和不同之处。
对 52 名目前和以前无家可归的患有精神疾病的人进行了深入访谈。在康复框架的指导下,使用两轮编码对定性数据进行了分析。
服务被认为通过以下方式影响康复:(1)寻找应对和生存的方法,(2)感到不那么孤独,(3)回馈,(4)被非人化或被视为某人,以及(5)在寻求帮助时遇到限制。与有住房的人相比,无家可归的参与者经历了更多的歧视、更少的回馈机会和有限的服务选择,这些经历加剧了他们的康复体验。
卫生和社会服务可以促进和阻碍目前和以前无家可归的患有精神疾病的人的康复。尽管两组参与者之间存在一些差异,但康复和服务使用之间的关系对目前和以前无家可归的参与者是相似的,这表明两组参与者都利用服务来满足与社会联系、健康和功能以及有意义的活动相关的需求。