Centre for Addiction and Mental Health, Toronto, ON, Canada.
MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.
J Urban Health. 2022 Oct;99(5):842-854. doi: 10.1007/s11524-022-00680-0. Epub 2022 Sep 7.
Emergency shelters are a core component of homeless service systems that address immediate basic needs. Service bans, which refer to temporary or permanent disallowances from a program or organization, are an underresearched phenomenon that can leave people experiencing homelessness without needed supports. This exploratory study examined the factors associated with shelter bans among people experiencing homelessness using secondary data from two Canadian studies: (1) a multisite randomized controlled trial of Housing First (At Home/Chez Soi Demonstration Project) and (2) a cross-sectional survey of youth experiencing homelessness across Canada (2019 Without a Home-National Youth Homelessness Survey). The two datasets were analyzed separately using logistic regression models with similar predictors to maximize the comparability of the results. Participants who experienced homelessness at an earlier age and had recent criminal justice system involvement were more likely to have shelter bans in both datasets. Impaired impulse control, more chronic medical conditions and living in Toronto were associated with increased likelihood of shelter bans in the At Home/Chez Soi dataset, whereas more adverse childhood experiences, physical violence victimization, engagement in survival sex behaviours and longer current episodes of homelessness were significant predictors of bans in the Without A Home dataset. Overall, the findings suggest that victimization and criminalization during homelessness may increase the risk of shelter loss from bans and further exclusion. The observed regional differences also highlight the potential limits of individual-level predictors. Further research is needed on shelter ban outcomes, as well as how capacity limits and organizational policies affect banning decisions.
紧急避难所是解决无家可归者基本需求的核心服务系统组成部分。服务禁令是指暂时或永久禁止一个项目或组织参与某项服务,这是一个研究不足的现象,可能会导致无家可归者失去所需的支持。本探索性研究使用两项加拿大研究(1:住房优先(安家/在家示范项目)的多地点随机对照试验;2:加拿大各地青年无家可归情况的横断面调查(2019 年无家可归者全国青年无家可归调查)中的二次数据,调查了与无家可归者的避难所禁令相关的因素。两个数据集都使用逻辑回归模型进行了单独分析,这些模型使用了相似的预测因子,以最大限度地提高结果的可比性。在两个数据集中,更早经历无家可归和最近有刑事司法系统参与的参与者更有可能被禁止进入避难所。冲动控制受损、更多慢性疾病和居住在多伦多与安家/在家数据集中的避难所禁令的可能性增加相关,而更多的童年逆境经历、身体暴力受害、从事生存性行为和更长的当前无家可归期是无家可归数据集中禁令的显著预测因素。总体而言,研究结果表明,无家可归期间的受害和犯罪可能会增加因禁令而失去避难所和进一步被排斥的风险。观察到的地区差异也突出了个体层面预测因素的潜在局限性。需要进一步研究避难所禁令的结果,以及能力限制和组织政策如何影响禁令决策。