Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada.
Providence Care Hospital, Kingston, Ontario, Canada.
Health Soc Care Community. 2022 Nov;30(6):e6018-e6029. doi: 10.1111/hsc.14035. Epub 2022 Sep 21.
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.
旨在识别和评估无家可归问题方法的研究主要集中在支持租房维持的策略上。较少的研究关注使无家可归者在摆脱困境后茁壮成长的策略，服务提供者和组织领导者（SPOL）对此主题的观点也很少见。我们在加拿大安大略省的两个城市开展了这项基于社区参与的研究项目。这项研究旨在确定现有支持措施在促进无家可归者摆脱困境后茁壮成长方面的优势和挑战，然后与无家可归经历者（PWLEH）和 SPOL 共同设计一个新的干预措施。当前的研究介绍了 2020 年至 2021 年期间对服务于 PWLEH 的组织中的 SPOL 进行的访谈结果。我们使用半结构化定性访谈采访了 60 人，包括服务提供者（n=38；63.3%）和组织领导者（n=22；36.7%）。访谈在 Zoom 上进行并录制，以符合与 COVID-19 大流行相关的物理距离协议。录音逐字转录，并根据社会正义和健康公平的视角进行了自由分析。我们的研究结果的本质是一位研究参与者的一句话：“我们把人们塞进一所房子里，然后说，好吧，你有房子住了。问题解决了”。这一本质通过五个主题得到了体现：（1）陷入阻碍发展的系统中，（2）将药物滥用作为阻止租房维持和发展的重要应对策略，（3）在无家可归后将重点放在社区融合上的重要性，（4）纳入同行专业知识的必要性，以及（5）在无家可归后，人们需要有选择住房和服务的机会。我们的研究结果表明，SPOL 设想了无家可归者摆脱困境后茁壮成长的可能性，但他们深陷于一个常常阻止他们支持那些摆脱无家可归的人的系统中。讨论了研究、实践和政策的影响。
