Adams Emma A, Brennan-Tovey Kerry, McGrath Joanne, Thirkle Steven, Jain Neha, Aquino Maria Raisa Jessica, Bartle Victoria, Kennedy Joanne, Ogden Margaret, Parker Jeff, Koehne Sophie, Kaner Eileen, Ramsay Sheena E
Newcastle University, UK.
Northumbria University, London, UK.
Trauma Violence Abuse. 2024 Nov 6:15248380241286839. doi: 10.1177/15248380241286839.
Trauma can be both a cause and a consequence of homelessness and has lasting impacts on mental health and wellbeing. Often research focusses on trauma and adversity in childhood leading to homelessness, but understanding traumatic experiences during adulthood homelessness can be just as important for informing intervention development and policies to mitigate and eradicate homelessness. Working with people with lived experience of homelessness, this review aimed to synthesis the qualitative evidence exploring the impact of trauma during homelessness on mental health (including substance use) from the perspective of adults (18 years of age and older) experiencing homelessness. Alongside gray literature, ASSIA, CINAHL, Cochrane, EMBASE, MEDLINE, Proquest theses and dissertations, PsychInfo, Scopus and Web of Science were searched from inception until February 2024. No language, date, or geographical limits were applied. A 'best-fit' framework synthesis of 26 papers, covering the experience of over 900 people, identified three overarching themes linked with the SAMHSA three E's of trauma: 1) making sense of homelessness as a trauma, 2) dealing with the impacts of trauma and 3) responses to repeated exposure to trauma. Trauma rarely takes place in isolation and often prior experiences shape how people experiencing homelessness make sense and cope with trauma. Policy and prevention should prioritise early intervention to reduce the mental health burden of trauma and homelessness. Additionally, creating support that empowers and builds resilience will encourage more positive management strategies.
创伤既是无家可归的一个成因，也是其一个后果，对心理健康和幸福有着持久影响。通常，研究聚焦于童年时期导致无家可归的创伤和逆境，但了解成年无家可归期间的创伤经历对于制定干预措施和政策以减轻及消除无家可归现象同样重要。本综述与有过无家可归经历的人合作，旨在综合定性证据，从18岁及以上成年无家可归者的角度探索无家可归期间创伤对心理健康（包括物质使用）的影响。除灰色文献外，从创刊至2024年2月，还检索了ASSIA、CINAHL、Cochrane、EMBASE、MEDLINE、Proquest学位论文、PsychInfo、Scopus和科学网。未设语言、日期或地理限制。对26篇论文进行“最佳拟合”框架综合分析，涵盖900多人的经历，确定了与美国药物滥用和精神健康服务管理局（SAMHSA）创伤三要素相关的三个总体主题：1）将无家可归理解为一种创伤，2）应对创伤的影响，3）对反复遭受创伤的反应。创伤很少单独发生，先前的经历往往塑造了无家可归者理解和应对创伤的方式。政策和预防应优先考虑早期干预，以减轻创伤和无家可归带来的心理健康负担。此外，创造赋权并增强复原力的支持将鼓励更积极的管理策略。
