Individuals experiencing extended homelessness face multifaceted risks in physical health, nutrition, substance use, mental health, continuing unemployment, and incarceration. Some of these adults may benefit from learning a problem-solving decision-making method to assist them in dealing with everyday problems they encounter. This study taught three men with extensive histories of homelessness, but who were currently housed, the SODAS problem-solving decision-making method, and assessed their ability to learn it and guide another adult in the use of the method in simulated role-play problem situations. The acquisition of SODAS from behavioral rehearsal training was evaluated using a multiple-baseline design across participants' role plays during the baseline, and post-training SODAS conditions. After demonstrating their ability to successfully guide another adult through the SODAS process when role-playing problem situations relevant to this population, the participants were instructed and provided SODAS forms for applying this method to their own every day lives' social and non-social problem situations. Social validity follow-up meetings were conducted weekly with each participant, and assessed the extent to which he reported the use and helpfulness of the SODAS method in addressing everyday life issues.

INTRODUCTION: Healthcare needs among homeless populations are difficult to meet within the scope of a standard healthcare model. A street medicine model addresses the specific needs of those experiencing homelessness; healthcare professionals seek to build trust and rapport with people who are living unsheltered by taking their clinical practice to the streets. The street medicine program evaluated in this study provides primary and behavioral care in a metropolitan area in the Southeastern United States. AIM: This program evaluation aimed to answer the following questions: how has the street medicine program affected the perceptions of ill-health and access to healthcare among its current patients? Further, how would the current patients of the street medicine program rate their satisfaction with the program and are they aware of all available services? METHODS: Using a mixed methods approach, 40 semi-structured interviews and participant observations were conducted with patients of the street medicine program. Participants were asked to rate their satisfaction with the program and their overall health status on a 5 point Likert scale. Informed by Consensual Qualitative Research (CQR) analysis methods, the qualitative data were transcribed and coded. All quantitative analyses were done using SPSS. RESULTS: Overall, 70% of participants rated their satisfaction with the street medicine program as excellent (n=28). For self-rated health status, there was a normal distribution across the Likert scale with 43% reporting their overall health status as moderate (n=17). Using CQR, four key domains emerged from the qualitative data: community trust, rapport building, needs addressed, and needs not addressed. These domains encompassed specific participant responses. Examples include: heard about the street medicine program through word of mouth (community trust), team showed kindness (rapport building), received diagnosis and treatment (needs addressed), and needing help getting into housing (needs not addressed). CONCLUSION: Overall, this study validated the effectiveness of the street medicine program in building trust and rapport with its patients. Satisfaction with the street medicine was high across patients. This study contributes information regarding patient experiences within an alternate healthcare model serving a highly vulnerable population.

This case study examines the history and structure of Art from the Streets (AFTS) a community-based art (CBA) program in Austin, Texas that for the past twenty years has offered art classes twice a week to the local homeless community. The purpose of this study is to determine if and how well AFTS integrates essential CBA components that define best practices of CBA programs that serve the homeless into their program. This study combines researcher observations with the firsthand perspective of the AFTS program, volunteers, and participants secured through class observations and interviews conducted to gain knowledge about the inner workings of the AFTS program. / text

This study aims to examine how the interventions for homeless persons in the municipality of Kalmar are organized. The study is based on four half-structured qualitative interviews with both representatives from different instances and also from persons who have experience of being homeless. The theoretical bases we have used to analyze the material are organization theory, specifically the concept of bureaucracy. Our results show that homelessness is not seen as a problem in itself, since the general view is that homeless people often have a complex problem scenario where drug- and alcohol abuse and mental illness are common. It is often the latter that takes priority in the interventions and the housing question is therefore neglected. We also found that social services do not have a satisfactory structure around the organization of the work on homelessness. They do not have any specific device in Kalmar that focus on homelessness issues with the result that the existing units are forced to take care of the work of homelessness. This represents a problem as the interventions are being adapted to this area of specialization with the result that the housing issue is overlooked. Another conclusion is that there is a lack of long-term solutions in the municipality. Today the efforts are mainly aimed at placing homeless people in short-term temporary accommodation.

Šiame darbe yra analizuojama benamių socialinė integracija į visuomenę. Ši problema atsirado Lietuvoje atkūrus nepriklausomybę ir pertvarkius planinę ekonomiką į rinkos. Po staigių ekonominių ir socialinių pasikeitimų, atsirado paklausos mažėjimas, išaugo nedarbingumo lygis, krito pragyvenimo lygis. To pasekmėje, dalis visuomenės neįgalėjo prisitaikyti prie naujų gyvenimo sąlygų, taigi atsirado naujas reiškinys – benamių subkultūra. Patekus į šią subkultūrą yra labai sunku iš jos išsiveržti, kadangi žmonės prisitaiko ir net įpranta prie tokio gyvenimo būdo. Benamiai praranda socialinius ir profesinius įgūdžius, negali savarankiškai išspręsti asmeninių problemų, nesugeba pasinaudoti viešojo sektoriaus tiekiamomis paslaugomis. Benamystės problema Lietuvoje yra a����tri ir aktuali visuomenės problema. Ji yra mažai nagrinėta. Benamystės problemai skiriama pernelyg mažai dėmesio, trūksta objektyvios ir patikimos informacijos. Lietuvoje yra išleisti įstatymai, reglamentuojantys įvairių socialinių grupių integravimą į visuomenę: asmenų, grįžusių iš kalėjimo, neįgaliųjų, rizikos grupių šeimų, imigrantų. Tačiau benamiais tampa asmenys, priklausantys visoms socialinėms grupėms, todėl jie turėtų būti išskirti kaip atskira socialinė grupė, kurios socialinę integraciją reglamentuotų įstatymai. Šio darbo tikslas – ištirti benamių išsilavinimo įtaką socialinės integracijos procesui. Uždaviniai: 1. Panagrinėti benamystės reiškinį ir jo atsiradimo priežastis. 2. Ištirti... [toliau žr. visą tekstą] / The problem of homeless social integration into society is analyzed in this work. This problem occurred in Lithuania after regaining independency and reforming planar economy into market economy. After sudden economical and social changes production recession showed up, increased unemployment and decreased living standards. As a result part of a society didn’t manage to adapt to changes taking place, therefore a new phenomenon appeared – homeless subculture. Got into this subculture it’s very hard to get out because people adapt and even become accustomed to such life. Homeless have lost their social and professional skills, they can’t resolve their problems on their own, can’t avail of public sector afforded services. Problem of homelessness is topical and studied little in Lithuania. Little attention is given to this problem, there’s lack of objective and reliable information. There is laws released regulating integration of different social groups into society: individuals, which returned from prison, the disabled, risk group families, refugees. However homeless becomes individuals belonging to all social groups, that’s why they should be pointed out as separate group whose social integration was regulated by separate laws. Objective of this work is to analyze possibilities of homeless social integration into society. Tasks: 1. To study phenomenon of homelessness and its origin of cause. 2. Examine homeless social integration implementation principles and ways. 3... [to full text]

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Bakgrund: Begreppet hemlöshet innefattar flera situationer. Det är svårt att veta hur många hemlösa personer som befinner sig i Sverige då hemlöshet även innefattar de som lever utan uppehållstillstånd, papperslösa och asylsökande. Hemlösa personer löper en högre risk av att drabbas av både fysisk och psykisk ohälsa och dåliga erfarenheter av vården kombinerat med en begränsad ekonomi och oklarheter vart i vården de ska vända sig kan göra att hemlösa inte uppsöker vården. Sedan 2013 har både asylsökande och papperslösa rätt till vård som inte kan anstå och enligt hälso-sjukvårds lagen ska vården ges med respekt på lika villkor. Trots detta sker det att papperlösa och asylsökande nekas vård. Syfte: Att beskriva sjukvårdspersonals upplevelse av att vårda patienter som lever i hemlöshet. Metod: Litteraturöversikt med nio vetenskapliga artiklar som valdes ut från databasen Cinahl Complete, Swepub, Pubmed, PsycINFO och Academic Search Complete. Åtta var av kvalitativ karaktär och en använde kvantitativ metod. Dessa analyserades och sammanställdes till tre huvudkategorier och fem underkategorier. Resultat: Litteraturöversikten innefattar följande kategorier: Vårdpersonalens känslor inför hemlösa patienter, Utmaningar av att vårda hemlösa patienter, Hinder i vårdandet, Hinder vid kommunikation och dokumentation, Hinder och utmaningar inför hantering av komplexa vårdbehov, Förhållningsätt i mötet med hemlösa patienter, Ett öppet sinne och en vilja att vårda och Att skapa en vårdrelation med hemlösa patienter. Resultatet visar att vårdpersonalen kan ha både positiva och negativa känslor inför den hemlösa patienten och att det uppkommer hinder i vården av hemlösa. Vårdpersonalen förhållningsätt i vården av hemlösa och skapandet av en vårdrelation kan vara svårt men anses viktigt.  Diskussion: Här diskuteras delar av alla kategorier ifrån resultatet i relation till forskning och Katie Erikssons teori om att ansa, leka och lära och konsensusbegreppet vårdande.

Homeless individuals in Berlin can be included into the group of people who do something more interesting than architects would ever dream of. With their knowledge of the city and the ability to claim spaces, they create their home within the city context. They use the city and what the city offers, to their advantage and create their homes with what is available in the city. They are not homeless. For the "city users" the city becomes home- the city home.To tell the stories of individuals who make the city their home, this thesis describes the daily routine of several individuals (with insights gained from a two-month internship) and appreciates these people for how they manage to survive somewhat independently on the streets of Berlin.It is argued that these individuals are not future clients for architects. Instead, it is suggested that we --architects, designers, planners, policy-makers, and others – have much to learn from those we consider to be homeless. / Department of Architecture

Homelessness is associated with poor health and premature death. Individual’s experiencing homelessness face multiple barriers when accessing health care. Barriers to health care are not limited to administrative issues such as lack of a valid health card or clinic hours but include feeling stigmatized, not respected or marginalized when attempting to access services. These experiences can impact homeless individuals’ willingness to engage with health care providers in the future and have the potential to negatively impact the development and maintenance of a relationship with a provider. Nurses are a point of access into the health care services available to individuals experiencing homelessness and can play a key role in facilitating access to health care. In this research, the experiences of individuals experiencing homelessness when seeking health care were explored. The approach used to guide the research was interpretive description. Interpretive description can have the effect of making one suddenly “see” something in a way that enriches one’s everyday understanding of the lived experiences (Thorne, 2008). Interpretive description while reflecting more traditional aspects of grounded theory as themes are identified and developed during research also utilized the constructivist paradigm. The constructivist paradigm with its’ focus on truth and knowledge coming from the participant supported the interactive link of the relationship between the researcher and the focus of the research on the experience of individuals who are homeless during interactions with community nurses. This study involved in-depth tape recorded conversations with eleven men who had experienced homelessness while seeking health care in the community. The transcribed conversations were analyzed utilizing interpretive description. Each of the participant’s stories are described followed by identification of shared experiences or themes, giving insight into the phenomena of engaging with health care providers, specifically community based nurses, while experiencing homelessness. The intent is to share the lived experience and perspectives embedded in the experiences participants shared, with nurses and health care professionals in the community. The hope is that, through these stories, health-care providers, in particular nurses may develop insights and understanding that can inform both practice and education. / Graduate

Doctor of Clinical Psychology/ Master of Science (DCP/ MSc) / A number of international studies reveal high prevalence rates of posttraumatic stress disorder (PTSD) within homeless populations. Recent research on PTSD indicates that cognitive responses to trauma are critical in determining who develops the disorder. In Australia, a number of studies indicate exceptionally high rates of trauma experience among homeless adults, yet PTSD has not been investigated in this cohort. Therefore, the primary aim of this project was to improve understanding of PTSD and related cognitions in a sample of homeless adults in Sydney. The project attempts to determine the prevalence of PTSD and its onset in relation to homelessness (Study One) and also explores the role of cognitions in PTSD (Study Two). The sample consisted of seventy homeless men and women aged 18 to 73 years, who were randomly sampled through eight homeless services. A computer-assisted face-to-face structured clinical interview was conducted for each participant. The majority of the sample stated that they had experienced at least one traumatic event in their lifetime (98.2%). The twelve-month prevalence of PTSD was higher among homeless adults in Sydney in comparison to the Australian general population (41.1% versus 1.5%). In 59.1% of cases, the onset of PTSD was found to have occurred before the age of the first reported homeless episode. In a comparison of those with and without a current diagnosis of PTSD, it was found that those with PTSD scored significantly higher overall on measures of posttraumatic cognitions and early maladaptive schemas. In particular, this group scored higher on schemas that centre on the world being entirely dangerous and the self being totally inept. A mediational analysis showed that when trauma and mental health care were controlled, the relationship between early maladaptive schemas and PTSD symptom severity was mediated by posttraumatic cognitions. It was concluded that homeless adults in Sydney frequently experience trauma and PTSD, which typically precedes homelessness. It was also concluded that among homeless adults, posttraumatic cognitions and early maladaptive schemas appear to play an important role in PTSD and may be associated with symptom severity. These findings have implications for public policy on homelessness and mental health, homeless service provision, PTSD theory, and PTSD treatment for homeless adults.