Deficits dominate our culture's narratives of homelessness, associating poverty with lower literacy and skewing social policies about access and equity in schools, jobs, healthcare, and community (Bomer, 2008; Miller, 2011; Miller, 2014; Moore, 2013). Scant, if any, literature exists about literacy and identity in homeless adults, in ways that they might enroll in college and/or seek long-term careers. Yet if one of our roles as educators is to advocate for justice and disrupt social apathy, then we ought to consider more studies identifying literacy strengths (Barton & Hamilton, 1998; Bomer, 2008; Janks, 2010; Miller, 2011, 2014; Moore, 2013) of marginalized groups. In particular, studies examining literacy spaces where homeless adults come together to partake in the writing culture of their town can inform, if not disrupt, what literacies we privilege, and whose. What can we learn about writing and writers, reading and readers when we broaden the boundaries of access to the community? When we appropriate Bakhtin's notion of dialogic tools inside a co-constructed learning space? This dissertation is based on my four-year and ongoing ethnographic observation of, and participation in, the literate lives of 75 men and women in the Community Stories Writing Workshop (CSWW) at a homeless shelter house (SH), a writing group I founded in fall 2010 and for which I am the facilitator. I focus on ways in which members negotiate, through composition, the layers of deficits ascribed to them as youths in school and as adults in transience (Gee, 2012, 2013; Holland, Lachicotte, Skinner, & Cain, 1998; Holland & Lachicotte, 2007) within the physical and mental, social and personal spaces of the CSWW. Implicitly this overarching pursuit assumes that the CSWW is indeed a kind of third space co-constructed by its members, and as such, throughout my dissertation, and particularly in the "pre-profile," I illustrate the various cultural practices and literacies or knowledge funds (González, Moll, & Amanti, 2013; Moje, et al., 2004) that members exchange with one another (and potentially integrate) inside the CSWW. In the first, second, and third profiles, I look at how members position themselves inside this space, as well as how my dual roles as facilitator and researcher affect the practices of the group. I consider, too, the various group dynamics inside the CSWW and ways in which they function as audience for the writers. Questions I ask in this study include: How might the act and process of telling, writing, revising, and sharing nonfiction narratives inside the CSWW afford adults in homeless circumstances the physical and mental, the social and personal spaces to exercise what they know and to construct who they are as literate beings? What identities and literacies do members perform in their stories (e.g., drafts of narratives) and off the page, or outside of their stories relative to audience? How does audience--inside the CSWW and CSWW-sponsored spaces--support and disrupt these self-discoveries and/or enactments for CSWW members--as writers, readers, and literate beings? As my ongoing quest, I wonder how these identities might correlate with those of the narrator's in drafts and the transformative implications of writing.

This chapter describes the implementation of two service-learning courses within the setting of a primary-care clinic for homeless and indigent individuals. The two courses are a campus-wide Introduction to Community Service and a Community Health Nursing Practicum. Although these two courses have different learning outcomes, they both address the primarygoals of service-learning, including (1) developing students' understanding about the responsibility of citizenship and preparing students for effective roles in society; (2) improving students' communication skills, problem-solving skills, and project-specific skills; (3) enhancing students' self-esteem and sense of social reality; and (4) providing an interdisciplinary perspective (Kendall and Associates 1990). The sections that follow describe the setting that the two service-learning courses share, the university-wide course, and the community health nursing practicum. Common issues faced in both courses that are discussed include reflective learning practices, community/client impact, communicating expectations to the student and the site personnel, collaboration to accomplish both service and learning outcomes, and practical issues associated with service-learning in a clinic for the homeless and indigent.

The population of people experiencing homelessness has decreased less than 15% in the last ten years, but issues like mental illness and substance use are rising. There are many misconceptions about race, gender, location and age of people experiencing homelessness. Music therapy research about the homeless population is minimal and often focused on just one setting or treatment location. The purpose of this study was to better understand the relationship between music therapists and people experiencing homelessness. A survey of 365 music therapists in the United States revealed just under half of working clinicians provide services to people experiencing homelessness. Results from the survey revealed the most common settings where music therapists provided service to people experiencing homelessness were mental health, medical, and school systems. Additionally, the results discussed people experiencing homelessness’ demographic differences in clinician’s experiences versus annual reports. Results are not to be generalized but to be used as a tool to better understand people experiencing homelessness.

The author narrates his teenage years as a homeless teen in suburban Washington State and Oregon. Among the items discussed are his struggles with parental drug use, verbal and physical abuse, finding shelter, and everyday life associated with homelessness. Upon establishing a stable living situation, the author explores his efforts to have a relationship with his father, and his eventual fallout with his family.

This cross-sectional study used a weighted sample of ED visits contained in the 2010-2015 years of the National Hospital Ambulatory Care Survey-Emergency Department (NHAMCS-ED) dataset. The purpose of this study was to: 1) identify differences in predisposing, enabling, and need characteristics, and ED use and medication prescribing characteristics between homeless and nonhomeless ED users; 2) assess the association between housing status and medication prescribing at ED discharge, and identify variables contributing to the disparity in medication prescribing between homeless and nonhomeless ED users; and 3) assess the predisposing, enabling, need, and ED use characteristics that predict medication prescribing at ED discharge among homeless ED users. This research is guided by the Andersen-Gelberg Behavioral Model for Vulnerable Populations. There were a total of 502,614,359 visits to EDs located within a MSA made by homeless and nonhomeless adults 18 years of age and older. About 0.9% of these visits were made by homeless individuals. Age, mental health diagnosis, substance use diagnosis, primary payer, and patient-reported pain differed significantly between homeless and nonhomeless ED users. A significantly greater proportion of homeless ED users arrived to the ED via ambulance, and was seen in the last 72 hours. Homeless ED users tended to have longer ED visits, and ED disposition differed significantly between homeless and nonhomeless ED users. A significantly smaller proportion of homeless ED users were prescribed a medication at ED discharge, and an opioid medication at ED discharge. There was no difference in the likelihood of medication prescribing at ED discharge between homeless and nonhomeless ED users after controlling for predisposing, enabling, need, and ED use characteristics. ED diagnosis was the greatest contributor to the disparity in medication prescribing at ED discharge between homeless and nonhomeless ED users. Among homeless ED users, visits covered by Medicare and other payers were significantly more likely to result in medication prescribing at ED discharge compared to nonhomeless ED users covered by private insurance. Homeless ED users with no substance use condition diagnosis were significantly more likely to be prescribed a medication at ED discharge compared to those with a substance use condition diagnosis.

Homeless research has focused on the service-directed approach, but few qualitative studies have focused on the critical and sensitive nature of the intake process. Staff in rural and remote communities struggle to refer services and mainstream resources to homeless veterans. The purpose of this case study was to explore case managers' perspectives on intake procedures in rural Pennsylvania communities. Lewin's force field analysis was used as a theoretical basis to examine the rationale for behaviors and forces that impact an individual's state. Six case managers and 1 supervisor were selected for face-to-face interviews based on their experience, job duties, and length of time involved in homeless services. The themes that emerged from coding analysis included coordinated entry, paperwork length and redundancy, geographical barriers including transportation and employment services, identification and outreach, and case management staff. Findings may be used to improve assessment techniques and critical time intervention strategies to reduce the length of homelessness for rural veterans.

Without interventions to address homelessness among youth, the risk of homelessness for future generations is great. As a result, the federal government has invested in funding Transitional Living Programs (TLPs), though it is not clear whether these programs have achieved the intended outcomes of helping youth transition from homelessness to being able to sustain employment and avoid poverty through access to educational and workforce programs. Using the broad conceptualization of democratic governance as the foundation, the purpose of this case study was to assess whether access to educational programs through TLPs benefitted homeless youth in terms of program success. Data for this study were collected through interviews with 9 administrators of TLP service providers and publicly available documents for the years 2008-2014. Interview data were inductively coded and subjected to thematic analysis, and data from public sources were evaluated using descriptive statistics. Qualitative analysis revealed that long term, post-TLP outcomes were difficult to track as individual TLPs tended to lose contact with youth, though self-advocacy for participants, coupled with the ability to sustain long term independence, were keys to success for program participants. Participants also noted their perception that education through TLPs provide opportunity for stable social and economic connections. Positive social change resulting from this study may be attained if TLP long-term outcomes are evaluated using metrics that are realistic for the target population, and organizational goals are refocused on improving opportunities for youth to make meaningful contributions to their communities, and thereby build the social equity necessary for long-term success.

Over 71% of American homeless individuals are adults over 25 years of age, and the numbers are increasing. Approximately 25% of homeless individuals own a companion animal (CA). Because most service providers do not allow CAs within their facilities, the current $60.2 billion dollar national budget for homeless resources may be underutilized or forfeited altogether by homeless adults with a CA. The purpose of this study was to explore community service utilization by homeless adults with a CA through the lens of attachment theory. The research question addressed the lived experiences and perceptions of homeless adults who own CAs regarding community service utilization. This is a qualitative, hermeneutic phenomenological study in which 11 participants were interviewed individually from a semi-structured, researcher created questionnaire. Participants were homeless adults at an emergency shelter in Texas or Oklahoma where their CAs were allowed. Through coding and thematic analysis, 3 themes developed: familial attachment to a CA, a willingness to forego services that do not accommodate their CA, and false belief in their CA as a necessary service provider. The results of this study builds upon the existing body of knowledge regarding homelessness, CAs, and community services as well as informs service provision, education, and policy. Positive social change implications include awareness of the perceptions and beliefs provided by this unique unsheltered sub-population who experienced physical illnesses, trauma, and a close familial bond with their CA. Their lived experiences are key indicators for community service providers and governmental organizations consideration in reference to budgeting allocations and future research.

In the United States, it is estimated that millions of adults are homeless. Some individuals choose not to use homeless shelters or are ineligible for their use. Researchers have indicated that many unsheltered homeless are men over the age of 45 years. The purpose of this phenomenological study was to examine the experiences with social services providers among unsheltered men. Understanding the social networks of unsheltered homeless and the use of spirituality or faith as a resource for coping was also examined, as a significant gap exists in the research on unsheltered homeless. Face-to-face, in-depth interviews were conducted with 8 men age 45 years and older to explore the lived experience of being unsheltered. A social constructivism framework and the theory of social capital were used to guide the data interpretation. Using the Giorgi data analysis method for inductive data analysis, 4 themes emerged from the data. The themes were difficulties and complexities of being unsheltered, barriers to becoming sheltered, specific needs of unsheltered homeless men, and the way in which faith sustains the unsheltered. The results of the study can promote positive social change by helping policy makers understand the unique needs of unsheltered men. As such, a reduction in the number of homeless living on the street can occur by reallocating funding to programs that address the unmet needs of unsheltered individuals.

A partir de três notas, desenvolveu-se neste trabalho a investigação do laço social, ou daquilo que se desvela do laço social, na escuta clínica com sujeitos que moram na rua. O trabalho abordou a contextualização da população em situação de rua articulada ao sistema capitalista. Depois, foi-se diferenciando terminologias e feita à escolha da expressão moradores de rua para apresentar algo no que tange a clínica psicanalítica com esses sujeitos. As notas são modos de grifar, ressaltar, colocar em relevo algo da experiência clínica com esses sujeitos, com todos os adendos, impasses, construções, direções e descobertas envolvidas nessa travessia. A metodologia deste trabalho foi realizada a partir da escuta de cenas e fragmentos clínicos vividos em cotidianos de serviços, tanto do Sistema Único de Saúde (SUS), como no Sistema Único da Assistência Social (SUAS). Além da revisão da literatura e da análise dessas cenas, optou-se por uma escrita que trouxesse a dimensão da narrativa na construção do trabalho. São três notas que disparam à temática: 1) O testemunho da barbárie; 2) A aposta teimosa no direito de desejar e 3) A vivência da rua articulada à dimensão do inumano. Visou-se o exercício de honestidade na construção de um trabalho que é atravessado por questões complexas: escuta clínica e dimensão política; efeitos da barbárie na experiência analítica/naquele (a) que ocupa a função analítica; exploração da noção de desejo desatrelando-se da vontade individual; exploração do laço social, proposto por Freud e por Lacan e assunção de um laço em que considere o território brasileiro como digno de ser acentuado, já que a escuta se deu num país, chamado Brasil / From three notes, it was developed in this work the investigation of the social bond or what the social bond reveals in clinical listening with subjects who live in the streets. The work approached the contextualization of the street population articulated to the capitalist system. Later, we differentiated terminologies and made a choice of using the expression \"homeless people\" to present something about the psychoanalytic clinic with these subjects. The notes are ways to underline, emphasize and highlight the clinical experience with these subjects, with all addendums, impasses, constructions, directions and discoveries involved in this crossing. The methodology of this work was based on the listening of scenes and clinical fragments lived in daily services, from both United Health System (Sistema Único de Saúde - SUS) and United Social Assistance System (Sistema Único da Assistência Social - SUAS). In addition to the literature review and the analysis of the scenes, it was chosen a writing that would bring the narrative dimension in the work construction. There are three notes that permeate the theme: 1) The testimony of barbarism; 2) The insistence on the right to desire; 3) The street life articulated to the inhuman dimension. The aim was to exercise honesty constructing a work that is crossed by complex issues: clinical listening and political dimension; barbarity effects on the analytical experience on that one which occupies the analytic function; exploring the notion of desire unattached to the \"individual will\"; exploring the social bond, proposed by Freud and Lacan; assumption of a bond that considers the Brazilian territory as worthy of being marked, since the listening took place in Brazil