Limited literature exists regarding best engagement practices of mental health service providers in encouraging the homeless individuals to participate in clinical mental health services in New York City. New York City has a population of more than 8.5 million, and in 2017 more than 129,803 homeless individuals slept in shelters. The purpose of this phenomenological qualitative study was to gain more insight and knowledge about the best engagement practices and experiences of mental health service providers in encouraging homeless individuals to participate in clinical mental health services. The conceptual framework used to guide this study comes from Kearsley and Shneiderman's engagement theory. The study employed a phenomenological method, utilizing a nonprobability sample design with a purposeful and criterion sample with 12 mental health service providers to reach saturation and to yield insights and in-depth understandings for the questions under research. Data were analyzed and coded to identify categories and themes. Findings from this research highlighted 3 themes based on participant responses: (a) building rapport, (b) medical and mental health, and (c) resistance to change. This study provides insight and understanding of the phenomenon of homelessness and provides information on engaging the homeless and how the participants encouraged homeless individuals to participate in clinical services.

This professional report explores the unique health needs of homeless individuals, how homeless individuals access medical and mental health services, and the impact that the Patient Protection and Affordable Care Act (ACA) may have on medical services for homeless individuals. Homeless individuals are more likely to experience physical and mental health problems and earlier mortality rates than the general population. Common access points for homeless medical services include clinics, such as Community Health Centers, and emergency care centers, such as hospital emergency rooms. Homeless individuals often face barriers of access to medical services, including competing priorities to sustain life, strained relationships with medical providers, and an inability to pay for high health care costs. Through the expansion of Medicaid and the Community Health Center network, the ACA has the potential to increase access to medical services for homeless individuals. This report concludes by offering recommendations to ensure that homeless individuals benefit from health care reform through the ACA. / text

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Diante da premente necessidade de integraÃÃo entre saÃde e espiritualidade que a transiÃÃo paradigmÃtica nos impÃe e de consolidaÃÃo de prÃticas integrativas de saÃde, nos espaÃos populares, dirigidas Ãs populaÃÃes de rua, as quais tÃm ficado à margem das aÃÃes promotoras de saÃde, formulamos o objetivo geral desta pesquisa: contribuir com uma produÃÃo de saber que dinamize os potenciais latentes de integraÃÃo entre saÃde e espiritualidade, no contexto do cuidado para com o sujeito em situaÃÃo de rua, realizado pelo Grupo EspÃrita Casa da Sopa (GECS). Utilizamos a pesquisa colaborativa como mÃtodo para gestar a produÃÃo de saber atravÃs de ciclos reflexivos sobre a prÃtica de cuidado de um grupo-sujeito, alÃm da coleta de histÃrias de vida, conforme o mÃtodo autobiogrÃfico e observaÃÃo participante com registros no Jornal da pesquisa. O GECS alcanÃou refletir sobre o modo de relacionar-se com o sujeito em situaÃÃo de rua a partir de uma compreensÃo que o situa como ser espiritual, o que implica admitir a existÃncia do EspÃrito. A Fluidoterapia â sistema terapÃutico que se inscreve no contexto do cuidado do GECS â possui dimensÃes teÃrico-prÃticas que a caracterizam como uma racionalidade em saÃde complexa que alcanÃa tecer uma teia de cuidados sociais e espirituais que se interrelacionam para integrar saÃde e espiritualidade. Assim, destacamos elementos que contribuem para uma reconceituaÃÃo do sujeito das prÃticas de saÃde em um contexto de produÃÃo de saber que situa a Fluidoterapia como uma racionalidade em saÃde, inscrita num paradigma emergente que estamos a chamar de paradigma do espÃrito. / As a result of the urgent need of integration between healthcare and spirituality that the paradigmatic transition impose to us and the consolidation of integrative practices of healthcare, in public spaces, targeted to homeless people, who have relied on the healthcare initiatives, we have formulated the main purpose of this research: to contribute with a production of knowledge that dynamize the latent potentials of integration between healthcare and spirituality, in the context of care of individuals in homelessness situation, carried out by the Spiritist Group Casa da Sopa (GECS). We employed the collaborative research as the method to generate the production of knowledge through reflexive cycles about the care practice of a group-individual, in addition to the gathering of life stories, accordingly to the autobiographical method and the participant observation with registers in the research Journal. The GECS achieved the reflection of the relationship with homeless individuals through the comprehension that place them as spiritual beings, which implicates the admittance of the spirit existence. The Fluid-therapy â therapeutic system that is applied in the care environment of GECS - has theoretical and practical dimensions that characterize it as a complex rationality in healthcare that aims to intertwine social and spiritual care that are interrelated to integrate healthcare and spirituality. Thus, we emphasize elements that contribute to a redefinition of the subject of healthcare practices in a context of production of knowledge that places Fluid-therapy as a rationality in healthcare, set in an emergent paradigm that we name as spirit paradigm.