This study conducted in-depth interviews with 11 homeless or formerly homeless individuals at eh Central City Lutheran Mission. The focus of this research project is mental health service utilization among the homeless in San Bernardino. A wide array of services are available to the mentally ill homeless in this area, however services offered often do not meet the needs of this population.

D. Cur. / The model "Facilitating mental health promotion through mobilising comfort for homeless mentally ill persons in urban areas" was developed by using a theory generative design that is qualitative, contextual, explorative and descriptive in nature. To achieve the research purpose specific objectives were formulated. This model was developed according to Chinn and Kramer's (1995:162) approach to theory generation as indicated in the first step. Identification of the central concepts for the model took place by conducting a field study to explore and describe the lived experiences of the homeless mentally ill persons and their views of what they think would alleviate their situation. A multiple case study strategy was followed. The sample consisted of three homeless mentally ill persons, purposively selected from the Soweto urban vii areas. Informed verbal consent had been obtained from all participants, and the reasons for conducting the research study were explained to them. Data collection was obtained through in-depth semi-structured interviews using the phenomenological perspective and communication techniques to elicit relevant information. Data from transcripts of recorded audiotapes and field notes were analysed using the methods of Tesch's steps (in Creswell, 1994:154; Yin, 1994:102; and Merriam, 1998:16). An independent coder assisted in coding the results. Reasoning strategies used were analysis, synthesis, inductive and deductive according to Tesch's method. The results were verified through a literature review. Further analysis of data for defining the major concepts of the model which are "HOPE and COMFORT", were determined according to the method described by Wandelt and Steward (1983:64). The concepts of the model were analysed thoroughly by going through different dictionaries and subject usage. The other related concepts were identified and classified by using a survey list of Dickoff, James and Wiedenbach (1968:430). In Step Two the defined concepts were related to each other to show interrelationships. Classification of central and relational concepts were followed to create relationship-statements as the conceptual framework of the model. In Step Three the structure and process description of the model was designed according to Chinn and Kramer (1995:108). The model was evaluated by a panel of experts. Step Four dealt with guidelines to operationalise the model in practice, education and psychiatric nursing research. Guba and Lincoln's (1985) model for trustworthiness of qualitative research was also employed. It is based on the identification of four strategies for ensuring trustworthiness used in this study, namely: truth value, applicability, consistency and neutrality. Recommendations and limitations of the research were also discussed.

M.A. (Social Work) / Please refer to full text to view abstract

This study examined the ethnic makeup of individuals who seek services from San Bernardino County, Department of Behavioral Health, Mentally Ill Homeless program.

The purpose of this study was to identify risk factors associated with homelessness, assess the relationship between housing status and consumption of costly publicly funded resources, to identify characteristics associated with service retention, and to evaluate whether length of treatment is associated with better outcomes. The target population was homeless and formerly homeless adults with SMI enrolled in community mental health services at the Downtown Emergency Service Center SAGE mental health program located in Seattle. The sample consisted of 380 SAGE patients who had continuous enrollment in 2005. These patients formed the cohort for the study. Agency records for these patients were reviewed for a 3-year period (2005-2007). The study utilized a non-experimental retrospective cohort study design. Multiple logistic regression, hierarchical multiple regression, two-way repeated measures ANOVA, and Cochran's Q test were used to analyze the data. Homelessness was associated with African American race, substance use, lower income, and younger age. Patients who were homeless spent more time in jail and required more mental health staff time compared with patients with stable housing. Patients with schizophrenia were more likely to retain services and African American patients were less likely to retain services. Overall, patients who remained enrolled in services from Year 1 to Year 3 had improved housing stability, fewer days of incarceration, and required less staff support. The overrepresentation of African Americans among patients who experienced homelessness suggests that racism could be a factor contributing to homelessness for this racial group. Further research is needed to assess the relationship between race and homelessness.