Thesis (Ph.D.)--University of Texas at Arlington, 2009.

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.

The overall purpose of this study was to examine the impact of psychological well-being on mental health and behavioral outcomes among transitioning homeless youth in a New York City shelter. The main objective was to elucidate the relationship between psychological health, distress, and behavioral program outcomes. Participants were 116 formerly homeless young adults enrolled in the transitional living Rights of Passage program at Covenant House New York; a homeless youth shelter providing both crisis services and residential transitional living programs to young adults age 18 – 21. The correlates of psychological distress and program outcome were studied in relation to psychological well-being as measured by the Scales of Psychological Well-Being (SPWB) identifying 6 core components of positive psychological functioning including Autonomy, Environmental Mastery, Positive Relationships with Others, Personal Growth, Purpose in Life, and Self-Acceptance. Markers of psychological distress were measured by using the PHQ-9 (Depression), GAD-7 (Generalized Anxiety), PTSD Checklist - Civilian Version (Posttraumatic Stress Disorder), GHQ-12 (General Distress), while behavioral outcome data (i.e., behavioral infractions/disciplinary incidents, employment, discharge disposition, education advancement, and total savings) were assessed via the Efforts to Outcome (ETO) online software database maintained by Covenant House New York. Results of Pearson r correlations demonstrated a statistically significant relationship between psychological well-being and psychopathology. Stepwise regression analyses also showed that certain components of psychological well-being accounted for a significant portion of the variance over time in anxiety, PTSD, and general distress above and beyond initial levels of psychopathology. Additionally, Pearson r correlations and ANOVA analyses demonstrated significant associations with psychological well-being and program outcome including behavioral infractions (verbal conflicts, and non-compliance infractions), time unemployed, total savings, and G.E.D. obtainment. In contrast, psychopathology demonstrated significant associations with only behavioral infractions (verbal conflicts) and total savings. Findings suggest that psychological well-being is differentially associated with program outcome from psychopathology and that interventions aimed at homeless youth may benefit from incorporation of strengths-based, positive psychological approaches.

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

Objective: Although factors that promote initial and recurring homelessness among inner city women have been long explored, impoverished women continue enter and re-enter shelters at troubling rates. This trend is projected to increase over time. This longitudinal study uses Sydemics as a framework to advance our understanding of the relationship between depression, PTSD, trauma and intimate partner violence and the loss of housing among impoverished women using inner city Emergency Departments. We hypothesized that depression, PTSD, childhood trauma and IPV are positively associated with homelessness at baseline and that women with higher rates of a combination of these variables (e.g. PTSD and IPV) in wave 1 will have higher odds of experiencing both an initial and repeat bout of homelessness in the second and/or third waves, controlling for all other variables in the study. Method: Multivariate analyses and logistic regression, at baseline and longitudinally, were conducted to test study hypotheses with homelessness as the dependent variable. Six multivariate logistic regression models were used. Odds ratios (OR) with their 95% confidence intervals are reported. Results: Depression and childhood trauma were individually associated with homelessness at the .05 level in this sample of low income women. IPV was marginally related to homelessness (p=0.0917). PTSD however was not. Importantly, although IPV and PSTD were not individually associated with homelessness in bivariate analyses, housed, never homeless women, and women who had previously experienced homelessness had a greater odd of becoming homeless than those who experienced only one of these risk variables. Specifically, housed, never homeless women who had PTSD and IPV had a 2.2 odd of becoming homeless for the first time in waves 2 and 3, whereas those who experienced PTSD only had a 1.3 odds of becoming homeless for the first time; never homeless participants who experienced IPV only a 1.7 greater odds of becoming homeless (CI.0.348, 14.84; p=0.385), adjusting for all other variables. Similarly, the odd of becoming homeless again among participants who had PTSD and experienced IPV was 1.7 whereas the odds of recurrent homelessness was 1.2 among those who experienced PTSD only and 1.1 among those who experienced IPV only (CI.0.397, 7.46; p=0.463), controlling for all other variables in the study. Conclusion: Our findings confirm our hypotheses that low-income women who have PTSD, depression, histories of childhood trauma, and/or IPV have a higher odds of initial and recurrent homelessness when compared with women who do not have these risk variables. Our findings further confirm that women who have combinations of risk variables have even higher odds of future homelessness. Due to the low sample size of women with histories of homelessness in the study, there was lack of power. Despite this challenge, the results of these explorations (in determining heretofore unidentified effect sizes) utilizing Syndemics as a conceptual framework are promising. Future research with larger sample sizes (and sufficient power) are important to further the initial findings from this study.

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.

The present study assessed the relationship between mentally ill homeless and their companion pets and questioned if the pets acted as a barrier for them to receive shelter and other services. The study also sought to find if pets acted as a communication tool between this population and society. themselves because they are mentally vulnerable and victims of a mental disorder.

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.