In a recent report on the state of homelessness in Canada, it is estimated that at least 200,000 Canadians access homeless emergency services or sleep outside per year, with approximately 30, 000 homeless on any given night (Gaetz, Donaldson, Richter, Gulliver, 2013, 5). A strategy to address homelessness is Housing First. Housing First is an evidenced-based housing intervention strategy which provides homeless individuals with immediate access to housing and supports. A unique feature of this program is that participants are offered immediate housing of their choice. Prior to the introduction of Housing First, housing intervention strategies focused on “housing readiness” and often required sobriety or psychiatric treatment prior to entry. The Housing First approach has demonstrated significant recovery, cost savings and housing retention rates in The Mental Health Commission of Canada’s (MHCC) At Home/Chez Soi project—one of the world’s largest research studies utilizing a randomized control trial to study the outcomes of the Housing First approach. The At Home/Chez Soi project operated in five cities across Canada; Toronto, Montreal, Moncton, Winnipeg and Vancouver. Approximately 14% of At Home/Chez Soi participants had three or more moves and a portion of individuals in the MHCC’s study struggled to achieve stable housing. In an early findings report released by the MHCC one of the main themes that emerged from qualitative interviews conducted by At Home/Chez Soi project researchers included “changes in the social aspects of day to day life” once acquiring housing. Some of these changes were described to be negative. This finding highlights the impacts that the acquisition of housing may have on the experiences of Housing First participants. This demonstrates a need for further research to explore how social experiences relate to housing retention and mental health recovery in Housing First programming. In this research, I address this gap by focusing on understanding the social experiences of participants of Housing First programming for whom the transition into stable housing was difficult. More specifically, I ask “In relation to factors that impact housing retention, what is the experience of social connection and sense of community for a group of participants who had difficulty transitioning into housing provided through the At Home/Chez Soi Housing First program?” In this thesis, I present qualitative findings from narratives collected from 5 participants of the At Home/Chez Soi project for whom the transition to stable tenancy was difficult. Semi-structured interviews were conducted with five participants who had a range of experiences with housing retention including one participant who remained in their first apartment, and four others who had between 1-4 moves during their involvement in the At Home/Chez Soi project. In this research, I explored whether the fundamental needs of social connection and sense of community are instrumental in producing positive outcomes such as mental health recovery and housing retention in Housing First programming. Using narrative methodology and interpretive description, I further explore how the unmet needs of social connection and sense of community can assist in understanding the challenges experienced by individuals who struggle to transition into stable housing. The findings demonstrate that participants experienced a shift in social connection and sense of belonging to the “street”, to a feeling of connection to the housed community. All of the participants expressed wanting to disassociate themselves from the DTES. This was difficult because of stigmatization particularly on the part of the landlords and neighbours in their new communities. Discriminatory treatment in their housing served to reinforce negative feelings of self. The process of shifting to a sense of belonging to the housed community presented additional challenges, such as periods of isolation and/or being in the difficult position of saying “no” to friends in order to preserve their tenancy by abiding by the rules of the Residential Tenancy Act (RTA). Participants overcame these challenges by making adjustments in meeting their social needs. Some ways that participants demonstrated resilience included connecting with professionals, creating community in local shops, setting boundaries with old friends, and in some instances, cutting off from old friends. I conclude that social connection is paramount for these individuals. I also contend that the participants are resourceful in ensuring these needs are met. Recommendations for new or existing Housing First programming are made to ensure sensitivities and practices are geared to supporting these connections including offering flexibility and choice around locations and activities for weekly meetings with case managers. Other recommendations, specific to the transition into housing include incorporating a survey of important shops or services during the housing search process, and ensuring a good landlord-tenant fit during the housing selection process. / Graduate / 0617 / jynene_s@hotmail.com

How are homeless individuals, who have no access to private space yet still have the same needs of dwelling as the rest of us, regarded when they exercise their right to dwell? This question guided my research of Edmontons Tent City, which emerged during the summer of 2007. Interviews with twenty-two individuals, including with encampment residents, service providers, and state officials, informed a broader understanding of why the encampment emerged at the time that it did; how Edmontons public spaces accommodate the homeless; and, how Tent City shaped municipal and provincial policy on housing and homelessness. Homeless campers saw Tent City as home, while state management focused on excluding homeless campers from the downtown public space to restore order to the streets of Edmonton, as well as their positive public image. Tent City constituted a claim by homeless campers to occupy public space and be represented as part of the public but hitherto this has been met with increased strategies of dispersement and exclusion rather than with an expansion of citizenship rights. I argue that Tent City illuminates the states preoccupation with regulating the visibility of homeless individuals rather than focusing on the dwelling needs of homeless campers.

The number of homeless people in Malmö has increased in recent years, which makes it a relevant subject to study. Structural homelessness has grown to be the most common reason to homelessness. Earlier social homelessness was the most common reason. How does that effect the work with the clients in social homelessness and how is the support designed. The reasons above makes it an interesting subject to study.This study mainly focuses on similarities and differences in the view of the support between professionals at Social Services and Housing First for people in social homelessness.The study has been conducted with a qualitative approach in which six semi structured interviews have been carried out with social workers at the Social Services and at Housing First.The results from the interviews were then analyzed through a thematic analysis using organizational theory.The main differences that were shown in the results were differences in support between Social Services and Housing First in the way they work with clients in social homelessness. The result also shows a common view of the need for more support efforts.

Using the methodology and criteria put forth by the Juvenile Justice Evaluation Center (part of the Justice Research and Statistics Association, Washington D.C.), an assessment for evaluation of the Metropolitan Ministries "Uplift UTM" Program was conducted using review of data previously collected by Metropolitan Ministries, examination of documents provided by the organization, participant observation, and interviews with Metropolitan Ministry staff. This assessment reveals that there are significant problems in several areas that must be addressed before their program can be formally evaluated; including data collection and organization, outcomes measures, client selection standards, and how the program is portrayed as opposed to how it is actually run. Preliminary analysis of the collected data suggests that there are no relationships between demographic information such as education, employability, or other factors, and successfully completing their program. Further analysis suggests that other factors related to rules, guidelines, and unpopular restrictions are related to the low success rate they have experienced. Based upon a literature review of successful programs, suggestions for improving the outcomes of Uplift UTM are provided.

People with mental illness and histories of homelessness represent a vulnerable and marginalized population for whom a wide range of health, social, and community services have been developed. Despite the array of services, their role in the lives of currently and formerly homeless people with mental illness is not fully understood. Three studies were conducted that addressed two research questions: [1] How do patterns of service use differ during transitions from homelessness to housing compared to those from housing to homelessness among people with mental illness? and [2] What is role of services in enhancing the lives of housed and homeless people with mental illness? The first research question was addressed in Study 1, which involved secondary data analysis from a multisite randomized controlled trial of Housing First in Canada known as the At Home/Chez Soi demonstration project. The study explored how service use patterns over 24 months differed among people who achieved housing stability compared to those who remained unstably housed or re-experienced housing instability during the second year of the study. Findings showed that, as homeless people with mental illness transition into stable housing, their service use patterns change, with less time being spent in psychiatric hospitals, prison, and emergency shelters. Housing First minimally affected the changes in service use patterns, indicating that housing stability is the key factor in producing the changes as people transition out of homelessness. Study 2 also used data from the At Home/Chez Soi demonstration project to examine predictors of recovery among homeless people with mental illness at baseline and 24 months. Findings showed that health and community factors most strongly predicted mental health recovery at baseline. The housing and service use block of predictors was also significantly associated with most components of recovery, though the effect sizes were small. At 24 months, the model, which included receipt of Housing First, did not significantly predict residual changes in recovery from baseline. Study 3 of this dissertation qualitatively explored how currently and formerly homeless people with mental illness view services in their lives using two theoretical frameworks: recovery (Part 1) and the capabilities approach (Part 2). In-depth interviews were conducted with 52 participants living in Ottawa, Ontario. Participants perceived services to have a range of positive and negative impacts of their recovery and capabilities. However, the limits of service helpfulness in helping people to move forward with their lives was also highlighted. Overall, the findings of this dissertation indicate that the health, social, and community services used by homeless people with mental illness change as people become stably housed yet are limited in their impacts on recovery and capabilities. Implications for transformative change, service delivery, and future research are discussed.

While researchers have identified the Housing First model of putting homeless persons into permanent housing as the best means of improving the quality of life for chronically homeless individuals, few studies have examined the perceptions of shelter staff workers on the barriers the homeless face in obtaining and maintaining long-term housing. This case study of 2 homeless shelters in New Jersey examined the relationship that fair and just democratic processes play in supporting or undermining Housing First. Data came from New Jersey's annual Point in Time counts of the number of homeless individuals and families and the causes and service needs of the homeless. Government reports were also analyzed, as well as from semi-structured interviews and focus group interviews with a purposive sample of 14 homeless shelter staff workers. The polarities of democracy model as described by Benet helped identify whether democracy was being served rightly and justly within these homeless communities. Information was analyzed by inductive coding and by identifying themes and patterns that emerged from the interviews. The primary finding of this study was that lack of available housing, lack of resources to gain access to housing, and lack of knowledge of resources that are available for housing acquisition and maintenance plays a role in causing individuals to become and remain chronically homeless. Social change implications include policy recommendations to local, state, and federal legislators to increase accountability in the allocation of funding for housing support and the development of a volunteer case management force to meet the service needs of the chronically homeless.

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The number of people that are categorized as being homeless in the Swedish society are increasing. This might be an indication that the methods being used today shows not to be working efficient enough. A group of researchers connected to the University of Lund are now in a process to spread new workingmethods against the problems with homelessness in Sweden. Their goal is to completely erase homelessness as a social problem. This new method of working is distinctively different from the one currently beeing used. The main idea is that a person is to be given a place to live before any other efforts and treatments are being given to them. Because of the differences between the models there is a need of inspiering and committed people with knowledge about issues avolving homeless people and the problems that comes with being homeless. In this essay we have chosen to focus on these inspiering people and what their drive to spread social inventions might evolve in. Often there is a strong case of following the path of the work that has always been used wich is familiar. This often leads to a struggle for the policyentrepreneurs in which they have to persuade the public to try a new solution to the problem. The personal connections an entrepreneur has plays an important part in the process of spreading the word about a new policy. Preservation and a set mind is required of an entrepreneur.

This study investigated clients' perceptions of two approaches to ending homelessness in the United States: the Continuum of Care approach and a Housing First approach. Data were collected about perceived differences between the Continuum of Care and Housing First models of resolving homelessness. The study was conducted at an award-winning Housing First program in Los Angeles County, California. Successful completion of the Housing First approach was examined. This research employed a descriptive case study design, using multiple sources of evidence to investigate a contemporary phenomenon within its real-life context. Nine clients were interviewed who had experienced both the Continuum of Care and Housing First approaches. The clients comprised a convenience sample that was selected in collaboration with the Housing First staff. Clients' perceptions of the two approaches were obtained primarily via the use of standardized open-ended interviews and informal conversational interviews. Clients' perceptions of the two approaches suggested that clients considered the Housing First approach to ending homelessness to be more effective than the Continuum of Care approach. The Housing First approach uses engagement of the clients by staff, teaching the clients to use tools of empowerment, and finally supporting the clients into a life of self-reliance.

Homelessness is a widespread social problem in Sweden. The phenomenon of homelessness is a complex subject area that involves several challenges and difficulties. In Sweden, the staircase model prevails within the Social Services work to counteract homelessness. Of this, Housing-first emerged as a counter-critique of the staircase model. The questions we have asked in this study are what difficulties and obstacles models face in practice, and how the work process from the staircase model to Housing-first can look like. The method in this work has been a systematic literature study of previous research material. The results have shown that Housing-first model has had good results in Sweden. Furthermore, the results have shown that it is difficult to exclude the staircase model in the current homelessness work. The results show that Housing-first model is cost-effective and that it leads to better living conditions for the individual. The Housing-first model has proved to have long-lasting effects, and many have remained living in their apartments for several years. Furthermore, this work will shed light on the difficulties and obstacles the model may face in the implementation of homelessness work in Sweden. And what a potential transition can look like, from the staircase model to the Housing-first model.