The purpose of this research is to examine the barriers to food security for single adults with mental illness and/or problematic substance use living in supported housing on Vancouver Island. The objectives are: (a) to examine the difference in the level of food security for tenants of supported housing neighbourhoods located in urban versus a rural community; (b) to examine the barriers to food access experienced by the tenants; and (c) to examine which barriers have the greatest effect on the tenants. Using an explanatory case study design, I employ a community-based research method with a social justice perspective as the framework. I have used an explanatory matrix to illustrate the tenant identified barriers to food security and the social structures that affect these barriers. As well, I have made recommendations for integrating food security services and programs into supported housing projects. I have argued that food security is a matter of public health and an integrative approach is needed. I am suggesting a shift on a larger policy scale, to promote the health and well-being of tenants in supported housing. An adequate holistic perspective with an integrated, long-term strategy linking all the determinants of health would result in health-in-all policies. This strategy could reduce the existing health inequities that the tenants in supported housing experience. / Graduate / judy@nahs.ca

The purpose of this study was to explore the perceptions and experiences of people living with serious mental illness (SMI) receiving housing assistance. A qualitative method was used to interview five adults with SMI living in a supported housing model. An Ecological Systems Theory (EST) was used as the theoretical orientation for the study. The major themes related to success of the supported housing that emerged were independence, involvement of owners, bonds with tenants, having access and means to resources, and positive engagement in well-being. No themes of unmet needs were presented. The study concluded people with SMI in need of housing will benefit by being in a supported housing model such as the one in the study. The two main limitations of the study are small sample size and limits in generalizing beyond the one location.

While health authorities have administered licensed residential care facilities for years, in the last two decades, health authorities have increasingly contracted with nonprofit organizations to house persons diagnosed with mental illness in the community in "supported" projects. Services may include medical and/or social supports such as medication, addiction services, case-management and life skills training. While flexible supports customized to meet the needs of service users may sound encouraging, numerous questions remain. This thesis generates a basis from which to explore how services might shift to better meet the needs of tenants. To do so, I examine meanings of support from a tenant perspective and consider the environment in which tenants experience support in supported housing. The analysis involves semi-structured, one-on-one interviews with two female and four male tenants who had been previously homeless, currently living in one supported housing project in a mid-sized city in British Columbia, Canada. The study draws on love ethic and neoliberal theory in an effort to frame mental health service user understandings and mainstream models of support. The tensions between support services employing principles of love ethic theory and mainstream models raise the question of whether the two models can co-exist, and if so, how and where compromises are made and at whose expense. These tensions are evident in the data and in turn are taken up within the analysis. Tenant meanings of support include relationships and resources that increase safety, security and independence, understood as the freedom to identify your own goals and maintain control over the support you receive. The findings point to a vital need to ensure tenants are included in decision-making with regard to support practices and policies. Utilizing tenant knowledge would go a long way toward addressing many of the concerns and dilemmas which surface in the research.

The aim of this study is to examine the experienced needs of elderly (65 years or older) homeless individuals who, currently, lives in supported housing facilities. The study is based on five qualitative unstructured interviews with five elderly homeless men living in two separate supported housing facilities. The theoretical framework is Maslows hierarchy of needs. The results of the study show that the elderly homeless in this study experience three types of needs, of which two are perceived as more important. The third type of needs (which falls under what Maslow describe as ” safety needs” and concerns the physical health), for which they experience that they get necessary help, constitutes more of an obstacle to meet their other needs. These two main needs are needs of belongingness and love (specifically needs to establish and/or maintain relationships to others such as family or friends) and, partly, needs of self-actualization (specifically needs to engage in activities which they are” suited” for and which interests them). One main problem to meet their needs, apart from their physical health problems, is associated with their current housing situation which limits their possibilities to meet these need as a result of e.g. existing rules and restrictions.

This study explores the implementation and impact of Supporting People, a policy of the New Labour and Coalition governments of 1997 to the present designed to provide housing related support to those considered vulnerable. The theoretical framework uses concepts from past studies of implementation, policy networks, governmentality, path dependency, other temporal concepts and a recent heuristic that provides an independent framework for analysing policy success. This conceptual framework was used in exploring the history of care and support services in the UK; assessing the successes and failures of the past. The study then looks at the drivers and policy goals for Supporting People and at some of the key reviews and studies of it thus far. The fieldwork uses a “mixed methods” approach utilising both quantitative and qualitative methods. An initial survey gathered views from a range of supported housing professionals, followed by a series of in-depth interviews with management practitioners from Supporting People funded organisations. Both stages utilised ideas from the conceptual framework in asking about implementation processes and successes and failures of the programme. This section also explores the use of evidence, dissemination and impact. In terms of the Supporting People policy, the study found a number of areas of strengths on which to build e.g. increased funding and improved strategic frameworks, but also many areas of weakness that require improvement. These include protection for funding, consistency across local authorities, fragmented structures of related policy networks and the top-down implementation style of the policy – there were lessons from No Second Night Out (NSNO) – Leicester in this regard. This was a piece of evaluative research carried out in tandem with the main study and integrated into it. The study found a consistent failure to provide adequate services for vulnerable people; services had failed to build up sufficient path dependent processes to protect them from funding and other resources being diverted to other priorities. The lack of a legislative and conceptual consensus around what it means to be “well housed” was key.

The Swedish child welfare system allows a possibility to place children in out-of-home-care. In 2016 a new form of placement was introduced: supported housing [stödboende]. The main purpose of a placement in supported housing is to prepare the residents – young people between the ages of 16 and 20 – for an independent life and living. Unaccompanied youths constitutes a category of service-users that has become relevant for placement in supported housing due to the assumption that they are in need of support-oriented rather that treatment- and care-oriented services. The purpose of this master’s thesis is to analyse how supported housing units for unaccompanied youths are organised and how the staff describe working to ensure the independence of the youths. To meet the purpose of the study, supported housing units in three Swedish municipalities have been studied through a total of 15 semi-structured interviews with section managers, unit managers, coordinators and staff. Supported housing for unaccompanied youths has been studied as an organisational idea which has been received and adopted in the municipalities. To understand how external pressure and internal processes influence the units and the work, an organisational perspective has been applied on the empirical material, through new institutionalism and Lipsky’s theory of street-level bureaucracies. From Said’s theory of orientalism the construction of “the other” is used as a complement to also understand how different constructions of residents and work with independency are expressed. The results of the study indicates that the organisation of the units and the work within them are highly affected by external factors, such as reduced economical resources and the situation in which many of the placed youths are still awaiting decisions on their asylum applications due to long processing times at the Swedish Migration Agency. This leads to great challenges both in terms of organisation and work. To meet the needs of the situation informal adjustments of routines and work are often made by both managers and staff. Concerning the work with independency, a division of three becomes visible: practical, societal and emotional/social independency. How the work is conducted seems to be influenced not only by the discretion of the staff, but also by whether or not the youths have received a residential permit. An important conclusion is the emergence of a construction of the “ideal” supported housing unit, where the placed youths can practice on standing on their own two feet in a safe environment. However there is also a parallel construction of “reality”, where challenges beyond the control of the staff and managers highly affect the units and the organisation of the work, including economical resources, the Swedish asylum politics, other social service actors, as well as the mental health of the placed youths.

Sverige nådde år 2015 en ny toppnotering vad gäller antal asylsökande. Detta förde med sig stora utmaningar för delar av socialtjänsten i relation till placering av ensamkommande barn och en snabbt stigande kostnadsutveckling för platser på asylboenden. Syftet med denna studie är att undersöka konsekvenserna av vad som sker när boendeformen för de asylsökande förändras. Undersökningen tar sin utgångspunkt i hur behandlingsassistenterna på ett kommunalt stödboende ser på sitt arbetet med ensamkommande ungdomar och hur de upplever sina möjligheter att hjälpa dem integreras i det svenska samhället. Studiens empiriska material består av sex semistrukturerade intervjuer med behandlingsassistenter som är verksamma på ett stödboende i Stockholm. Analyserna tar sin begreppsliga utgångspunkt i Michael Lipskys (1980/2010) teori om gräsrotsbyråkrater samt Ludvig Beckmans (2011) integrationsteori. Resultatet visar att behandlingsassistenterna tenderar att fokusera på allmän kunskap kring samhällsinstitutioner, språk och relationer som viktiga faktorer man försökte forma sitt arbete kring. Samtidigt upplever behandlingsassistenterna en konflikt mellan vad man kunde göra och vad man upplever att de ensamkommande ungdomarna behöver. Studien visar bland annat på utmaningar i inkluderandet av boendepersonal och kommuner i beslutandet kring olika policyn givet det extraordinära sammanhang landet befinner sig i. / At the end of the year 2015, Sweden peaked in regards to asylum-seeking refugees. Concequently, parts of the social service would face numerous challenges in regards to the placement of unaccompanied minors in out-of home care and in rising costs for asylum accommodation for unaccompanied minors. The purpose of this thesis is to examine the consequences of what happens when the asylum housing for unaccompanied minors changes. This thesis takes its starting point in how treatment assistants at a municipal support housing view integration in regards to their work with unaccompanied minors. The empirical basis for this study consists of six semi-structured interviews with treatment assistants at a municipal support housing in Stockholm. The analysis takes its conceptual basis in Michael Lipsky's (1980/2010) theory of street-level bureaucrats and Ludvig Beckman's (2011) integration- theory. The results showed that treatment assistants tend to focus on general knowledge about societal institutions, language and relationships as important factors that they attempted to shape their work around. At the same time, the treatment assistants experience a conflict between what they can do and what they perceived that the unaccompanied minor needs. The study shows i.a. the challenges in including housing staff and municipalities on the forming and decision-making off public policies in extraordinary situations.

Uppsatsen syftade till att undersöka vilket handlingsutrymme socialtjänstens handläggare i en mindre kommun har vid utredning av insatsen boendestöd. Sju informanter, två stycken enhetschefer och fem stycken handläggare, från två enheter deltog i en intervjustudie kompletterad med tre stycken vinjettfall. En av enheterna arbetar gentemot beroende och den andra mot socialpsykiatri. I resultatet framkom en viss skillnad i hur enheternas personal förklarar och beskriver sitt handlingsutrymme. I den aktuella kommunen saknas lokala riktlinjer för insatsen boendestöd vilket påverkar handläggarnas handlingsutrymme och handlingsfrihet på flera sätt enligt informanterna. Några informanter känner sig begränsade i sitt arbete på grund av avsaknaden av lokala riktlinjer medan andra ger intryck av att känna sig friare i sitt arbete. För att beviljas boendestöd från socialpsykiatrin krävs en längre tids kontakt med psykiatrin, medan det inte krävs någon dokumentation gällande ett missbruks varaktighet för att beviljas boendestöd från beroende.

Att utarbeta effektiva arbetssätt för att hjälpa människor ifrån hemlöshet är en angelägensamhällsfråga. Vår undersökning genomförs i samverkan med Socialförvaltningen i Uppsala kommun. I studien har vi intervjuat klienter och handläggare om deras upplevelser och syn på hur en boendekedja för klienter med missbruksproblematik fungerar. Resultatet av vår studie visar att boendekedjan förenklar arbetsprocessen med denna klientgrupp och leder till att fler klienter snabbare kan få ett bostadssocialt hyreskontrakt. Det framkommer också att det finns en diskrepans mellan hur handläggare och klienter uppfattar tydligheten i processen.

Introdução: Residências Terapêuticas ou Serviços Residenciais Terapêuticos são moradias inseridas preferencialmente na comunidade, com a finalidade cuidar de pessoas que passaram longos anos asiladas em hospitais psiquiátricos. As diferentes formas de morar são estruturadas no cotidiano de todo homem e é na vida cotidiana que o homem participa com toda a sua individualidade e personalidade. Do ponto de vista de estrutura social, é no desenvolvimento das habilidades do cotidiano que o homem firma-se enquanto ser social amadurecido. Assim, questiona-se de que forma os moradores de um Serviço Residencial Terapêutico apropriam-se de seu processo de morar e de seu cotidiano. Objetivo: analisar o processo de morar e o cotidiano dos moradores de um Serviço Residencial Terapêutico. Método: trata-se de um estudo de caso, com abordagem qualitativa. O referencial teórico que norteou este estudo foi a Teoria do Cotidiano e a Reabilitação Psicossocial. Utilizou-se como técnica de coleta de dados a entrevista semiestruturada e a observação participante. Foram sujeitos deste estudo, seis moradores de um serviço residencial terapêutico do município de São Paulo, que aceitaram participar e assinaram o Termo de Consentimento. Os dados foram analisados pela técnica de análise temática, considerando os aspectos históricos e sociais em que foram coletados. Os resultados evidenciaram: a caracterização sóciodemográfica dos moradores; os hábitos de vida e a percepção do morador em relação ao morar no Serviço Residencial Terapêutico; sua compreensão do processo saúde-doença; a reabilitação psicossocial e a vida cotidiana. Os moradores apropriaram-se de seus cotidianos, sendo que estes últimos, em alguns momentos os cotidianos ficaram alienados e foram utilizados mecanismos para superá-los. São necessárias estratégias constantes, para gestores profissionais, a fim de tornar o morar e o cotidiano destes moradores possível, entretanto, urge que o homem social (profissionais, gestores, moradores, comunidade) destrua em si, as amarras manicomiais que foram histórica e socialmente instituídas. / Introduction: Therapeutic Houses or Homecare Therapeutic Services are houses preferentially located into the community, aiming the care of people who stayed sheltered in psychiatric hospitals for many years. The different ways of living are structured in daily life of all persons. Men attend the daily life with all their individuality and personality. In the social structure point of view, men are firmed as a matured social being during the skills development of daily life. Thus, we ask how residents of a Homecare Therapeutic Service have been appropriated of their living process and daily life. Objective: to assess living process and daily life of people residing in a Homecare Therapeutic Service. Method: this is a case study with qualitative approach. Theoretical framework, which has guided this study, was the Theory of Daily life and Psychosocial Rehabilitation. Semi-structured interview and participant observation were used as data gathering method. Six residents of a Homecare Therapeutic Service located in Sao Paulo were subjects of this investigation, having agreed to participate of this research and signed the Free and Informed Consent Term. Data were analyzed through the thematic analysis technic, considering the historical and social contexts where data were gathered. The Research Ethical Committee approved this project, CAAE: 29721114.5.0000.5392. Results: data were grouped into the following empirical categories: sociodemographic characterization of Homecare Therapeutic Services residents; the narratives; the daily life features; and the daily life. The analysis highlighted that most of residents were female, with non-white skin, single, catholic, unemployed, without personal health insurance, and with unfinished basic school degree. Residents representations about facts of theirs lives showed that home is understood by most of them as the place where they live and get affects; where they are accept for everyone. Thematic sentences stand out that people have not only one concept of mental illness, being their daily life marked by manicomial precedents. Although residents tangibly aim their daily life, through the language, tools or uses and costumes, too many difficulties remains, including those that are relational; pragmatic, such as pay a bill; hierarchical as to decide what to do first; or, even when contradictorily, daily life is inducted to the alienation and to the overcoming for own health professionals, and also for residents. Conclusion: the Homecare Therapeutic Service is perceived as a place that may be habited for people who had manicomial experiences. However, professional actions and strategies need to be constantly rethought to avoid the replication of manicomial practices.