Homeless Persons

There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.

Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.

A case-based, clinical guide applicable to a variety of settings, this book offers evidence-based expert advice on the difficult challenges inherent in working with underserved homeless populations. The American Association of Community Psychiatrists' Clinical Guide to the Treatment of the Mentally Ill Homeless Person is a concise, practical work that gives busy clinicians the information they need; it not only is more up-to-date than existing publications, but also offers case- and site-based content that provides more hands-on, practical advice. Written by clinicians, for clinicians, it offers approaches to therapy and rehabilitation from the vantage point of the treatment environment, from street to housing and everything in between. The book reflects approaches to the clinical care of homeless people refined over two decades, building not only on the work of academic research but more importantly on the firsthand experience of clinicians. Its organization by treatment setting or specific subpopulation allows readers quick access to the chapters most relevant to their work. The first five chapters follow a sequence of naturalistic settings -- such as shelters and the work of Assertive Community Treatment Teams -- that demonstrate a model of engagement, intensive care, and ongoing rehabilitation. Subsequent chapters define specific scenarios that depict patients at various points on the engagement-rehabilitation continuum. Each chapter contains a clinical case example; guides to differential diagnosis, treatment planning, and accessing entitlements; and a flow chart for rehabilitation, including opportunities for student/resident or community involvement. The book emphasizes: A real-world orientation that provides a nuts-and-bolts approach to such cases as families, homeless children, veterans -- even individuals in rural settings. Cases that enable readers to follow the progress of individuals as they progress through the network of care. The importance of Assertive Community Treatment and "housing first" models of rehabilitation. Data supporting the importance of Critical Time Intervention, particularly with regard to homeless families. Examples of clinical interviewing techniques for engagement and treatment of challenging individuals who are being seen in community settings. These illustrated techniques can be incorporated into educational curricula. This is an indispensable resource for any mental health professional working with homeless populations and is also useful for medical students' clinical rotation in community psychiatric settings. Its examples of clinically engaging the homeless person are equally instructive for teaching interviewing skills to any professionals -- whether in law enforcement, social work, substance abuse treatment, or the clergy -- who encounter these forgotten members of society.

The homeless person is thought to be different. Whereas we get to determine our difference or sameness, the homeless person’s difference is imposed upon them and assumed to be known because of their homelessness. Exclusion from housing – either a commodity that should be accessed from the market or social provision – signifies the homeless person’s incapacities and failure to function in what are presented as unproblematic social systems. Drawing on a program of research spanning ten years, this book provides an empirically grounded account of the lives and identities of people who are homeless. It illustrates that people with chronic experiences of homelessness have relatively predictable biographies characterised by exclusion, poverty, and trauma from early in life. Early experiences of exclusion continue to pervade the lives of people who are homeless in adulthood, yet they identify with family and normative values as a means of imaging aspirational futures.

It has long been established that access to food, clothing, medical care, and housing are fundamental human rights the world over. Helping the approximately 600,000 Americans and 300,000 Canadians who are currently homeless work toward this goal is a complex undertaking. This text presents the fundamental knowledge and skills that frontline workers need in order to help vulnerable and homeless persons. It provides readers with both an understanding of the lived experiences of those who have faced homelessness and an outline of the interprofessional practice context of services for homeless people. Waegemakers Schiff focuses on the interventions and best practices that have been found to be most effective in making connections, establishing helping relationships, and working with individuals on moving toward stabilization.

Around the world and across a range of contexts, homelessness among older people is on the rise. In spite of growing media attention and new academic research on the issue, older people often remain unrecognized as a subpopulation in public policy, programs, and homeless strategies. As such, they occupy a paradoxical position of being hypervisible while remaining overlooked. Late-Life Homelessness is the first Canadian book to address this often neglected issue. Basing her analysis on a four-year ethnographic study of late-life homelessness in Montreal, Canada, Amanda Grenier uses a critical gerontological perspective to explore life at the intersection of aging and homelessness. She draws attention to disadvantage over time and how the condition of being unhoused disrupts a person’s ability to age in place, resulting in experiences of unequal aging. Weaving together findings from policy documents, stakeholder insights, and observations and interviews with older people, this book demonstrates how structures, organizational practices, and relationships related to homelessness and aging come to shape late life. Situated in the context of an aging population, rising inequality, and declining social commitments, Late-Life Homelessness stresses the moral imperative of responding justly to the needs of older people as a means of mitigating the unequal aging of unhoused elders.

This ethnographic exploration of contemporary spaces of homelessness takes an expanded view of homeless space, threading together experiences of organizational spaces, routes taken through the city and the occupation of public space. Through engaging with participants' accounts of movement and place, the book argues that young homeless people become fixed in mobility, a condition that impacts on both everyday life and possible futures. Based on an innovative multi-method study of a day centre in London for young homeless people, the book contextualizes spaces of homelessness within the social relations and flows of people that produce the world city. The book considers how the biographical and everyday trajectories of young homeless people intersect with place attachments and forms of governance to produce urban homeless spaces. It provides a new angle on the city made by movement, foregrounding the impact of mobilities shaped by loss, violence and the search for opportunity. The book draws on mental maps, photography, interviews and observation in order to produce an engaging and rich ethnographic account of young homeless people in the city.