Research Matters Blog

Canadian Observatory on Homelessness/Homeless Hub: York University
July 29, 2016
Categories: Ask the Hub

This question came from Margaret A. via our latest website survey.

I’m glad that this question has been asked because it touches on an incredibly important issue. Indigenous peoples are over-represented in the homeless population in general, and Indigenous women are homeless in much greater numbers than non-Indigenous women. A history of colonization and marginalization has resulted in what Browne and Fiske (2001) called “a multiple jeopardy” (p. 27) for Indigenous women, “who face individual and institutional discrimination, and disadvantages on the basis of race, gender and class” (Patrick, 2014, p. 39). Patriarchy (male dominance at a structural level), racism, trauma, oppression, racist legislation (like The Indian Act), and ineffective child welfare policies are all contributing factors to poverty, abuse and homelessness for many Indigenous women.

VAW shelters & transition houses in Canada

Before looking at Housing First for this population, it's important to consider the state of the emergency response system. Most shelters and transitional houses are consistently full, often operating well over capacity. This is also true of shelters that focus on housing women fleeing violence, often called VAW (violence against women) or intimate partner violence (IPV) shelters. According to a 2014 Statistics Canada report, 66% of female shelter residents reported emotional abuse and 50% cited physical abuse as reasons for seeking shelter. Earlier this year, the third annual Shelter Voices survey found that in one day alone:

  • 416 women and children reached out for shelter at 234 shelters and transition houses that focus on VAW
  • 111 became new residents
  • 305 turned away due to lack of capacity (that’s 73% of those seeking shelter)

These numbers only give us a snapshot and are certainly underestimates. Because safety is a paramount concern, women are most likely to be “hidden homeless” – taking their children to stay with friends or family. While most women and children turned away find space at other non-VAW specific shelters and transition houses, these numbers speak to the need for an adequate crisis response, but also a greater focus on prevention and accommodation and supports. Affordable housing is key to this, and is unfortunately in low supply countrywide. So if a woman and her children do make it into some emergency housing, where can they go afterwards?

In the same survey, 96% of shelters reported a waiting period for social housing of at least one month, 68% of three months, and 36% over six months. Waiting periods can feel extremely long when seeking stability for children and refuge from an abusive partner. And that’s just for those who can even get on waiting lists. Nearly 80% of shelters in remote locations, and almost 70% on reserves, reported an absence of social housing programs in their areas (full graphic posted right). For Indigenous women in northern Canada, where the private market is tiny and cost of living is high, there are very few places for them to go.

Reported lack of social housing programs

Statistics on violence against Indigenous womenHousing First and Indigenous women

The effectiveness of Housing First, an approach to homelessness that attempts to reduce the barriers to permanent housing, for Indigenous women and children fleeing violence hasn’t been fully explored. As Indigenous women are at a much higher risk of violence than other women (pictured right), it's crucial that we investigate what housing options work and don't work for them. While we don’t have a lot of information right now, Housing First model shows promise exactly because it isn’t a one-size-fits-all model. Much of its success relies on adaptation, both for individuals and specific populations.

There’s some evidence that shows Housing First can be effective for Indigenous people generally, if adapted to their unique needs. As the writers of Housing First in Canada stated:

Housing First programs work best when people are in the most appropriate type of housing for their situation. When things do not work out, people might be tempted to conclude the program does not work, when in fact it might have been a bad match. Housing First in Calgary has been adapted to meet the needs of youth, women fleeing domestic violence and Aboriginal people, to best meet people’s unique needs and support housing stabilization. (p.14)

Emerging examples

Two case studies in the Housing First in Canada book had a significant focus on Indigenous populations: Lethbridge and Edmonton. The Lethbridge program included an Indigenous-specific Housing First team to respond to the needs of Indigenous people experiencing homelessness, and prioritized connecting with nearby reserves to help people transition to city life. According to data processed in 2009 (which was unfortunately, not Indigenous-specific), over 864 households were permanently housed and 90% were still housed throughout 2012 and 2013.

In the Edmonton program (Nikihk, with Bent Arrow Healing Society and Homeward Trust), the Housing First team included workers who specialize in trauma and traditional practices and spirituality. Homeward Trust also emphasized the importance of having Indigenous people as part of governing boards, and partnering with Indigenous-led organizations for programs to be successful. As the report discovered, 2325 people (786 of whom were Indigenous) were housed between 2009 and 2012, and 86% retained their housing.

The Winnipeg At Home/Chez Soi project combined assertive community treatment and intensive case management teams, one of which specialized in working with Indigenous people. As 71% of the participants were Indigenous, including local Indigenous organizations and incorporating an Indigenous worldview were extremely important. Overall, the project saw much more positive results than other homelessness interventions, reporting that:

With knowledge of the legacy of colonialism and respect for Indigenous cultural practices, all service teams integrated an Aboriginal holistic approach in delivering Housing First to participants and elders, and traditional teachers were integrated as part of the services and programming offered to participants. At the same time, excellent research follow-up rates were achieved (81 per cent) and outcomes clearly favour the Housing First approach in Winnipeg. In the last six months of the study, 45 per cent of HF participants were housed all of the time, 28 per cent some of the time, and 27 per cent none of the time; whereas 29 per cent of TAU [treatment as usual] participants were housed all of the time, 18 per cent some of the time, and 52 per cent none of the time. This finding is particularly noteworthy given the extremely low vacancy rate for rental housing in Winnipeg.

While these case studies are promising, they don’t tell us specific outcomes of Indigenous participants. A study on the Homeward Trust program by Blue Quills College identified several areas for improvement, including — more trauma and relational supports, life skills training, improving agency Indigenous identity, etc.— but didn’t touch on Indigenous women and children fleeing violence.

Things to consider                                                                                                            

For Housing First to work for this population, inclusion criteria need to be reflective of the unique experiences of homelessness for Indigenous women and girls. The Housing First model has been criticized in terms of how it can be applied to women in need, as it tends to prioritize people who are single, chronically homeless and who have significant issues with mental health and/or substance use. A 2013 brief from Homes for Women highlighted this concern:

Chronic homelessness, for the purposes of inclusion in Housing First programs, has been variously defined. Couch surfing, doubling up with other families in conditions of extreme overcrowding, cycling in and out of abusive relationships, trading sex for temporary accommodation, and other survival strategies that homeless women deploy have generally been categorized as indicative of “relative homelessness.” When the price women and girls pay for shelter is violence and abuse, their homelessness is qualitatively different from a person “provisionally accommodated” in the home of a friend and every bit as profound and as “absolute” as that of men on the street or in shelters. Moreover, many women experience episodic homelessness, as they move in and out of abusive relationships, and in and out of shelters (both homelessness and violence against women [VAW] shelters), in search of safety. The episodic nature of their homelessness is obscured when only time on the street or stays in homelessness shelters are considered.

In his critical examination of Housing First in Canada and Winnipeg, Matthew Stock has similar concerns, and reiterates that women are most likely to be experiencing hidden homelessness and can be harder to reach. He also highlights important cultural differences that may complicate efforts to recruit Indigenous people experiencing homelessness in Housing First programs:Grandmother Moon prayer

The homeless Aboriginal population also tends to be highly mobile, which runs counter to HF’s emphasis on establishing a home base (Peters and Robillard 2009: 653). Culture may also be a barrier that prevents Aboriginal participants from effectively utilizing HF services. A Winnipeg study (Deane et al. 2004: 240) found that, because of the importance placed on reciprocity within the Aboriginal community, Aboriginal people tended to rely on their own social networks for support, as opposed to mainstream organizations, which were seen as practicing charity. Furthermore, the history of colonialism and racism may cause Aboriginal participants to feel less comfortable working with non-Aboriginal organizations (p.15).

Another important consideration highlighted by the Homes for Women brief is that “visible” homelessness may put children at risk of apprehension by child welfare agencies, so mothers may avoid services that would connect them to Housing First programs in the first place.

If Indigenous women fleeing violence can (and want to) make it into programs, a wide array of supports need to be available. Housing First models emphasize the importance of offering various supports in addition to housing casework, like:

  • Services and programs for children
  • Extra safety measures
  • Income support
  • Trauma-informed support
  • Transitional options. As Mosher and Homes for Women point out:
    • Transitional housing (or congregate housing with women and children only) is an important option for women who have experienced the trauma of violence, mental health, sex work, addictions, where trust needs to be established. It has also been an effective option for youth and Aboriginal people, where trauma and violations of trust complicate their experience of homelessness and access to housing. (p. 9)
    • Culturally relevant services for Indigenous women and children (access to traditional education, Elders, etc. if they want it)

In rural and remote areas, Housing First programs need to be more creative in finding spaces for Indigenous women and children to live. When possible, and if the woman wants to, it is best to help participants stay in their community if it is safe to do so. For others, relocating further away will be a difficult and necessary transition requiring other kinds of support.

Are there other examples happening in your community? Share them on the Community Workspace on Homelessness.

To learn a bit more about Indigenous women, violence and homelessness, I recommend reading:

This post is part of our Friday "Ask the Hub" blog series. Have a homeless-related question you want answered? E-mail us at thehub@edu.yorku.ca and we will provide a research-based answer.

Homeless Hub
July 27, 2016
Categories: Topics

On July 28, the World Health Organization will mark World Hepatitis Day to raise awareness of worldwide efforts towards the elimination of viral hepatitis by 2030. With 400 million people living with hepatitis B or C worldwide, this year’s campaign theme in Canada is “Know your Status? Get Tested – Learn Your Options”.  While the general population in Canada is at lower risk of contracting hepatitis compared to people living in other parts of the world, it is a serious health concern that disproportionately affects homeless people worldwide

Hepatitis is one of a number of infectious diseases caused by viruses or bacteria that are spread between people or from animals to people. Most infectious diseases cause mild short-term effects, while others cause serious long-term effects which could lead to life-threatening complications. Researchers on homelessness and infectious disease often focus their investigation on hepatitis A, B and C, tuberculosis (TB), HIV/AIDS and a range of sexually transmitted infections. 

Homelessness has an impact on the spread, severity and treatment of infectious diseases. Because of their compromised immune system due the inability to maintain personal hygiene and adequate nutrition, people who are homeless are more vulnerable to illness than the general population. Having to stay in overcrowded and sometimes poorly ventilated spaces with other vulnerable people also raises the likelihood of spreading infectious diseases. In addition, transitioning between prison and homelessness, engaging in sex work and using intravenous drugs also increases the risk for infectious diseases to spread.

One study found that hepatitis C rates among homeless people in Toronto are 29 times higher than in the rest of the Canadian population. 23% of the homeless people surveyed in the study reported having hepatitis C, compared to less than 1% of the general population.  Researchers believe that the percentage is actually much higher as people tend not to experience symptoms for many years and/or they fail to be diagnosed. 

An American study looking at the links between affordable housing, homelessness and HIV/AIDS reported that people experiencing homelessness have HIV infection rates up to 16 times higher than those living in stable homes. For people living with HIV or AIDS, having a stable home decreased emergency room visits by 35% and slashed hospitalization by 57%, resulting in reduced health care costs.

In Canada, 70% of new cases of active TB reported every year occur among foreign-born individuals and 20% among Indigenous Peoples. Although active TB rates in Canada are among the lowest in the world, it has remained consistent for the last 30 years. In Toronto, a longitudinal study led by St. Michael’s Hospital found that one in five homeless people with active TB die within a year of their diagnosis. Homelessness not only delays treatment but also results in treatment complications for patients.

Treatment of infectious diseases among people who are homeless is complicated by the fact that many homeless people face barriers in accessing health services, lack funds for medication, and may not easily be able to follow treatment schedules. Further challenges include not having ID or a health card, feelings of stigmatization and/or the lack of transportation to health visits. The reality is that people experiencing homelessness have few options but to continue using emergency services or staying in unhealthy environments, meaning that even if they have access to treatment, they are still at high risk of contracting other infectious diseases. 

In England, the National Institute for Health and Clinical Excellence recommends the following guidelines to better treat, control and decrease the cases of TB, hepatitis C, and HIV among the homeless population and those at-risk:

  • Simultaneous screenings for TB, hepatitis C, and HIV
  • Transportation and housing supports as well as ensuring adequate nutrition
  • Active case-finding screenings (should not be restricted to symptomatic patients)
  • Needle exchange programmes
  • Free condom distributions
  • Community health centres in large cities
  • Better access to health care

While these are important recommendations, addressing the inequalities experienced by homeless people and their impact on social determinants of health is also a critical component of a wider public health strategy.

In 2014, the Government of Canada announced the Tuberculosis Prevention and Control in Canada: A Federal Framework for Action. The Framework for Action addresses the high rates of TB among Indigenous communities and foreign-born populations with high incidence of TB. It also deals with the underlying risk factors related to social determinants of health. While it may be too early to determine the outcomes of the Framework, the federal government plays a key role in building best practices in collaboration with provincial and territorial governments and other stakeholders in the global response to preventing and controlling TB.

With better access to quality health care, including harm reduction programs and further support services, infectious diseases can be successfully managed, treated and prevented. To join the conservations on social media and raise awareness on hepatitis, use the hashtags #worldhepday, #WHDCanada2016, #LightsUp4Hep, and #Nohep. You can also visit the Canadian Society for International Health’s website to access their campaign toolkit including posters, template letters to politicians, logos and further information for those organizing an event.  

 Photo Credit: Canadian Society for International Health, World Hepatitis Day 2016

University of Toronto; Canadian Observatory on Homelessness, York University
July 25, 2016

One of the unfortunate contradictions of our time is that we have more knowledge and the ability to share our knowledge faster with greater numbers of people in the world than ever in our history – and yet we still have poverty, homelessness, climate change, hatred and war. – Gary Meyers

For decades, Canada has largely responded to homelessness through emergency services and supports. It is now evident that this approach has not been effective at reducing homelessness. In fact, homelessness has continued to increase in some parts of Canada despite years of such efforts.

In contrast, research has persuasively shown that homelessness can be reduced through the expansion of affordable housing and responses focused on prevention, supports, systems coordination, and rapid re-housing. Cities such as Medicine Hat have made significant strides in reducing homelessness through such strategies. Although homelessness is a complex problem, we have many of the answers we need to address it. This forces us to ask: why haven’t we ended homelessness in Canada?

One barrier to ending homelessness is that policy and programming is often developed without the benefit of research. While there is lots of research on innovative, evidence-based solutions to homelessness, this research often fails to reach or be used by policy makers and practitioners. When governments fail to use research, they lose the opportunity to benefit from past experiences, build on community knowledge, and implement policies that are evidence-based. In view of this, we need to foster stronger links between research, policy, and practice.

What Prevents Research from Impacting Policy and Practice? 

There are many reasons that research may not reach or be used by policy makers, practitioners, or the public. Some of these reasons include:

  • Researchers primarily publish in academic journals that policy makers, practitioners, and the public don’t have access to
  • Practitioners and policy makers often juggle many competing priorities and have limited time to keep up with new research findings
  • Research is often presented in technical or academic language that is inaccessible to many audiences
  • Knowledge users may not feel that research is relevant, timely, or important, or they may feel excluded from helping to create knowledge
  • There are limited opportunities for collaboration between researchers, policy makers, practitioners, and the public

These challenges often create a gap between the creation of knowledge and the use of knowledge, making it difficult for policy makers, practitioners, researchers, and the public to learn from each other and pursue shared goals.

Addressing the Gap between Knowledge and Action 

Fortunately, in the last decade there has been a growth of research institutions, NGOs, and community-based organizations focused on making research “count” in the fight to end homelessness. These organizations are often engaged in what we call “knowledge mobilization.” 

Knowledge Mobilization refers to efforts to bridge the gap between research and action. Organizations that mobilize research often try to:

  1. Use unique strategies to share knowledge with a range of knowledge users,
  2. Work with various knowledge users to determine what research is needed and how researchers can help meet the needs of their communities, and
  3. Build partnerships between research producers, research users, and intermediaries to increase the impact of existing knowledge.

Knowledge mobilization is all about building relationships and making research active when addressing problems like homelessness.  

The process of translating research into action.

Knowledge mobilization is at the core of what we do here at the Canadian Observatory on Homelessness (COH). Collaboration between researchers and the communications team is critical to our goal of making research more accessible, understandable, useable, and relevant. To do this, the COH produces content in “layers”, giving our audience the option to get a quick overview of the research or dive as deep as they’d like. For example, when we release a research report, it can be accompanied by infographics, a blog post, a plain language summary and/or a video. As host of the largest web-based library on homelessness (the Homeless Hub), the COH employs a unique communication strategy that includes social media, a blog, an online community forum, and the creation of resources such as toolkits, infographics, research summaries, and free e-books. The Homeless Hub is a great place to get you thinking about translating research into action!  

How can you use research to help end homelessness in Canada?

Here are a few ways that different groups and organizations can mobilize research to end homelessness in Canada:

Agencies

  • Use research to shape the practices and policies in your organization (e.g., RENT’s Housing First: Best Practices for Managers)
  • Collaborate with researchers, community members, and other partners in the sector to increase knowledge about the needs of the community you serve
  • Invite researchers to help you evaluate your organization’s programs and identify areas for growth

Researchers

  • Share your findings through social media, a blog, the media, and/or plain language reports (the Ontario Centre of Excellence for Child and Youth Mental Health has a great guide to get you started)
  • Design studies in which agencies, organizations, and people experiencing homelessness are partners or collaborators
  • Create easy-to-use tool kits and resources for agencies and government so that findings can be easily understood and put into practice (the Canadian Housing First Toolkit is a great example)

Governments

  • Collaborate with researchers and build on existing research when designing policy and making funding choices
  • Build on the knowledge of agencies and people with lived experiences of homelessness when designing policy (e.g., Lived Experience Advisory Council’s seven principles)
  • Invite researchers and the public to consult on proposed policy, providing sufficient time for individuals and groups to offer feedback 

Advocates

  • Use research findings to educate the public about homelessness and encourage public engagement
  • Invite researchers, politicians, and policy makers to meet with affected communities and listen to their needs and proposed solutions
  • Use research findings when developing petitions, writing letters to your local MP, or deputing at your local city council meeting

The Public

  • Use research to inform your opinions about homelessness in your community (e.g., when a new shelter is being built in your neighbourhood)
  • Challenge stereotypes about people experiencing homelessness using evidence from research (e.g., many people experiencing homelessness want to work or are employed)
  • Use research to learn about the needs of community members who are homeless and get involved with local groups who are addressing those needs

Using Research to Impact Policy: The National Housing Strategy

It is a great time to start flexing your knowledge mobilization muscles because the federal government is currently seeking feedback on its proposed National Housing Strategy. Through letstalkhousing.ca, you have the opportunity to show the government that homelessness is a priority for Canadians.

Fortunately, the government has identified homelessness as a key outcome. The question becomes how? How can we put an end to homelessness through a National Housing Strategy? We know, by leveraging existing research, the answer lies beyond affordable housing. A successful National Housing Strategy will couple improved access to housing with evidence-based strategies to prevent homelessness. Stay tuned for the Canadian Observatory on Homelessness prevention-focused response to the consultation.

Remember, by using research findings in your feedback you can strengthen your argument and demonstrate that homelessness is a solvable problem.

If we want to end homelessness in Canada, let’s use all the tools available to us - that includes research!

Canadian Observatory on Homelessness/Homeless Hub: York University
July 22, 2016
Categories: Ask the Hub

As Canada’s aging population and rates of chronic and terminal illnesses rise, palliative and end-of-life care services will be more and more in demand.

Palliative care helps people live the best lives they can while facing life-threatening illness. It focuses on relieving pain, easing confusion, and considers the emotional and spiritual needs of the patient and their families. As Dr. Dosani pointed out in his blog post a few years ago, there’s increasing evidence that early palliative care (upon diagnosis) should be a priority for everyone.

According to research by Donna Wilson and others, most Canadians want to die at home, or in places that feel like home (cabins, somewhere in nature, etc.), with only a small percentage of people saying they want to die in a hospital or nursing home (where most people do end up dying). This discrepancy has inspired much conversation about the rising importance of hospices, palliative care, and making it more affordable for people to die at home. But what happens to someone who is terminally ill and doesn’t have a home?

People experiencing homelessness, especially chronically, are more likely to have a wide range of health issues and a much lower average mortality age than people who are housed. Despite having high needs, many have a hard time accessing mainstream health services due to stigma, discrimination, past negative experiences, inflexible programming, and location. While there isn’t much research on people experiencing homelessness and palliative care, we know that many are interested in advanced care planning and choosing location of death. One 2007 study found that among its 53 participants:

  • Many had experiences with death (of friends, family and other street-involved people).
  • There was a lot of interest in advance directives and end-of-life care, but participants felt that programs were inaccessible.
  • Many echoed the same sentiments about dying that have come up in other studies with the general population (being reunited with family), but others had more unique concerns, like dying anonymously, alone or undiscovered.

Despite expressing a desire for choice, most people experiencing homelessness die in acute-care settings.

Barriers to palliative care

A 2013 Toronto-based study assessed how people experiencing homelessness accessed palliative care. The participants, nurses and outreach workers, highlighted the following as important barriers:

  • Housing sector staff are rarely trained in end-of-life care, and don’t have sufficient access to medical professionals.
  • Many people experiencing homelessness have had past negative experiences in healthcare and don’t feel comfortable seeking it.
  • Many echoed the same sentiments about dying that have come up in other studies with the general population (being reunited with family), but others had more unique concerns, like dying anonymously, alone or undiscovered.

In another study, participating housing workers outlined four main recommendations to help improve access to palliative care: “(1) increasing positive interaction between the health care system and the homeless, (2) training staff to deal with the unique issues confronting the homeless, (3) providing patient-centered care, and (4) diversifying the methods of delivery.”  

Types of palliative care

There’s a few different ways people experiencing homelessness can get palliative care, depending on where they’re located:

Shelter-based programs

Some hostels and shelters coordinate with other organizations and medical staff to provide palliative care when needed, though there are limitations to what can be offered in many cases. Many residents are expected to leave during the day for cleaning – not a possibility for the very ill – and guests are often only allowed within specific timeframes. Exceptions can be made but it is at the discretion of shelter staff.

Even so, there is evidence that this model is not only effective at reducing pain, improving comfort and – sometimes – helping patients reconnect with friends or family, but is also more cost effective than if patients sought treatment elsewhere. In one 2006 study, 28 patients who were terminally ill and homeless were admitted to and died in a hospice.  Researchers compared the hospice to other care locations and projected $1.39 million in savings for these patients’ care.

One of the challenges of these programs is that partnerships with health professionals aren’t always strong enough, resulting in role confusion and a burden of work placed on shelter workers. Another is the devaluing of end-of-life and palliative care in general, resulting in unpaid overtime and heavy emotional stress for shelter workers. The participants of Webb’s U.K-based study all identified situations in which they’d gone beyond the call of duty for residents:

‘That weekend when I spent 17 hours at the hospital it was in my own time.’ Participants had even visited dying residents while they were off duty in order to meet their emotional needs. Two had worked unpaid in order to be there for the resident’s final moments of life and one staff member described a scenario where she took complete responsibility for arranging the resident’s funeral (p. 242).

While it’s wonderful that there are people willing to provide such care, these stories speak to a greater need for funding and training for end-of-life care in the hostels and shelters that provide them.

Mobile programs

Another less common, but more flexible model of palliative care is mobile programs, which meet people in need whether they be on the street or sheltered. In Toronto, PEACH (Palliative Education and Care for the Homeless) is one such program (its principles listed below). In May of this year, The Toronto Star ran a story about nurse Namarig Ahmed, who coordinates PEACH, and secured a bed for a man dying of cancer in the shelter he spent most of his time in. Though PEACH is doing much to give people experiencing homelessness the dignity of choosing how to die and minimizing their pain, there is much more work to be done. As Alex Newman wrote in the article:

Although the PEACH program is “one step closer to dying with dignity, and with as little pain or discomfort as possible, we’re still trying to find better way to deal with this,” Ahmed says. “Having conversations with other health-care providers is a vital first step to find a solution and make this care accessible to all."

PEACH Principles


Improving access to palliative care

Of course, both shelter- and mobile-based programs are usually only available to people living in urban centres. Hospices, shelters, and hostels are in much smaller supplies in rural and remote areas. There, people almost always need to go to hospitals or pay for personal care – options which are often unavailable to people experiencing homelessness.

As the writers of this 2015 literature review point out, we need more models of intervention for advanced care planning, palliative care, and end-of-life care that address the needs of people experiencing homelessness. More importantly, as Huynh, Henry and Dosani proposed in a recent article, a national strategy is needed to “address this glaring gap in our healthcare provision,” and promote policy development around ensuring everyone has access to palliative and end-of-life care.  

This post is part of our Friday "Ask the Hub" blog series. Have a homeless-related question you want answered? E-mail us at thehub@edu.yorku.ca and we will provide a research-based answer.

Graphic credit: Juxta Magazine

Canadian Observatory on Homelessness/Homeless Hub: York University
July 20, 2016

This week’s infographic is from Rock Trust, an Edinburgh, UK-based organization that educates and supports homeless and at risk youth to enable them to build the skills required to make a positive and healthy transition to adulthood. The infographic, based Rock Trust’s Beyond Homelessness report, demonstrates the positive impact both formal and informal relationships can have for young people.   

The Beyond Homelessness report studied the everyday experiences of youth over a three-year period. The study found that the social networks directly impact a youth’s resiliency to homelessness, wellbeing and need for formal support while homeless. Access to informal supports, such as family members or friends, were proven to help youth become more resilient and feel less isolated, leading to an increase in their overall wellbeing. When youth were homeless, there was a decrease in the amount of contact with informal supports. As a result, youth would depend on formal supports such as individuals from organizations or agencies, who could provide help or assistance through homeless services or programs.

Youth who were homeless were highly dependent on formal support networks to help with housing issues, physical health, depression and for general advice. In many cases youth were equally as likely to approach formal or informal networks for support. There was a balanced distribution of sources of informal and formal support concerning wellbeing, addictions and relationship issues; however, there was a large number of those interviewed who did not know where they would go to for help on a range of issues.

The area where youth felt they would like more support were additional monies (48%), housing (44%), legal matters (30%), and mental health (26%). Creating stronger relationships with family members and friends, or with personal feelings were one of the least areas needing additional support (11%).

In a follow-up interview, the key skills interviewees felt they had developed were confidence, self-esteem, overcoming addictions, reducing their negative networks, better self-awareness, better understanding of relationships, patience, money awareness, socializing/opening up, help to pick oneself up/keep going, and life skills such as cooking/cleaning/budgeting. Of those interviewed, 85% felt that there had been an improvement in their wellbeing, 78% felt that they had been able to make good use of the support offered and 93% felt more able to support themselves compared to year prior.

The Beyond Homelessness report aimed to act as a resource for those working within the homelessness sector to develop an understanding and awareness into the integral role social networks can play in developing paths out of homelessness. 

Beyond Homelessness Report Infographic

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