Purpose: Self-managed institutional homeless programmes started as an alternative to regular shelters. Using institutional theory as a lens, we aim to explore the experiences of stakeholders with the institutional aspects of a self-managed programs.Method: The data we analysed (56 interviews, both open and semi-structured) were generated in a longitudinal participatory case-study into JES, a self-managed homeless shelter. In our analysis we went back and forth between our empirical data and theory, using a combination of systematic coding and interpretation. Participants were involved in all stages of the research.Results: Our analysis revealed similarities between JES and regular shelters, stemming from institutional similarities. Participants shared space and facilities with sixteen people, which caused an ongoing discussion on (enforcement of) rules. Participants loathed lack of private space. However, participants experienced freedom of choice over both their own life and management of JES and structures were experienced more fluid than in regular care. Somestructures also appeared stimulated self-management.Conclusion: Our analysis showed how an institutional context influences self-management and suggested opportunities for introducing freedom and fluidity in institutional care.
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BACKGROUND: People experiencing homelessness often encounter progressive incurable somatic diseases in combination with psychiatric and psychosocial problems, and many need palliative care at the end of their lives. Little is known about how palliative care for this group can be started in good time and provided optimally. The objective of this paper is to give insight into the extent people experiencing homelessness have access to good palliative care.
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The use of social networking and e-health technology through mobile (and other) devices, like smartphones and tablets, has been increasing in the last 20 years. This is equally true for people in marginalized situations, like homeless people. Earlier research shows that the majority of homeless people own a smart phone (Heaslip et al., 2021) and that mobile technology has the potential to support the health and wellbeing of persons who are homeless (Calvo & Carbonell, 2019). In our presentation, we will explore this potential further and shed light on how and why online social networking is used by homeless people and their social workers.We will present findings from our two-year qualitative research project ‘Social Network First?’ on network support offered to homeless people in Amsterdam and Haarlem, two cities in the Netherlands. In the recent decade, the Netherlands has seen the number of homeless people doubled (CBS, 2021) and the urgency to support this disadvantaged group has increased. Whereas policy in previous years focused predominantly on a ‘housing first’ approach, in which the main priority is to accommodate homeless people, the belief grows that this approach is not sufficient. For that reason, in addition to housing, Dutch shelter organizations are implementing a novel network support approach in the care of homeless people. With this approach, loosely based on the resource group method, social workers attempt to empower their homeless clients by involving and strengthening their clients’ social contacts. To understand the network support approach and its contribution to the empowerment of homeless people, we have conducted 25 semi-structured interviews with homeless people, their relatives and friends, social workers, and other professionals involved. The analysis of the interview data reveals that online social networking is of crucial importance for the network support approach. Our (preliminary) results show that especially WhatsApp is used by social workers to connect the homeless person to his/her social network in two ways. Firstly, WhatsApp is used for thoroughly mapping the social network of the client. Secondly, WhatsApp is used to create an online support group, which offers the client and his/her network possibilities for (re)connection and mutual support. In addition, WhatsApp is used extensively by social workers to easily maintain contact with homeless clients. This is important because, especially with clients who are not ready yet to work on their recovery, using WhatsApp allows social workers to just check in once in a while, while giving control of the process to the client. Whereas these results are predominantly positive, we will also discuss the cons of social networking technology, like privacy issues. In conclusion, our presentation offers a comprehensive exploration of the opportunities of social networking technology in the context of supporting homeless people. By examining the implications for social workers, we aim to inspire attendees with insights in how digital communication methods can be used to improve their social work practice. Subsequently, we aspire this contributes to developing pathways out of homelessness with the help of others.
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Cognitive impairment is a prevalent problem among the homeless and seems related to more psychosocial problems. However, little is known about the care needs of the subgroup of homeless people with an intellectual disability compared to those without an intellectual disability and how their care needs develop over time. This study explores self-reported care needs within a broad range of life domains among Dutch homeless people with and without a suspected intellectual disability to gain insight into the transition of self-reported care needs from baseline to follow-up in both subgroups. This longitudinal study is part of a cohort study among homeless people who had been accepted for an individual programme plan in four major Dutch cities. The initial cohort consisted of 513 participants who were interviewed in 2011. At 1.5-year follow-up, 336 participants (65.5%) were also interviewed and screened for intellectual disability. Of these participants, 31% (95% CI 26.2-36.1) had a suspected intellectual disability. For both groups, between baseline and follow-up, the number of 'unmet care needs' decreased significantly and the number of 'no care needs' increased significantly, while at follow-up, participants with a suspected intellectual disability reported 'no care needs' on significantly fewer life domains than those without a suspected intellectual disability (mean numbers 16.4 vs. 17.5). Between baseline and follow-up, 'met care needs' decreased significantly on housing for both groups, and increased on finances and dental care for participants with a suspected intellectual disability. At follow-up, participants with a suspected intellectual disability more often preferred housing support available by appointment than those without a suspected intellectual disability. These findings suggest that homeless people who had been accepted for an individual programme plan with a suspected intellectual disability have care needs for a longer period of time than those without a suspected intellectual disability. Providing care to homeless people with a suspected intellectual disability might require ongoing care and support, also after exiting homelessness. Support services should take this into account when considering their care provision and planning of services.
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The demographics of the homeless population in many countries are currently shifting, and this cannot be explained by the different welfare systems to be found in these countries. Nevertheless, there is some evidence that the homelessness policies of some countries are converging, and we observe a combination of decentralisation, housing first, and a taylor-made, individualised approach. However, what is interesting is the question as to what extent these policies are based on a punitive dimension or on a justice dimension.
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This is the report on the situation in the Netherlands in the field of youth, young homeless people and unaccompanied minor aliens. The report describes risk factors for children and young people in relation to social exclusion and homelessness. This report forms the first part of the international comparative study ‘CSEYHP’. MOVISIE carries out this three-year study by order of the European Union. The cooperative partners are three universities in: England, the Czech Republic and Portugal. The objectives of ‘Combating Youth Homelessness’ are as follows: 1. to understand the life trajectories of different homeless youth populations in different national contexts; 2. to develop the concepts of risk and social exclusion in relation to the experience of young homeless people and to the reinsertion process; 3. to test how different methods of working contribute to the reinsertion process for young people; 4. to investigate the roles of and relationships between the young person, trusted adults, lead professionals, peer mentors and family members in the delivery of these programmes across all four countries. When preparing the national reports, the three partner countries the Czech Republic, England and Portugal use the same format as used in the Dutch report. Based on the four national reports, England will prepare a comparative report, in which the four national situations will be compared.
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Housing stability is an important focus in research on homeless people. Although definitions of stable housing differ across studies, the perspective of homeless people themselves is generally not included. Therefore, this study explored the inclusion of satisfaction with the participant's current housing status as part of the definition of housing stability and also examined predictors of housing stability with and without the inclusion of homeless person's perspective. Of the initial cohort consisting of 513 homeless participants who were included at baseline in 2011, 324 (63.2%) were also interviewed at 2.5-year follow-up. To determine independent predictors of housing stability, we fitted multivariate logistic regression models using stepwise backward regression. At 2.5-year follow-up, 222 participants (68.5%) were stably housed and 163 participants (51.1%) were stably housed and satisfied with their housing status. Having been arrested (OR = 0.36, 95% CI: 0.20-0.63), a high level of somatisation (physical manifestations of psychological distress) (OR = 0.52, 95% CI: 0.30-0.91) and having unmet care needs (OR = 0.77, 95% CI: 0.60-0.99) were negative predictors of housing stability. Having been arrested (OR = 0.43, 95% CI: 0.25-0.75), high debts (OR = 0.45, 95% CI: 0.24-0.84) and a high level of somatisation (OR = 0.49, 95% CI: 0.28-0.84) were negative predictors of stable housing when satisfaction with the housing status was included. Because inclusion of a subjective component revealed a subgroup of stably housed but not satisfied participants and changed the significant predictors, this seems a relevant addition to the customary definition of housing stability. Participants with characteristics negatively associated with housing stability should receive more extensive and individually tailored support services to facilitate achievement of housing stability.
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OBJECTIVES: We explored whether changes in the perceived health of homeless people after entering the social relief system (SRS) in The Netherlands were predicted by housing, income, hours of work, social support, unmet care needs, arrests, physical and mental health, substance use, and experiences of autonomy, competence and relatedness, in addition to perceived health at baseline, demographics, suspected intellectual disability, the duration of homelessness and the company of children in the shelter facility.METHODS: A hierarchical regression analysis was used to explore the significant predictors of the perceived health of 344 homeless persons 18 months after entering the social relief system.RESULTS: A decrease in psychological distress and an increase in hours of (paid/voluntary) work as well as competence predicted a better perceived health.CONCLUSIONS: Perceived health is not only influenced by objective circumstances related to work and mental health, but also self-determination, as shown by the influence of competence. Services should aim to reduce psychological distress of homeless people, support them in increasing their working hours and focus on strengthening their competence.
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Although homelessness is inherently associated with social exclusion, homeless individuals are rarely included in conventional studies on social exclusion. Use of longitudinal survey data from a cohort study on homeless people in four major Dutch cities (n = 378) allowed to examine: changes in indicators of social exclusion among homeless people over a 2.5-year period after reporting to the social relief system, and associations between changes in indicators of social exclusion and changes in psychological distress. Multinomial logistic regression analysis was applied to investigate the associations between changes in indicators of social exclusion and changes in psychological distress. Improvements were found in various indicators of social exclusion, whereas financial debts showed no significant improvement. Changes in unmet care needs, health insurance, social support from family and relatedness to others were related to changes in psychological distress. This study demonstrated improvements in various indicators of social exclusion among homeless people over a period of 2.5 years, and sheds light on the concept of social exclusion in relation to homelessness.
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This thesis has increased our knowledge of the needs of homeless people using shelter facilities in the Netherlands and of the needs and wishes of people living in persistent poverty. It provides guidance for policy and further professionalization and quality improvements to the services and support provided to homeless people and people living in persistent poverty. The results underscore the importance of broad and integrated policy measures to strengthen socioeconomic security, and emphasize the need for including the views of clients and experts by experience in the development of policy. Our research also stresses the need for services to employ peer workers to support homeless people and people living in persistent poverty and to apply a more human-to-human approach.
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