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.
Summary Self-managed shelters claim that participants who have been homeless, are better able to run a shelter than regular providers. Little research has investigated self-managed shelters. In this paper we described the experiences of participants and peer workers with empowerment processes in Je Eigen Stek (Your own place, JES), a self-managed shelter, based on an eight year qualitative responsive evaluation. FindingsWe distinguish three clusters of individual experiences: 1) enthusiastic, 2) moderate to critical, and 3) negative, respectively associated with decreasing engagement with social life in and management of JES. Those not engaged can still benefit materially and from the freedom of choice JES offers, which is generally appreciated. Empowerment provides a useful framework and JES in turn offers new insights into the dialectical nature of empowerment. Empowerment consists of freedom of choice and capacity development and neither should be emphasized over the other. The emphasis in JES is on freedom of choice, which does not automatically lead to developing capacities. Social workers try to balance both aspects of empowerment.Applications Our analysis shows how offering freedom of choice can contribute to empowerment, although social workers need to be aware that participants might opt not to work on capacity development.
Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their perceived goal-related self-efficacy and their QoL. A hierarchical regression analysis was used to analyse the association between QoL and goal-related self-efficacy, relative to factors contributing to QoL, such as demographic characteristics, socioeconomic resources, health and service use. Results indicate that the majority of homeless adults had at least one personal goal for the coming 6 months and that most goals concerned housing and daily life (94.3%) and finances (83.6%). The QoL of homeless adults appeared to be lower in comparison with general population samples. General goal-related self-efficacy was positively related to QoL (β = 0.09, P = 0.042), independent of socioeconomic resources (i.e. income and housing), health and service use. The strongest predictors of QoL were psychological distress (β = −0.45, P < 0.001), income (β = 0.14, P = 0.002) and being institutionalised (β = 0.12, P = 0.004). In conclusion, the majority of homeless adults entering the social relief system have personal goals regarding socioeconomic resources and their goal-related self-efficacy is positively related to QoL. It is therefore important to take the personal goals of homeless people as the starting point of integrated service programmes and to promote their goal-related self-efficacy by strength-based interventions.
