SOWK 562 – Summer 2014
Assignment #3: Intervention Literature Review
July 20, 2014
Dr. Hsin-Yi Hsiao
Intervention Description
There are two distinct service models for persons experiencing homelessness that also have issues with mental illness and/or addictions, the treatment first model or the Housing First model. Housing First models utilize a supported housing approach in which consumers start with permanent, independent apartments and providers work with consumers regardless of their symptoms, substance abuse, or whether they participate in formal treatment (Henwood, 2011). The housing is the treatment or intervention and the treatment is offered as long as the client needs the support.
Although the housing first
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Where individuals have been deemed somehow responsible for their homelessness, they have frequently been considered less worthy of support.
Another theoretical framework discussed in tandem with the effectiveness of housing first programs is the concept of human agency. Human agency is the idea that individuals understand their problems in context with socially acceptable norms (Parsell, 2014). It recognizes that the homeless population has a unique set of skills and strengths from which they can draw on to navigate their way out of the current situation. People have the capacity to invent new possibilities (Parsell, 2014).
Analysis of the Empirical Literature on Intervention
In the article written by Benjamin Henwood comparing front line providers’ views of housing first programs versus traditional programs, 41 front line service providers in the New York area were studied using a longitudinal qualitative study. 20 providers used the housing first model and the other 21 used the treatment first model. The protocols of the study included a baseline interview during the first month of being housed and a follow up interview either when the client left the program or six months later (Henwood, 2011). The data was then analyzed using a coding process called Thematic analysis.
There were three main conclusions drawn from the study. First, it was found that the
During the Great Depression, the homeless were almost glamorized as vagabonds who rode the rails with their belongings neatly tied up in a bandana over their shoulder. Today, the homeless can be anyone: children or women escaping an abusive relationship or those who just cannot afford to pay for housing. While some homeless people maintain employment of some sort, long term homelessness is usually a function of the inverse; either severely under-employed or no income stream at all with which to pay rent and utilities. While quite a bit of academic research has shown the need to focus on societal causes of homelessness, people who are homeless seem to be increasingly perceived and treated within a paradigm of individual sickness. While
Homelessness is often accompanied by many other problems such as mental disorders, substance abuse issues, isolation from family and friends, and poor general health. Often time’s people that suffer from homelessness experience a lower quality of life than those who have a place to call home.
Homelessness is basically another form of poverty except more extreme, yet society treats it as if it was on another spectrum of problems. Some in society stigmatize this population by saying things like: they’re homeless because they are drug addicts, alcoholics, they don’t want to work and just live off the government for free. What many forget to think about are the factors that have these people on the street, or the fact that they are not only experiencing personal hardship by being without a permanent residence but emotional ones as well. Add the fact they are sometimes discriminated against and excluded by society, and you will realize you are looking at one of the most vulnerable populations.
Homelessness in the United States is a multifaceted problem, there are many factors to consider when examining this homelessness including access to health care, economic conditions and public policy as well as a host of other issues. Problems with homelessness that need addressed are the stigmatizations of being homeless and how this perception has led to anti-homeless policies, how reforming anti-homeless policies can lead to shifting society’s perception of the issue of homelessness, and finally why social workers must be at the forefront of the campaign to facilitate meaningful change to reduce the human suffering
Homelessness tends to be associated with images of people who sleep in the streets, parks, subways, and sidewalks; who lack shelter of any kind, and are transient throughout the year, moving from place to place. The homeless are sometimes considered as undeserving of support; they are frequently stigmatized as being mentally ill, out of control, and are viewed by some as personally responsible for their situation (Phelan, Link, Moore & Stueve, 1997).
In the United States, almost 2 people out of every 1000 people experience homelessness (National Alliance to End Homelessness). In 2014, statistics have revealed that on any given night, almost half a million people experienced homelessness. Many people have a misconception that homelessness simply means living on the street. The United States Department of Housing and Urban Development suggests homelessness is a whole spectrum. According to the HUD, people experiencing homelessness are people who don’t have a fixed and regular residence (shelter, house, hotel, etc…), people running away from all sorts of domestic violence and sexual abuse, and/or people living in places not intended for residence, such as streets, cars, etc...(U.S. Department of Housing and Urban Development). Regardless of what definition society uses, homelessness is, and will always be, unjust.
The Homeless are a vulnerable population. Homelessness is a social issue that anyone can almost be subjected to despite his or her age, race, ethnicity or geographical background. Kornblum (2012) defined homelessness as… “as a social condition in which people do not have regular housing and are forced to sleep in public places, public shelters, or facilities designed for homeless individuals and families” (p.280). The homeless population faces several adversaries in their lifetime of being homeless. Their adversaries are a lack physical and emotional disabilities, and possibly drug abuse. Grant some are homeless by choice, whereas most are homeless by mishaps, but nevertheless, they are humans deserving to be treated with fairness, dignity,
According to Donovan, S and Shinseki, E.K. of the American Journal of Public Health, the suggestion to combat this issue is to reenforce intervention strategies of certain government organizations that work and to funnel federal resources to those strategies (Donovan, 2013). One of the main factors for why people are homeless is due to the mental and physical illness and substance abuse. Effective intervention strategies must be achieved in order to combat homelessness and to ensure veterans are receiving aid they deserve. An example of improving intervention would be to increase investment in effective, evidence-based programs utilizing such as the Housing First model created by the VA which helps assist veterans with access to health care, employment and other supportive services that promote long-term housing stability, reduce recidivism and improve quality of
Researchers and policymakers are newly optimistic about the prospect of ending homelessness. For two decades, the goal of our homeless programs was to first treat people for their myriad afflictions (substance abuse, say, or illness) and hope that
A homeless person is an individual without a permanent, stable housing situation who either spends his or her nights on the streets or in temporary facilities, such as shelters and abandoned buildings. Throughout history, society has been “holding the poor, rape or incest victims, minorities, or the handicapped responsible for their misfortunes” (Zur). Society has been blaming the homeless for being in the position they are in. However, upon closer inspection, it must be noted that “children under the age of 18 accounts for 39% of the homeless population…battered women who live in poverty are often forced to choose between abusive relationships and homelessness…[and] 40% of homeless men have served in the armed forces” (Who Is Homeless?). It is clear that those who are homeless are not
Denver’s homeless population runs in the thousands. Homelessness may be caused or exacerbated by an individual’s chronic mental or physical illness, all issues that the Mental Health Center of Denver (MHCD), a member of the National Council for Behavioral Health, addresses. Integrated housing and recognizing the effects of trauma have already been a part of the services offered by MHCD. After participating in a National Council Trauma-Informed Care (TIC) Learning Community, MHCD created a workgroup to discuss integrating more TIC principles into the organization. From this, the concept of integrating these trauma-informed care principles into the center’s housing and residential services emerged.
The issue of homelessness has been called as one that is "highly ambiguous and intangible" (Neale, 1997, p.7). Wright defines the homeless a "diverse, heterogeneous lot. No single catch phrase or easy myth can possibly describe them all" (p.46)
Despite millions of dollars from Congress funding services for the homeless, homelessness did not decrease in he U.S. during the 1980s or 1990s. Since then, an ideology known as Housing First has come into popularity, which will be elaborated on in the literature review section. The National Alliance to End Homelessness (NAEH) defines Housing First as “a homeless assistance approach that prioritizes providing people experiencing homelessness with permanent housing as quickly as possible – and then providing voluntary supportive services as needed” (“Housing First”). This
Understanding how both individual and structural factors contribute to and sustain homelessness is a critical factor in successfully addressing homelessness. All to often service providers blame homeless individuals for the circumstances they are in, making assumptions that substance abuse or other irresponsible behaviors have caused the problems leading to the individual to become homeless. Hoffman and Coffey (2008) suggest, “the perpetuation of homelessness is not internal to the homeless individual as many claim, but rather may be embedded in the service industry itself, which subjects both clients and providers to bureaucratic forms of authority and experiences of disrespect.” While not all homeless people suffer from mental illness or substance abuse, all of
Transitional housing was selected as a social problem because of the disturbing number of homeless mothers professionally encountered under the age of 25, and the need for housing related interventions. The human service model can best be applied through the fundamental concepts of the Ecological Perspective which explores the nature of the relationship between the individual, the human behavior professional and the environment, with a direct focus on human relatedness, competence, self-direction, and self-esteem (Lesser & Pope, 2007).