This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual-level interventions that, on their own, cannot raise people out of poverty. The paper calls for a social justice value, informed by the concept of citizenship, as a necessary complement to the recovery concept that has informed community mental health practice for almost 25 years. Finally, the paper argues that community psychologists, with their concepts, methods, and values, are well positioned to contribute to this important issue. However, it also contends that addressing poverty requires collaboration from community psychologists with researchers and practitioners from other fields and domains of expertise to begin to make progress.
Homelessness has consequences for families, including risk of deterioration in the health of their members, disruption of family dynamics, and separation of parents and children. This study used qualitative interviews to explore pathways into and perceived consequences of homelessness among 18 families living in an emergency family shelter system in Canada. Findings showed that families’ experiences prior to their homelessness were characterized by vulnerability, instability, and isolation. In the emergency shelter system, families faced new challenges in environments that were restrictive, noisy, chaotic, and afforded little privacy. Participants described a further disruption of relationships and described having to change their family practices and routines. Despite the challenges that families encountered, some participants felt optimistic and hopeful about the future. Future research is needed on ways in which shelters can be more hospitable, supportive, and helpful for parents and their families to minimize negative impacts and facilitate timely rehousing of families.
Objective eHealth interventions are being developed to meet the needs of diverse populations. Despite these advancements, little is known about how these interventions are used to improve the health of persons experiencing homelessness. The aim of this systematic review was to examine the feasibility, effectiveness, and experience of eHealth interventions for the homeless population. Methods Following PRISMA guidelines, a systematic search of PsycINFO, PubMed, Web of Science, and Google Scholar was conducted along with forward and backward citation searching to identify relevant articles. Results Eight articles met eligibility criteria. All articles were pilot or feasibility studies that used modalities, including short message service, mobile apps, computers, email, and websites, to deliver the interventions. The accessibility, flexibility, and convenience of the interventions were valued by participants. However, phone retention, limited adaptability, a high level of human involvement, and preference for in-person communication may pose future implementation challenges. Conclusions eHealth interventions are promising digital tools that have the potential to improve access to care and service delivery. eHealth interventions are feasible and usable for persons experiencing homelessness. These interventions may have health benefits by augmenting existing services and if implementation challenges are addressed. Further evaluation of the effectiveness of eHealth interventions is needed before widespread implementation. Those with lived experience should also be engaged in developing and evaluating these interventions.
Housing is a key social determinant of health that contributes to the well-documented relationship between socioeconomic status and health. This study explored how individuals with histories of unstable and precarious housing perceive their housing or shelter situations, and the impact of these settings on their health and well-being. Participants were recruited from the Health and Housing in Transition study (HHiT), a longitudinal, multi-city study that tracked the health and housing status of people with unstable housing histories over a 5-year period. For the current study, one-time semi-structured interviews were conducted with a subset of HHiT study participants (n = 64), living in three cities across Canada: Ottawa, Toronto, and Vancouver. The findings from an analysis of the interview transcripts suggested that for many individuals changes in housing status are not associated with significant changes in health due to the poor quality and precarious nature of the housing that was obtained. Whether housed or living in shelters, participants continued to face barriers of poverty, social marginalization, inadequate and unaffordable housing, violence, and lack of access to services to meet their personal needs.
Purpose Foreign-born families face challenges following migration to Canada that may impact their well-being and lead them to homelessness. Yet, there is limited research on the experience of homelessness in this population. The purpose of this paper is to examine the health of foreign-born families staying in the emergency shelter system in Ottawa, Ontario, Canada, and compare their experiences to Canadian-born homeless families who are also living in shelters. Design/methodology/approach Interviews were conducted with 75 adult heads of families who were residing in three family shelters. This study focused on mental and physical health functioning, chronic medical conditions, access to care and diagnoses of mental disorders. Findings Foreign-born heads of families reported better mental health than did Canadian-born heads of families with a significantly lower proportion of foreign-born participants reporting having been diagnosed with a mental disorder. Foreign-born heads of families also reported fewer chronic medical conditions than did Canadian-born heads of families. Research limitations/implications This study relied on self-reported health and access to healthcare services. Data were drawn from a small, non-random sample. Originality/value This study is one of the first studies to examine the health and well-being of homeless foreign-born heads of families. Moreover, this paper also focuses on disparities in health, diagnoses of mental disorders, and access to healthcare services between foreign-born and Canadian-born families – a comparison that has not been captured in the existing literature.
Background Barriers to recruiting and retaining people with psychosis and their families in research are well-established, potentially biasing clinical research samples. Digital research tools, such as online platforms, mobile apps, and text messaging, have the potential to address barriers to research by facilitating remote participation. However, there has been limited research on leveraging these technologies to engage people with psychosis and their families in research. Objective The objective of this study was to assess the uptake of digital tools to engage patients with provisional psychosis and their families in research and their preferences for different research administration methods. Methods This study used Research Electronic Data Capture (REDCap)—a secure web-based platform with built-in tools for data collection and storage—to send web-based consent forms and surveys on service engagement via text message or email to patients and families referred to early psychosis intervention services; potential participants were also approached or reminded about the study in person. We calculated completion rates and timing using remote and in-person methods and compensation preferences. Results A total of 447 patients with provisional psychosis and 187 of their family members agreed to receive the web-based consent form, and approximately half of the patients (216/447, 48.3%) and family members (109/187, 58.3%) consented to participate in the survey. Most patients (182/229, 79.5%) and family members (75/116, 64.7%) who completed the consent form did so remotely, with more family members (41/116, 35.3%) than patients (47/229, 20.5%) completing it in person. Of those who consented, 77.3% (167/216) of patients and 72.5% (79/109) of family members completed the survey, and most did the survey remotely. Almost all patients (418/462, 90.5%) and family members (174/190, 91.6%) requested to receive the consent form and survey by email, and only 4.1% (19/462) and 3.2% (6/190), respectively, preferred text message. Just over half of the patients (91/167, 54.5%) and family members (42/79, 53.2%) preferred to receive electronic gift cards from a coffee shop as study compensation. Most surveys were completed on weekdays between 12 PM and 6 PM. Conclusions When offered the choice, most participants with psychosis and their families chose remote administration methods, suggesting that digital tools may enhance research recruitment and participation in this population, particularly in the context of the COVID-19 global pandemic.
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