Being homeless has a negative effect on health and the health needs of individuals experiencing homelessness are complex and challenging to address. As a result of limited access to and use of primary healthcare, the main point of entry into the healthcare system for individuals experiencing homelessness is often hospitals and emergency departments. Persons experiencing homelessness are commonly discharged from hospital settings to locations that do not support recovery or access to follow-up care (e.g. shelters or the street). This can be costly to both the healthcare system and to individuals' health and quality of life. We conducted a scoping review of the literature published between 2007 and 2017 to identify the types of health supports needed for persons experiencing homelessness who are discharged from the hospital. Thirteen literature sources met inclusion criteria and thematic data analyses by two researchers resulted in the identification of six themes related to the types of health supports needed for persons experiencing homelessness who are transitioning (i.e. being discharged) from the hospital. Using a community consultation approach, the scoping review themes were validated with 23 health and shelter service providers and included in our integrated findings. Themes included: (a) a respectful and understanding approach to care, (b) housing assessments, (c) communication/coordination/navigation, (d) supports for after-care, (e) complex medical care and medication management, and (f) basic needs and transportation. These themes were found to resonate with participants of the community consultation workshop. Recommendations for trauma-informed care and patient- or client-centred care approaches are discussed.
Waterscapes can have meaningful benefits for people’s wellbeing and mental health by helping them feel calmer and more connected to nature, especially in times of stress such as the COVID-19 pandemic. The waterscapes along the San Marcos River (Texas, USA) provide economic, social, environmental, and emotional benefits to the surrounding community. To assess the social demand for and emotional experiences in these blue spaces, we used a new framework called Blue Index that collects noncontact data from photo stations. From 10 photo stations across different waterscapes, we collected and analyzed 565 volunteer assessments from May 2021 to March 2022—during the COVID-19 pandemic and following the reopening of riverside parks. Most respondents (57%) indicated they spend more time at the river than they did before the onset of the pandemic. Moreover, 93% of respondents agreed that the waterscape they were visiting represented a refuge from stress and isolation caused by COVID-19. Overall, people valued waterscapes for ecological benefits and relationships with the place, rather than for recreation and tourism. Emotions experienced at all 10 waterscapes were overwhelmingly positive. Statistical tests revealed that higher positive emotions were significantly associated with biophysical perceptions of flow, cleanliness, and naturalness. Our results demonstrate that the benefits of blue spaces derive from an interrelated combination of ecosystem and mental health. The new Blue Index approach presented here promotes participatory land management through noncontact community engagement and knowledge coproduction.
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