“I can’t remember the last time I was comfortable about being home”: lived experience perspectives on thriving following homelessness

Abstract

Purpose Strategies for preventing and ending homelessness are frequently measured by their effectiveness on indices of tenancy sustainment. To shift this narrative, we conducted research to identify what is needed to “thrive” following homelessness from the perspectives of persons with lived experience in Ontario, Canada. Methods Conducted in the context of a community-based participatory research study aimed at informing the development of intervention strategies, we interviewed 46 persons living with mental illness and/or substance use disorder [ n = 25 (54.3%) unhoused; n = 21 (45.7%) housed following homelessness] using qualitative interviews. A subsample of 14 participants agreed to engage in photovoice interviews. We analysed these data abductively using thematic analysis informed by health equity and social justice. Results Participants described experiences of “living in a state of lack” following homelessness. This essence was expressed through four themes: 1) housing as part one of the journey to home; 2) finding and keeping “my people”; 3) meaningful activity as critical for thriving following homelessness; and 4) struggling to access mental health supports in the context of challenging circumstances. Conclusions Individuals struggle to thrive following homelessness in the context of insufficient resources. There is a need to build on existing interventions to address outcomes beyond tenancy sustainment.

‘We stick people in a house and say okay, you're housed. The problem is solved’: A qualitative study of service provider and organisational leader perspectives on thriving following homelessness

“…The parent study, called the ‘Transition from Homelessness Study’, involved qualitative interviews with PWLEH and SPOL. Findings detailing the perspectives of PWLEH in this research and our co‐design process can be found in two separate papers (Marshall, Phillips, Holmes, Todd, Hill, Panter, Easton, Jastak, et al, 2022; Marshall, Phillips, Holmes, Todd, Hill, Panter, Easton, Landry, et al, 2022). Methods and findings associated with SPOL interviews conducted across both recruitment sites are detailed in this paper.…”

“…These include high rates of mental illness and substance use disorders (Hossain et al, 2020), traumatic brain injury (Hwang et al, 2008), poverty (Gaetz et al, 2016), housing instability (Macnaughton et al, 2015) and food insecurity (Parpouchi et al, 2016). Although it could be assumed that these needs are alleviated upon obtaining housing, research suggests that PWLEH struggle to thrive following homelessness by continuing to experience difficulties with managing the symptoms of mental illness, substance misuse, poor community integration, a lack of engagement in meaningful activity, unemployment and poverty (Marshall et al, 2017, 2018, 2019, 2021; Marshall, Phillips, Holmes, Todd, Hill, Panter, Easton, Jastak, et al, 2022; Poremski et al, 2015; Stergiopoulos et al, 2014; Tsai et al, 2012; Tsemberis et al, 2004). Leaving these needs unmet has the potential to perpetuate the cycle of homelessness, decrease housing stability and prolong social and health challenges for this population.…”