Navigating the system for families experiencing homelessness: a community-driven exploration of barriers encountered

Abstract

This study examined the journey of families with children seeking shelter to inform future system navigation solutions that will serve this population. Families living in emergency shelter, rapid re-housing, or unsheltered were interviewed (n = 24). Participants created a journey mapping of their path through the homelessness system and described the barriers they encountered. Most participants were women (79%), and the number of children per family ranged from one to five, with an average of 2.5 children. For these 24 participants, the average length of time between the interview and their last permanent housing was 68.5 weeks with one to eight transitions in living situations (e.g., domestic violence shelter, doubled-up) having transpired over that period. The top three barriers to exiting homelessness-transportation issues, finding and keeping employment, and child care needs-co-occurred and appeared to be interrelated. Families faced unique challenges, which included safety concerns, space obstacles, and a need for children's activities. Examining families' lived experiences during their homelessness journeys can help policymakers, social service providers, and communities understand the burden that families experiencing homelessness face while attempting to provide for their children and the adverse experiences children may encounter during the journey.

Integrating Mobile and Portable Technologies With In-Person and Telehealth Care to Increase Perinatal Healthcare Equity for the Unstably Housed

“…Many at-risk and housing unstable persons are also hesitant to seek care during pregnancy due to concerns related to CWS involvement. 28 Furthermore, those living in rural regions can have difficulty accessing care because of transportation and childcare issues, work schedules, 29 caretaker responsibilities in multigenerational households, and/or a lack of obstetric or pediatric providers in the area. This translates into unfavorable conditions to support positive perinatal outcomes.…”

“…Patients who lack health insurance and who experience homelessness, substance use disorder, mental health disorders, and/or domestic violence often are unable to navigate the healthcare system successfully and may not be aware of nearby resources, including Federally Qualified Health Centers, and face barriers to accessing care in office locations. Many at-risk and housing unstable persons are also hesitant to seek care during pregnancy due to concerns related to CWS involvement 28. Furthermore, those living in rural regions can have difficulty accessing care because of transportation and childcare issues, work schedules,29 caretaker responsibilities in multigenerational households, and/or a lack of obstetric or pediatric providers in the area.…”

Psychological Costs and Administrative Burdens Produce Systemic Service Avoidance among People Experiencing Homelessness

“…Our data were collected during the early stages of the COVID-19 pandemic and because of that, our findings have implications for service provision during future infectious disease outbreaks. However, given the fact that administrative burdens disproportionately impact the poor (Herd & Moynihan 2020) and people experiencing homelessness (Robinson 2022), and given the ample research conducted prior to the COVID-19 pandemic showing challenges unhoused people encounter when interacting with bureaucracies (some examples include Calderón-Villarreal, et al 2022;Flanigan & Welsh, 2021;Herring 2021;Hoffman & Coffey 2008;Robinson 2022;Thompson et al 2020; Welsh JHHSA Vol 45 ssue 3 & Abdel-Samad, 2018), we expect our findings also are relevant outside the context of infectious disease outbreaks.…”

“…Unfortunately, the current shelter system is often set up for single individuals experiencing homelessness, often leading families experiencing homelessness to make excruciating choices between shelter or staying together (Halverstadt & Peattie, 2022;Thompson et al, 2020). Viewed from the perspective of administrative burdens, for many participants the compliance costs of separating from loved ones posed psychological costs that made shelter stays untenable (Herd & Moynihan, 2018, 2020.…”

Using the Plan-Do-Study-Act Evaluation Framework to Improve the Recruitment of Women Experiencing Homelessness

“…Although mothers experiencing homelessness continue to prioritize their search for housing, employment, childcare, and transportation,2 locating these resources while finding time to participate in research is challenging, especially given recent COVID-19 pandemic restrictions. Furthermore, the content and nature of research may involve the additional emotional burden of reliving potentially traumatic events and sharing information that may not directly benefit them in an imbalanced power dynamic as a research participant 3,4.…”