The Health Needs of Regionally Based Individuals Who Experience Homelessness: Perspectives of Service Providers

Abstract

The bidirectional relationship between homelessness and poor health and the barriers that individuals who experience homelessness face when trying to access healthcare are well documented. There is, however, little Australian research exploring the situation of individuals who experience homelessness in regional contexts and, moreover, from the perspective of service providers. A qualitative descriptive methodology underpinned this study, with in-depth semi-structured interviews being conducted with 11 service providers to identify barriers to care faced by people who experience homelessness and barriers that service providers themselves experience in supporting this population. The key barriers identified were client-level barriers: living day-by-day, financial, health literacy, mental health conditions, behaviour, safety and stigma; provider-level barriers: few bulk-billing doctors, fragmented services, limited resources, negative past experiences with healthcare; and system level barriers: transportation, over-stretched healthcare services. The combined impact of these barriers has significantly contributed to the desperate situation of people experiencing homelessness in Launceston. This situation is likely replicated in other regional populations in Australia. Given that individuals experiencing homelessness have higher rates of every measure in health inequality, steps need to be taken to reduce barriers, and a standardised approach to health care urgently needs to be implemented by governments at the state and national level to improve the health of regionally based individuals experiencing homelessness.

Mental Health and Homelessness in the Community of Madrid (Spain): The Impact of Discrimination and Violence

“…There is a need to replace fragmented care services with a consolidated new model of comprehensive care that takes into account the social determinants of health and the discrimination and violence that PSH face. In line with the contributions of Bennet-et al [85], the conclusion is that, although homelessness should be approached as a housing problem, it is also necessary to implement specific measures that consider the health inequalities affecting PSH. Mental health has been repeatedly identified as an important problem for PSH, and action is hence needed to establish community links between mental health services and the current providers of support to PSH.…”

“Just a knife wound this week, nothing too painful”: An ethnographic exploration of how primary care patients experiencing homelessness view their own health and healthcare

“…The barriers expressed to feeling these things have been widely reported in the literature. Physical and emotional pain [ 42 – 45 ], competing emotions [ 44 ], mental health conditions [ 43 – 50 ], violence [ 44 , 45 , 47 , 50 ], stigma [ 44 , 47 , 51 , 52 ], and disability[ 43 , 50 , 53 ] are pervasive both prior to, and during experiences of homelessness, compounded with inequitable access to satisfactory health information and care [ 47 , 54 ]. Unique to this study, participants proposed their own solutions for helping to overcome these challenges including appropriate and accessible mental health and addiction care that involves grief counselling, psychotropic medications, recognition of dual diagnosis, and faster access to residential addiction treatment; receiving compassion from qualified health care professionals and staff; holding transparent conversations with health care providers about treatment goals and options; increased availability of refuge spaces; wider societal understanding of addiction and homelessness; and increased focus on addiction prevention and outreach for those in early stages of substance use or those wishing to reduce their usage.…”

Assisting Homeless Women in a City in Brazil during the COVID-19 Pandemic in the Context of a Street Outreach Office: The Perceptions of Health Professionals

“…It is important to note that the pandemic added to or maximized barriers that already existed for working with homeless people. In Launceston, Tasmania, the fragmentation of services and lack of professionals to provide free care were indicated as barriers to accessing health care [30]. In Copenhagen, Denmark, the difficulty of working cooperatively with other organizations was also highlighted; however, the professionals who managed to establish a positive network demonstrated their intention to continue and expand this integrated and collaborative way of working [31].…”