Turning Off the Tap: A Typology for Homelessness Prevention

Dej, Erin; Gaetz, Stephen; Schwan, Kaitlin

doi:10.1007/s10935-020-00607-y

Cited by 22 publications

(31 citation statements)

References 40 publications

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“…Moreover, family support, particularly in the form of accommodation provision, financial assistance, and practical aid can be a strong protective factor against homelessness, just as the experience of family conflict and the withdrawal of financial and practical support can be associated with housing insecurity (Johnson and Chamberlain 2011). Indeed, the relationship between housing and mental health pathways are rarely linear (Brackertz, Borrowman et al 2020), leading to calls for improved discharge planning and transition support between services (Dej, Gaetz et al 2020;Xiao, Tourangeau et al 2019). More broadly, efforts to identify pathways for people exiting institutional settings (such as mental health inpatient settings and AOD residential settings) have led to calls for tailored, wrap-around post-exit supports that better support housing and recovery (Aubry, Goering et al 2016;Stein 2012).…”

Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

“…Despite the benefits of early intervention and prevention, the mental health, AOD and housing sectors in Australia are still largely 'crisis-based' insofar as they largely respond to existing health and social problems with limited 'up-stream' prevention (Dej, Gaetz et al 2020;Mackie, Thomas et al 2017). Crisis responses in the mental health, AOD and housing sectors are often marked by poor individual outcomes and high economic and social costs (Kidd 2013).…”

Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

“…Successful homelessness prevention and early intervention initiatives require the development of a responsive and integrated service system. The homelessness prevention typology developed by Dej, Gaetz et al (2020) provides helpful insights into the refinement of discharge planning arrangements across mental health inpatient services and AOD residential treatment in Australia.…”

Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

“…Discharge planning is relevant to all three prevention strategies, though it is especially important in secondary and tertiary settings where it can be understood as a 'strategic intercept' (Backer, Howard et al 2007:240) for managing living arrangements, financial and social supports, health and wellbeing issues for individuals receiving treatment. As a practical example, rent subsidies to support client's private rental arrangements for the duration of their stay in residential treatment have been shown to be highly effective 'tertiary prevention' strategies for mitigating the risk of housing insecurity for vulnerable care recipients (see Dej, Gaetz et al 2020). Effective discharge planning requires the development of comprehensive needs assessment procedures, patient-centred care, adequate resourcing, effective communication, and strong service coordination (Xiao, Tourangeau et al 2019).…”

Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

See 3 more Smart Citations

Leaving rehab: enhancing transitions into stable housing

Duff¹,

Hill²,

Blunden³

et al. 2021

AHURI Final Report

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Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

Section: Insights From the Housing Mental Health And Substance Use Literature: Findings Gaps And Conceptual Problemsmentioning

confidence: 99%

See 2 more Smart Citations

Leaving rehab: enhancing transitions into stable housing

Duff¹,

Hill²,

Blunden³

et al. 2021

AHURI Final Report

View full text Add to dashboard Cite

show abstract

“…Since the mid-nineties, homelessness typologies were used to analyze inequalities and disclose underlying cracks in welfare systems (9)(10)(11). Regarding typologies, Kuhn & Culhane's cluster analyses in the public shelters of New York City and Philadelphia yielded innovative insights (9).…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Assessment to Enable Recovery of the Homeless: The HOP-TR Study

Everdingen

Peerenboom²,

Velden

et al. 2021

Front. Public Health

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Background: Homelessness is an increasing problem in Western European countries. In the Netherlands, policy reforms and austerity measures induced an urgent need for management information on local homeless citizens. Municipal authorities initiated cross-sectional reviews of Homeless Service (HS) users. The resulting Homeless People Treatment and Recovery (HOP-TR) study developed a health and needs assessment strategy over different domains to comprehensively assess individuals and care networks with the perspective on recovery.Methods: Dutch HS users were selected using a naturalistic meta-snowball sampling. Semi-structured interviews provided the primary data source. The interview content was partly derived from the InterRAI Community Mental Health questionnaire and the “Homelessness Supplement.” Using the raw interview data, algorithmic summary scores were computed and integrating clinical parameters assessed. The data describe health and needs in a rights-based, recovery-oriented frame of reference. The mental health approach is transdiagnostic. The positive health framework is used for structuring health and needs aspects in relation to the symptomatic (physical and mental health), social (daily living, social participation), and personal (quality of life, meaning) dimensions of recovery.Results: Recruitment (between 2015 and 2017) resulted in a saturated sample of 436 HS users in 16 facilities and seven cities. Most participants were long-term or intermittently homeless. The sample characteristics reveal the multi domain character of needs and the relevance of a broad, comprehensive approach. Local authorities used the reports to reflect and discuss needs, care provision, access, and network cooperation. These dialogs incited to improve the quality of care at various ecosystem levels.Discussion: This paper describes new recruitment strategies and data collections of comprehensive data domains, to improve our knowledge in the field of homelessness. Traditional epidemiological literature on homelessness is often domain specific and relies on administrative sources. The HOP-TR study uses an analytical epidemiological approach. It shifts the assessment focus from problem-centered marginalization processes toward a comprehensive, three-dimensional recovery-oriented vision of health. Different perspectives are integrated to explore the interaction of homeless people with care networks.

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Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

et al. 2022

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ImportanceHousing insecurity—that is, difficulty with housing affordability and stability—is prevalent and results in increased risk for both homelessness and poor health. However, whether interventions that prevent housing insecurity upstream of homelessness improve health remains uncertain.ObjectiveTo review evidence characterizing associations of primary prevention strategies for housing insecurity with adult physical health, mental health, health-related behaviors, health care use, and health care access.Evidence ReviewPairs of independent reviewers systematically searched PubMed, Web of Science, EconLit, and the Social Interventions Research and Evaluation Network for quantitative studies published from 2005 to 2021 that evaluated interventions intended to directly improve housing affordability and/or stability either by supporting at-risk households (targeted primary prevention) or by enhancing community-level housing supply and affordability in partnership with the health sector (structural primary prevention). Risk of bias was appraised using validated tools, and the evidence was synthesized using modified Grading of Recommendations Assessment, Development, and Evaluation criteria.FindingsA total of 26 articles describing 3 randomized trials and 20 observational studies (16 longitudinal designs and 4 cross-sectional quasi–waiting list control designs) were included. Existing interventions have focused primarily on mitigating housing insecurity for the most vulnerable individuals rather than preventing housing insecurity outright. Moderate-certainty evidence was found that eviction moratoriums were associated with reduced COVID-19 cases and deaths. Certainty of evidence was low or very low for health associations of other targeted primary prevention interventions, including emergency rent assistance, legal assistance with waiting list priority for public housing, long-term rent subsidies, and homeownership assistance. No studies evaluated health system–partnered structural primary prevention strategies.Conclusions and RelevanceThis systematic review found mixed and mostly low-certainty evidence that interventions that promote housing affordability and stability were associated with improved adult health outcomes. Existing interventions may need to be paired with other efforts to address the structural determinants of health. As health care systems and insurers respond to increasing opportunities to invest in housing as a determinant of health, further research is needed to clarify where along the housing insecurity pathway interventions should focus for the most effective and equitable health impact.

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Turning Off the Tap: A Typology for Homelessness Prevention

Cited by 22 publications

References 40 publications

Leaving rehab: enhancing transitions into stable housing

Leaving rehab: enhancing transitions into stable housing

A Comprehensive Assessment to Enable Recovery of the Homeless: The HOP-TR Study

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

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