Abstract
This qualitative study explored how individuals who are homeless perceive outreach practices and available services. Interviews were conducted with 24 people who had been homeless for ≥1 year and who consistently resided on the streets of west midtown, Manhattan, New York. Reasons why these individuals refuse services include a pervasive mistrust of outreach workers and the agencies that employ them, as well as a prominent lack of confidence in available services. The findings suggest a need for an approach to outreach that incorporates giving individualized attention from outreach workers, using an empathetic listening approach, minimizing stereotyping, providing greater choices, and employing formerly homeless people as outreach workers.
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Bottomley, J. M., Bissonnette, A., & Snekvik, V. (2001). The lives of homeless older adults: Please, tell them who I am. Topics in Geriatric Rehabilitation, 16(4), 50–64.
Burt, M. R., Aron, L. Y., Lee, E., & Valente, J. J. (2001). Helping America’s homeless. Washington, DC: Urban Institute Press.
Chan, S. (2007). New York’s annual estimate of homeless is challenged. The New York Times, May 22.
Crane, M., & Warnes, A. M. (2001). The responsibility to care for single homeless people. Health & Social Care in the Community, 9(6), 436–444. doi:10.1046/j.0966-0410.2001.00327.x.
Dennis, D. L., Buckner, J. C., Lipton, F. R., & Levine, I. S. (1991). A decade of research and services for homeless mentally ill persons: Where do we stand? The American Psychologist, 46(33), 1129–1138. doi:10.1037/0003-066X.46.11.1129.
Fisk, D., & Frey, J. (2002). Employing people with psychiatric disabilities to engage homeless individuals through supported socialization: The Buddies Project. Psychiatric Rehabilitation Journal, 26(2), 191–196. doi:10.2975/26.2002.191.196.
Fisk, D., Rakfeldt, J., Heffernan, K., & Rowe, M. (1999). Outreach workers’ experiences in a homeless outreach project: Issues of boundaries, ethics and staff safety. The Psychiatric Quarterly, 70(3), 231–246. doi:10.1023/A:1022003226967.
Fisk, D., Rowe, M., Brooks, R., & Gildersleeve, D. (2000). Integrating consumer staff members into a homeless outreach project: Critical issues and strategies. Psychiatric Rehabilitation Journal, 23(3), 244–252.
Gibeau, J. L. (2001). Home free: An evolving journey in eradicating homelessness. Topics in Geriatric Rehabilitation, 17(1), 22–52.
Hannappel, M., Calsyn, R. J., & Morse, G. A. (1989). Mental illness in homeless men: A comparison of shelter and street samples. Journal of Community Psychology, 17, 304–310.
Lam, J. A., & Rosenheck, R. (1999). Street outreach for homeless persons with serious mental illness: Is it effective? Medical Care, 37(9), 894–907. doi:10.1097/00005650-199909000-00006.
Larsen, L., Poortinga, E., & Hurdle, D. E. (2004). Sleeping rough: Exploring the differences between shelter-using and non-shelter-using homeless individuals. Environment and Behavior, 36(4), 578–591. doi:10.1177/0013916503261385.
Levy, J. S. (1998). Homeless outreach: A developmental model. Psychiatric Rehabilitation Journal, 22(2), 123–131.
Ng, A. T., & McQuistion, H. L. (2004). Outreach to the homeless: Craft, science, and future implications. Journal of Psychiatric Practice, 10(2), 95–105. doi:10.1097/00131746-200403000-00004.
North, C. S., & Smith, C. E. (1993). A systematic study of mental health services utilization by homeless men and women. Social Psychiatry and Psychiatric Epidemiology, 28(2), 77–83. doi:10.1007/BF00802096.
NYC Department of Homeless Services. (2007). Overall unsheltered homelessness down 15% since baseline count two years ago. http://www.nyc.gov/html/dhs/html/press/pr050207.shtml. Accessed January 08, 2008.
Padgett, D., Struening, E. L., & Andrews, H. (1990). Factors affecting the use of medical, mental health, alcohol, and drug treatment services by homeless adults. Medical Care, 28(9), 805–821. doi:10.1097/00005650-199009000-00010.
Patton, M. Q. (2001). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, California: Sage Publications.
Pope, C., Ziebland, S., & Mays, W. (2000). Qualitative research in health care. British Medical Journal (Clinical Research Ed.), 320, 114–116. doi:10.1136/bmj.320.7227.114.
Rosenheck, R., Kasprow, W., Frisman, L., & Wen, L. M. (2003). Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry, 60, 940–951. doi:10.1001/archpsyc.60.9.940.
Rosenheck, R., Morrissey, J., Lam, J., Calloway, M., Johnsen, M., Goldman, H., et al. (1998). Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness. American Journal of Public Health, 88(11), 1610–1615.
Rossi, P. H. (1989). Down and out in America: The origins of homeless. Chicago: The University of Chicago Press.
Rowe, M., Fisk, D., Frey, J., & Davidson, L. (2002). Engaging persons with substance use disorders: Lessons from homeless outreach. Administration and Policy in Mental Health, 29(3), 263. doi:10.1023/A:1015147710813.
Segal, B. (1991). Homelessness and drinking: A study of a street population. Drugs and Society, 5(3/4), 1–136.
Sowell, R. L., Bairan, A., Akers, T. A., & Holtz, C. (2004). Social service needs and case management implications for individuals accessing a faith-based suburban homeless shelter. Lippincott’s Case Management, 9(2), 72–86. doi:10.1097/00129234-200403000-00004.
Tsemberis, S., Gulcur, L., & Makae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with dual diagnosis. American Journal of Public Health, 94(4), 651–656.
Tsemberis, S. J., Moran, L., Shinn, M., & Asmussen, S. M. (2003). Consumer preference programs for individuals who are homeless and have psychiatric disabilities: A drop-in center and a supported housing program. American Journal of Community Psychology, 32(3/4), 305–317. doi:10.1023/B:AJCP.0000004750.66957.bf.
U.S. Department of Housing and Urban Development. (2004). Strategies for reducing chronic street homeless. http://www.huduser.org/publications/homeless/chronic_homeless.html. Accessed January 08, 2008.
Wojtusik, L., & White, M. C. (1998). Health status, needs, and health care barriers among the homeless. Journal of Health Care for the Poor and Underserved, 9(2), 140–151.
Wong, Y. L. I. (1999). Utilization of community-based services among homeless persons: An application of a theoretical model. Journal of Community Psychology, 27(3), 327–345. doi:10.1002/(SICI)1520-6629(199905)27:3<327::AID-JCOP7>3.0.CO;2-U.
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Kryda, A.D., Compton, M.T. Mistrust of Outreach Workers and Lack of Confidence in Available Services Among Individuals who are Chronically Street Homeless. Community Ment Health J 45, 144–150 (2009). https://doi.org/10.1007/s10597-008-9163-6
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DOI: https://doi.org/10.1007/s10597-008-9163-6