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Czechowski K, Sylvestre J, Gogosis E, Agha A, Kerman N, Polillo A, Palepu A, Hwang SW. Cycles of instability: Proximal and distal influences on residential instability among people with histories of homelessness in three Canadian cities. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3402-3420. [PMID: 35322426 DOI: 10.1002/jcop.22843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/31/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
People with histories of homelessness often have difficulties obtaining and maintaining adequate housing. This qualitative study examined the residential transitions of people with histories of residential instability and homelessness to understand factors contributing to the instability they experience. Interviews were conducted with 64 participants about their housing transitions, in the final year of a 4-year, prospective cohort study in three Canadian cities (Ottawa, Toronto, and Vancouver). Findings showed that participants pointed to both distal and proximal factors as affecting residential transitions, including interpersonal conflict, safety concerns, substance use, poverty, pests, and health. Many reported disconnection from their housing and a lack of improvement from one housing situation to the next, demonstrating how even when housed, instability persisted. Our study highlights the complexity associated with participants' often unplanned and abrupt residential transitions. The complex and distal issues that affect housing transitions require structural changes, in addition to individual-based interventions focused on the proximal problems.
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Affiliation(s)
- Konrad Czechowski
- Centre for Research on Educational and Community Services, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - John Sylvestre
- Centre for Research on Educational and Community Services, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Evie Gogosis
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Ayda Agha
- Centre for Research on Educational and Community Services, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Nick Kerman
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Alexia Polillo
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anita Palepu
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephen W Hwang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, Division of General Internal Medicine, University of Toronto, Toronto, Ontario, Canada
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Roy L, Abdel-Baki A, Bérubé FA, Crocker A, de Benedictis L, Dostie M, Latimer E, Roy MA. Housing trajectories and the risk of homelessness among new mental health service users: Protocol for the
AMONT
study. Early Interv Psychiatry 2022; 17:495-501. [PMID: 37156495 DOI: 10.1111/eip.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 06/20/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022]
Abstract
AIMS High rates of mental illness among individuals experiencing homelessness, as well as documented contacts with psychiatric services prior to episodes of homelessness, indicate that early intervention could play a key role in homelessness prevention. Decision-makers and clinical teams need longitudinal data on housing trajectories following initial contact with psychiatric services, as well as on predictors of risk of housing instability and homelessness. This paper describes the AMONT study, a mixed-methods naturalistic longitudinal cohort study of individuals identified as new psychiatric service users in seven clinical sites across the province of Québec (Canada). METHODS The goal of AMONT is to examine the housing situations of individuals over 36 months after their initial contact with psychiatric services, and to identify environmental and individual correlates and predictors of housing outcomes. Participants complete a broad battery of instruments at baseline and follow-up assessments after 24 and 36 months. We explore housing stability following an initial episode of psychiatric service use from the perspective of service users, family members, and service providers, through qualitative interviews. RESULTS AND CONCLUSIONS The findings from the AMONT study will yield a better understanding of the residential pathways of individuals with mental illness, from their first contact with psychiatric services and for 3 years subsequently. This will inform service providers, decision-makers and managers on the specific housing concerns and issues that affect first-time mental health service users. This in turn can lead to the development and implementation of evidence-informed practices and policies that aim to prevent instability and homelessness.
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Affiliation(s)
- Laurence Roy
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Douglas Mental Health University Institute Research Center, Montreal, Canada
| | - Amal Abdel-Baki
- Université de Montréal, Montréal, Canada
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada
| | - Félix-Antoine Bérubé
- Université de Montréal, Montréal, Canada
- Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | - Anne Crocker
- Université de Montréal, Montréal, Canada
- Institut National de Psychiatrie Légale Philippe-Pinel, Montréal, Canada
| | - Luigi de Benedictis
- Université de Montréal, Montréal, Canada
- Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | - Mathieu Dostie
- Douglas Mental Health University Institute Research Center, Montreal, Canada
| | - Eric Latimer
- Douglas Mental Health University Institute Research Center, Montreal, Canada
| | - Marc-André Roy
- Université Laval, Québec, Canada
- Institut Universitaire en Santé Mentale de Québec, Québec, Canada
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Frederick T, Vitopoulos N, Leon S, Kidd S. Subjective housing stability in the transition away from homelessness. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1083-1101. [PMID: 34520067 DOI: 10.1002/jcop.22702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 07/29/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
Housing stability is a complex concept to measure. One set of factors under consideration are those based on a personal or subjective sense of stability. We explore the variables associated with subjective stability and explore how subjective stability relates to housing stability across time. We use data from longitudinal, mixed methods research with 85 young people exiting homelessness. We find that subjective stability is a meaningful construct that can be validated through qualitative and quantitative data. The construct is primarily linked to indicators of environmental and social wellbeing. Subjective stability is also one of the only variables with a significant relationship to T2 housing stability. Qualitative analysis is used to explore these relationships in more detail. We conclude that subjective stability can provide holistic insight into the complex life circumstances influencing housing stability. However, this strength introduces complexity in that subjective stability appears to be developed in comparison with past experiences, as well as feelings of forward momentum on goals beyond housing.
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Affiliation(s)
- Tyler Frederick
- Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, Ontario, Canada
| | - Nina Vitopoulos
- Psychology, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Scott Leon
- Wellesley Institute, Toronto, Ontario, Canada
| | - Sean Kidd
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Deschênes JM, Roy L, Girard N, Abdel-Baki A. Comment aider les jeunes atteints de psychose à éviter l’itinérance ? SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1088183ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Roy L, Rousseau J, Fortier P, Mottard JP. Postsecondary academic achievement and first-episode psychosis: A mixed-methods study. The Canadian Journal of Occupational Therapy 2015; 83:42-52. [DOI: 10.1177/0008417415575143] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background. Postsecondary academic achievement as an area of functional recovery for young adults living with mental illness has received little research attention. Purpose. This study had three purposes: to compare rates of participation, performance, and satisfaction in postsecondary education between young adults with first-episode psychosis and closely matched young adults; to identify characteristics associated with academic participation; and to explore the processes associated with educational experiences. Method. One hundred young adults ages 18 to 30 participated in the study. Quantitative data on academic engagement, performance, and satisfaction, and qualitative data ( n = 52) on academic experiences were integrated through pattern analyzes. Findings. Young adults with psychosis were significantly less likely to be engaged in postsecondary education. No difference appeared for the extent of engagement, but performance and satisfaction were lower among participants with psychosis. Participants engaged in reflexive decision making to access postsecondary education and to maintain adequate academic performance. Strategies used by successful students with mental illness were identified. Implications. Assessment and intervention focused on educational needs and skills should become landmark practices for psychiatric rehabilitation practitioners, including occupational therapists.
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