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Thurman W, Heitkemper E, Hutson T, Preston A, Hecht J. "The System Tends to Scoop You Up and Spit You Out and They're Done With You": The Intersection of Intellectual/Developmental Disability and Homelessness From the Perspectives of Service Providers. QUALITATIVE HEALTH RESEARCH 2023; 33:1017-1029. [PMID: 37550990 PMCID: PMC10494477 DOI: 10.1177/10497323231186880] [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] [Indexed: 08/09/2023]
Abstract
People with intellectual and developmental disabilities (IDD) experience elevated risk for poor health and social outcomes in adulthood and are at risk for experiencing homelessness and housing instability. Although the exact prevalence of IDD among homeless populations is unknown, a small body of literature related to the intersection of IDD and homelessness suggests differential health needs and service use patterns, with a need for targeted health and social services. In this study, we explore the perceptions and experiences of 18 homeless or disability service providers about (a) their clients at the intersection of IDD and homelessness and (b) their role and the services provided at the intersection of IDD and homelessness. Participants struggled to provide appropriate, accessible services for this population, owing to lack of training and awareness of specific needs, fragmented systems, and inadequately funded healthcare and housing support. Our findings also reveal that clients at this intersection have high contact with public systems, which places them at risk for losing their right to self-determination. Recommendations center on systems transformation to facilitate the ability of providers to collaborate and to make data-driven decisions to deliver person-centered care.
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Affiliation(s)
- Whitney Thurman
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | | | - Tara Hutson
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Angela Preston
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Jonathan Hecht
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
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Reid N, Kron A, Lamanna D, Wen S, Durbin A, Rajakulendran T, Lunsky Y, Roy S, DuBois D, Stergiopoulos V. Building Bridges to Housing for homeless adults with intellectual and developmental disabilities: outcomes of a cross-sector intervention. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:16-27. [PMID: 32715590 DOI: 10.1111/jar.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 06/08/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities (IDD) have high rates of homelessness. This observational study evaluates Bridges to Housing, a cross-sector intervention offering immediate access to housing and supports to this population in Toronto, Canada. METHODS Twenty-six participants, enrolled between April 2016 and December 2017, were assessed at baseline, six and 12 months post-enrolment. Descriptive statistics and generalized linear modelling evaluated quality of life (QOL) and service needs outcomes. Twenty-one service users and providers participated in semi-structured interviews between August 2017 and June 2018 to elicit their experiences of the intervention, which were analysed thematically. RESULTS Twelve months post-enrolment, 24 participants were successfully housed and reported increased QOL scores (F(2,43) = 13.73, p = <.001) and decreased perceived unmet service needs (Wald χ2 (2) = 12.93, p = .002). Individual-, intervention- and system-level characteristics facilitated housing stability in this population. CONCLUSIONS Cross-sector approaches can improve outcomes for homeless adults with IDD and may have an important role in supporting this marginalized population.
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Affiliation(s)
- Nadine Reid
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Amie Kron
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Denise Lamanna
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sophia Wen
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anna Durbin
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Yona Lunsky
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sylvain Roy
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Inner City Family Health Team, Toronto, Ontario, Canada.,York University, Toronto, Ontario, Canada
| | - Denise DuBois
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Providence Care Hospital, Kingston, Ontario, Canada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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