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Marshall CA, Phillips B, Holmes J, Todd E, Hill R, Panter G, Easton C, Landry T, Collins S, Greening T, O’Brien A, Jastak M, Ridge R, Goldszmidt R, Shanoff C, Laliberte Rudman D, Carlsson A, Aryobi S, Szlapinski J, Carrillo-Beck R, Pacheco N, Perez S, Oudshoorn A. "I can't remember the last time I was comfortable about being home": lived experience perspectives on thriving following homelessness. Int J Qual Stud Health Well-being 2023; 18:2176979. [PMID: 36803094 PMCID: PMC9946331 DOI: 10.1080/17482631.2023.2176979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
PURPOSE Strategies for preventing and ending homelessness are frequently measured by their effectiveness on indices of tenancy sustainment. To shift this narrative, we conducted research to identify what is needed to "thrive" following homelessness from the perspectives of persons with lived experience in Ontario, Canada. METHODS Conducted in the context of a community-based participatory research study aimed at informing the development of intervention strategies, we interviewed 46 persons living with mental illness and/or substance use disorder [n = 25 (54.3%) unhoused; n = 21 (45.7%) housed following homelessness] using qualitative interviews. A subsample of 14 participants agreed to engage in photovoice interviews. We analysed these data abductively using thematic analysis informed by health equity and social justice. RESULTS Participants described experiences of "living in a state of lack" following homelessness. This essence was expressed through four themes: 1) housing as part one of the journey to home; 2) finding and keeping "my people"; 3) meaningful activity as critical for thriving following homelessness; and 4) struggling to access mental health supports in the context of challenging circumstances. CONCLUSIONS Individuals struggle to thrive following homelessness in the context of insufficient resources. There is a need to build on existing interventions to address outcomes beyond tenancy sustainment.
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Affiliation(s)
- Carrie Anne Marshall
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada,CONTACT Carrie Anne Marshall Assistant Professor Western University, Occupational Therapy Director, Social Justice in Mental Health Research Lab – www.sjmhlab.com Faculty of Health Sciences Elborn College, Room 2533 1201 Western Rd., London, ON, Canada N6H 1H1 Tel: 519 661-2111 Ext. 88956
| | - Brooke Phillips
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Julia Holmes
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Eric Todd
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | | | - George Panter
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Corinna Easton
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | | | - Sarah Collins
- Salvation Army London Centre of Hope, London, Canada
| | | | | | - Marlo Jastak
- Addiction and Mental Health Services Kingston, Frontenac, Lennox & Addington (KFLA), Kingston, Canada
| | | | - Rebecca Goldszmidt
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Chelsea Shanoff
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | | | | | - Suliman Aryobi
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Jessica Szlapinski
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Rozelen Carrillo-Beck
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Nicole Pacheco
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Canada
| | - Shauna Perez
- Addiction and Mental Health Services Kingston, Frontenac, Lennox & Addington (KFLA), Kingston, Canada
| | - Abe Oudshoorn
- School of Nursing, Western University, London, Canada
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Rye BJ, Goldszmidt R. Do Attitude Functions and Perceiver Demographics Predict Attitudes Toward Asexuality? Psychology & Sexuality 2023. [DOI: 10.1080/19419899.2023.2185534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- B. J. Rye
- Department of Psychology, St. Jerome’s University at the University of Waterloo
| | - Rebecca Goldszmidt
- Department of Psychology, St. Jerome’s University at the University of Waterloo
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Marshall CA, Crowley P, Carmichael D, Goldszmidt R, Aryobi S, Holmes J, Easton C, Isard R, Murphy S. Effectiveness of Suicide Safety Planning Interventions: A Systematic Review Informing Occupational Therapy. Can J Occup Ther 2022; 90:208-236. [PMID: 36324257 DOI: 10.1177/00084174221132097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background. Suicide safety planning (SSP) is a suicide prevention approach that involves developing a collaborative plan between a service provider such as an occupational therapist and a person who is at risk of suicide. Purpose. To synthesize effectiveness studies on SSP. Method. Using the Joanna Briggs Institute methodology, we conducted a systematic review of effectiveness studies including a: (1) title and abstract screening; (2) full-text review; (3) critical appraisal; and (4) narrative synthesis. Findings. We included 22 studies. Critical appraisal scores ranged from 38.5 to 92.3 (m = 63.7). The types of interventions included were: standard and enhanced SSP (n = 11); electronically delivered SSP (n = 5); and SSP integrated with other approaches (n = 6). Only three studies identified meaningful activity as a component of SSP. Evidence across a range of studies indicates that SSP is effective for reducing suicide behavior (SB) and ideation (SI). While some studies have demonstrated effectiveness for reducing symptoms of mental illness, promoting resilience and service use, the number of studies exploring these outcomes is currently limited. Implications. Occupational therapists support individuals expressing SI, and SSP is a necessary skill for practice.
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Marshall CA, Phillips B, Holmes J, Todd E, Hill R, Panter G, Easton C, Landry T, Collins S, Greening T, O'Brien A, Jastak M, Ridge R, Goldszmidt R, Shanoff C, Laliberte Rudman D, Carlsson A, Aryobi S, Perez S, Oudshoorn A. 'We stick people in a house and say okay, you're housed. The problem is solved': A qualitative study of service provider and organisational leader perspectives on thriving following homelessness. Health Soc Care Community 2022; 30:e6018-e6029. [PMID: 36128972 DOI: 10.1111/hsc.14035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 06/15/2023]
Abstract
Research aimed at identifying and evaluating approaches to homelessness has predominately focused on strategies for supporting tenancy sustainment. Fewer studies focus on strategies for enabling thriving following homelessness, and the perspectives of service providers and organisational leaders (SPOL) on this topic are rare. We conducted this study in the context of a community-based participatory research project in two cities in Ontario, Canada. This research was aimed at identifying the strengths and challenges of existing supports in enabling thriving following homelessness, followed by co-designing a novel intervention alongside persons with lived experience of homelessness (PWLEH) and SPOL. The current study presents the findings of interviews conducted in 2020-2021 with SPOL in organisations serving PWLEH. We interviewed 60 individuals including service providers (n = 38; 63.3%) and organisational leaders (n = 22; 36.7%) using semi-structured qualitative interviews. Interviews were conducted and recorded on Zoom to align with physical distancing protocols associated with the COVID-19 pandemic. Recordings were transcribed verbatim and analysed abductively informed by the lenses of social justice and health equity. The essence of our findings is represented by a quote from a research participant: 'We stick people in a house and say okay, you're housed. The problem is solved'. This essence was expressed through five themes: (1) stuck in a system that prevents thriving, (2) substance use as an important coping strategy that prevents tenancy sustainment and thriving, (3) the critical importance of targeting community integration following homelessness, (4) incorporating peer expertise as imperative and (5) people need to be afforded options in selecting housing and services following homelessness. Our findings indicate that SPOL envision possibilities of thriving following homelessness yet are embedded within a system that often prevents them from supporting individuals who are leaving homelessness to do so. Research, practice and policy implications are discussed.
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Affiliation(s)
- Carrie Anne Marshall
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Brooke Phillips
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Julia Holmes
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Eric Todd
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - River Hill
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - George Panter
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Corinna Easton
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Terry Landry
- Providence Care Hospital, Kingston, Ontario, Canada
| | - Sarah Collins
- Salvation Army London Centre of Hope, London, Ontario, Canada
| | | | - Ashley O'Brien
- HIV and Aids Regional Services, Kingston, Ontario, Canada
| | - Marlo Jastak
- Addiction and Mental Health Services Kingston, Frontenac, Lennox & Addington (KFLA), Kingston, Ontario, Canada
| | | | - Rebecca Goldszmidt
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Chelsea Shanoff
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | | | | | - Suliman Aryobi
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Shauna Perez
- Addiction and Mental Health Services Kingston, Frontenac, Lennox & Addington (KFLA), Kingston, Ontario, Canada
| | - Abe Oudshoorn
- School of Nursing, Western University, London, Ontario, Canada
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Marshall CA, Boland L, Westover LA, Goldszmidt R, Bengall J, Aryobi S, Isard R, Easton C, Gewurtz R. Effectiveness of employment-based interventions for persons experiencing homelessness: A systematic review. Health Soc Care Community 2022; 30:2142-2169. [PMID: 35748222 DOI: 10.1111/hsc.13892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/26/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
Employment is frequently desired by persons who experience homelessness yet is often elusive. Little is known about the range and effectiveness of employment-based interventions evaluated in existing literature on key psychosocial outcomes including employment participation, mental well-being, housing tenure, community integration and substance use. To identify and synthesise existing studies, we conducted a systematic review of effectiveness using the methodology proposed by the Joanna Briggs Institute (JBI) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Following the removal of duplicates, we screened 13,398 titles and abstracts, and reviewed 79 studies at the full-text review stage using two independent raters. A total of 16 studies met criteria for inclusion in a narrative synthesis and were subjected to critical appraisal. The majority of studies were conducted in the US (n = 14; 87.5%) with other studies published in Canada (n = 1; 6.3%) and Australia (n = 1; 6.3%). Interventions evaluated in existing studies included combined substance use and vocational skills interventions (n = 7; 43.8%), supported employment (n = 6; 37.5%), and integrated supports including an employment component (n = 3; 18.8%). The effectiveness of these interventions on employment, mental well-being, housing tenure, community integration, and substance use is presented. Findings suggest that research evaluating employment interventions for persons who experience homelessness is in an early stage of development. Researchers and practitioners may consider collaborating with persons with lived experiences of homelessness and practitioners in co-designing and modifying existing approaches to target key outcomes more effectively. Policymakers may consider allocating resources to such initiatives to further the development of practice and research aimed at supporting persons who experience homelessness to secure and sustain employment during and following homelessness.
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Affiliation(s)
- Carrie Anne Marshall
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Leonie Boland
- Faculty of Health and Human Sciences, Occupational Therapy, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Lee Ann Westover
- Teacher's College, Columbia University, New York City, New York, USA
| | - Rebecca Goldszmidt
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Jordana Bengall
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Suliman Aryobi
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Roxanne Isard
- Disciplinary Coordinator for the Faculty of Information & Media Studies & the Faculty of Education, Allyn & Betty Taylor Library, Western University, London, Ontario, Canada
| | - Corinna Easton
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Rebecca Gewurtz
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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