SWK 661 6.2 Assignment Literature Review

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1 6.2 Assignment: Literature Review Tangala Parker Indiana Wesleyan University SWK 661: Research Proposal 1 Aaron Cheek February 11, 2024

2 Abstract The homeless community grapples with serious mental health disorders and physical disabilities, which make it difficult for them to find shelter or services that are equipped to handle their specific needs. However, utilizing a mentorship program to identify in depth problems that the homeless face can increase participation in services. Homelessness remains a pressing issue that affects both the social fabric and the well-being of individuals, especially those grappling with mental illness. To truly make a positive impact on their quality of life and overall wellness, it is crucial for programs aimed at assisting homeless individuals with mental illness to prioritize two key aspects: ensuring stable housing and providing essential services to meet their basic needs and physical health requirements. Additionally, it is imperative to offer training that empowers individuals to prioritize their personal safety, while also implementing strategies that effectively alleviate depressive symptoms. By addressing these multifaceted needs, we can pave the way for a brighter future for those experiencing homelessness and mental illness (Sullivan et al., 2000).

3 Introduction Homelessness and mental health issues in today's world are influenced by various factors. Some of the most prevalent factors include poverty, mental illness, substance abuse, trauma, and discrimination. Poverty can lead to homelessness as individuals may lack the financial means to afford housing. People with mental illness may struggle to find the necessary resources and support to live independently, increasing their risk of homelessness. Substance abuse can also contribute to homelessness as it may hinder job stability and housing maintenance. Those who have experienced trauma may find it challenging to cope with daily life, increasing their vulnerability to homelessness. Discrimination can also play a role, as it may limit access to housing and resources. It is important to recognize that these factors are not exhaustive, and each person's experience is unique. Epidemiology Various local, state, and national studies have brought to light a significant finding in the past ten years. These studies have shown that a considerable proportion, ranging from 20 to 25 percent, of individuals experiencing homelessness suffer from mental disorders. These disorders encompass conditions such as schizophrenia, severe and recurrent major depression, as well as bipolar disorder (Olivet et al., 2021). According to (HUD), it determined that a staggering number of approximately 570,000 individuals were without shelter on January 23, 2020 (HUD). It is an undeniable fact that homelessness affects various regions and demographic groups. However, it is crucial to acknowledge that only some people face the same level of risk. Extensive research has revealed a concerning trend - individuals belonging to communities of color are disproportionately vulnerable to eviction and homelessness. It is a disheartening reality that despite making up only 13 percent of the total population in the United

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4 States, black individuals represent a staggering 40 percent of those who find themselves without a home (Olivet et al., 2021). There is an urgent need for us to tackle the systemic issues that contribute to homelessness within the black community. By acknowledging and actively working to rectify this imbalance, we can strive towards a more equitable society where people can access safe and stable housing. Homelessness is a pressing issue, especially for individuals facing chronic homelessness. Sadly, many of them also struggle with severe mental health disorders or physical disabilities. Seeing those needing shelter have limited resources that cannot accommodate their needs is disheartening. Etiology Homeless individuals with mental illness are disproportionately more likely to receive crucial financial assistance such as SSI, Social Security Disability Insurance, Veterans Affairs disability benefits, or Medicaid. Despite accessing these resources, individuals with mental illness still face significant challenges in terms of their physical health, meeting basic needs, experiencing victimization, and overall subjective quality of life (Sullivan et al., 2000). The research conducted highlights the underlying structural or macro reasons behind homelessness. These factors indicate that implementing comprehensive measures to tackle housing affordability, low incomes, and income inequality could be the most impactful strategies in preventing homelessness. People without housing is a complex issue that can be attributed to various factors, including individual challenges such as mental illness or substance use, as well as poverty (O’Regan et al., 2021). It is essential to recognize that local governments often approach service provision in a way that separates behavioral services and emergency shelter provision from departments responsible for housing affordability and equality. However, when it comes to finding solutions

5 for homelessness, it is evident that social services alone do not directly impact housing stability. Nonetheless, these services benefit supportive housing residents (O'Regan et al., 2021). Poverty, on the other hand, plays a significant role in homelessness. It is not just about low incomes but also about income inequality within a community. Studies show that higher levels of income inequality have a substantial and undeniable impact on the prevalence of homelessness (O’Regan et al., 2021). Sequela Homelessness leads to severe healthcare problems, such as HIV/AIDS, addiction, mental disorders, and various illnesses that demand continuous, extended treatment. Infectious diseases spread rapidly within the homeless community. Homelessness has a detrimental impact on individuals, leading to a decline in self-confidence and a sense of worthlessness. It often results in individuals becoming dependent on medical or mental health institutions, exacerbating their vulnerability. Substance misuse tends to escalate in such circumstances, further compounding the challenges faced by the homeless population. Additionally, the ability and motivation to take care of oneself diminishes, leading to a multitude of behavioral problems and an increased likelihood of engaging in violent acts. Furthermore, the risk of being caught up in the criminal justice system significantly rises for those experiencing homelessness as well. Homeless individuals frequently face numerous health challenges throughout their lives. Their well-being deteriorates over time due to the absence of care and support from individuals such as doctors, spouses, family members, and others. Additionally, the lack of necessities exposes them to a range of diseases, including cold injuries, cardio-respiratory diseases, tuberculosis, skin diseases, nutritional deficiencies, sleep deprivation, mental illness, and physical and sexual assault.

6 A broad spectrum of challenges, spanning from mental and health concerns to feelings of personal confinement, are faced by individuals experiencing homelessness. We believe many of these individuals have struggled to effectively address their hardships, leading to isolation and detachment from society. Homeless individuals encounter a diverse array of obstacles, including both physical and mental well-being, as well as a sense of being trapped in their circumstances. Significance of Study Homelessness is a complex problem that affects millions of people in the United States. Social workers, practitioners, administrators, educators, and policy makers all play a role in addressing homelessness. Mentorship programs can help to improve the lives of people experiencing homelessness by providing them with support, guidance, and resources. For social work researchers, mentorship programs can provide an opportunity to study the effectiveness of different approaches to homelessness prevention and intervention. Researchers can also use mentorship programs to train future social workers on how to work with people experiencing homelessness. For social work practitioners, mentorship programs can provide support and guidance as they work with people experiencing homelessness. Mentors can help practitioners to develop new skills and strategies and can also provide emotional support. For social work administrators, mentorship programs can help to create a more supportive work environment for social workers. Mentors can help administrators to develop policies and procedures that are supportive of social workers and can also help to create a culture of collaboration and support. For social work educators, mentorship programs can provide an opportunity to train future social workers on how to work with people experiencing homelessness. Mentors can help educators to develop new curriculum and teaching materials and can also provide guidance to the homeless and its impact on people's lives. For policy makers,

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7 mentorship programs can provide an opportunity to learn about the experiences of people experiencing homelessness and the challenges they face. Mentors can help policy makers to develop policies that are more responsive to the needs of people experiencing homelessness. In conclusion, mentorship programs can have a significant impact on the lives of people experiencing homelessness, as well as on the social work profession. Mentorship programs can provide support, guidance, and resources to people experiencing homelessness, and can also help to improve the lives of social workers, practitioners, administrators, educators, and policy makers. A mentorship program can play a crucial role in assisting homeless individuals in accessing essential social services, healthcare, and housing with the appropriate and healthy mindset and attitude. By offering a strong support system, respect, compassion, active listening and valuable resources, mentors empower homeless individuals to navigate the intricate web of social services and connect with the necessary resources to rebuild their lives. Moreover, mentors provide invaluable emotional support and guidance, offering a lifeline to those grappling with the challenges of homelessness. Literature Review According to The Voices Be Heard research, they conducted a project from a post- positivist perspective. The project aimed to create a platform for people to share their stories of homelessness, explore themes of resilience and compassion, and share stories and findings with the wider community for educational advocacy purposes to improve service delivery. The findings show that interactions with service providers were crucial in addressing the three levels of oppression in homelessness. Service providers and the systems they work in have the power to either perpetuate oppressive attitudes or foster relationships and opportunities where individuals

8 can "feel human again" (Schneider et al., 2019). Understanding that creating an empowering environment that encourages individuals to share their stories can be done in various settings, such as shelters, permanent supportive housing, drop-in centers, and community-based homeless service organizations. Based on the stories shared by their participants, it was recommended that the following strategies to address individual and cultural oppression: seeing the person beyond their problems, inviting their complete story, working on building relationships, and eliciting stories of survival and wisdom. At the systemic level, reevaluating protocols, and service structures, looking beyond the present, incorporating storytelling, and investing in staff development and support will increase participation in services (Schneider et al., 2019). Researchers in Mobile, Alabama conducted a study at a homeless day shelter in downtown Mobile to explore the perceptions of health care experiences among homeless individuals. The study revealed that many guests reported troubling encounters with health care providers who disregarded their needs. Understanding the experiences and perceptions of homeless individuals can help health care providers better engage with this vulnerable population. Interestingly, when clinicians were asked about their attitudes towards homeless people, they refused to participate due to extreme distress. This contrasts with the homeless participants in the study who were eager to share their health care experiences. It raises questions about how professional experiences influence attitudes towards the homeless and how professionals reconcile these beliefs with their codes of conduct. Additionally, the study suggests that organizational cultures and influential individuals may contribute to the development of negative beliefs or group think. Further research is needed to gain insight into the perceptions and interactions between providers and homeless patients to improve outcomes and experiences for both groups (Moore-Nadler et al., 2019).

9 Previous research on homelessness focused on how people became homeless, but little is known about how they accessed services while experiencing homelessness. One study examined the service pathways of homeless individuals in the United States. They conducted 12 in-depth interviews to understand the history of accessing services, including the number of organizations they interacted with, the time gaps between services, and referral patterns. It was observed that a subset of participants and how they interacted with caseworkers. The length of service pathways varied, ranging from less than five years to over two decades. On average, participants accessed services from three to eight organizations. This was identified both negative and positive experiences in accessing services, such as strict organizational policies and demeaning attitudes from caseworkers (negative), or supportive organizational culture and competent employees (positive) (Lee et al., 2022). This literature review will be highlighting the challenges faced by homeless individuals in navigating services, including institutional barriers, limited social services, lack of housing, health care and insufficient communication from service providers. This will also emphasize the need for financial support and various resources to address homeless people health and social needs. Research Problem Homelessness continues to be a critical issue that profoundly impacts both society as a whole and the well-being of individuals, particularly those struggling with mental illness. In order to truly make a positive difference in their quality of life and overall wellness, it is imperative for programs designed to assist homeless individuals with mental illness to prioritize two crucial elements: ensuring stable housing and providing essential services to address their basic needs and physical health requirements. The homeless community faces significant

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10 challenges due to severe mental health disorders and physical disabilities, which hinder their ability to find suitable shelter or access services that cater to their specific needs. However, implementing a mentorship program that delves into the underlying problems faced by the homeless can greatly enhance their engagement in available services. The power of community cannot be underestimated when it comes to utilizing mentoring programs. By operating within a well-established community, mentoring programs can thrive and reach new heights. The program can be used in various forms, whether it be a department within a company, a global organization, a group of like-minded individuals, or even an online community centered around a specific interest or profession. Regardless of the type, the community provides a valuable framework and a shared sense of purpose, values, and aspirations. These commonalities create a fertile ground for the formation of meaningful mentoring relationships and foster a strong bond within the homeless community. Moreover, the broader community can offer additional support and resources to mentors to further enhance the overall effectiveness of the mentoring program. Embracing the strength of community is essential in building successful mentoring programs that empower individuals to grow and thrive in whatever environment they are in. Research Question and Hypothesis Would a mentorship program be an essential conduit to help homeless people with assessing resources and services? Research shows that mentoring programs can be an effective way to help homeless people. Mentoring programs provide homeless people with emotional support, guidance, and practical assistance. They can also help homeless people to develop the skills and resources they need to become self-sufficient. I strongly believe in the transformative power of community and

11 mentoring programs in assisting homeless individuals in accessing vital resources and services. These programs play a crucial role in equipping the homeless with valuable information about the resources available to them, while also offering emotional support and guidance. Through the guidance of mentors, homeless individuals can develop the necessary skills and confidence to secure employment and housing, ultimately paving the way for a brighter future.

12 References Desmond, M., & Gershenson, C. (2017). Who gets evicted? Assessing individual, neighborhood, and network factors. Social Science Research , pp. 62 , 362–377. https://doi.org/10.1016/j.ssresearch.2016.08.017 D’Souza, M. S., & Mirza, N. A. (2021). Towards Equitable Health Care Access: Community participatory research exploring unmet health care needs of homeless individuals. Canadian Journal of Nursing Research , 54 (4), 451–463. https://doi.org/10.1177/08445621211032136 Garcia, C., Doran, K., & Kushel, M. (2024). Homelessness and health: Factors, evidence, innovations that work, and policy recommendations. Health Affairs , 43 (2), 164–171. https://doi.org/10.1377/hlthaff.2023.01049 Hopkins, J., & Narasimhan, M. (2022). Access to self-care interventions can improve health outcomes for people experiencing homelessness. BMJ . https://doi.org/10.1136/bmj-2021- 068700 Hossain, M. M., Sultana, A., Tasnim, S., Fan, Q., Ma, P., McKyer, E. L., & Purohit, N. (2020). Prevalence of mental disorders among people who are homeless: An Umbrella Review. International Journal of Social Psychiatry , 66 (6), 528–541. https://doi.org/10.1177/0020764020924689 HUD, U. S. D. of H. and U. D. (n.d.). News releases: HUD releases 2019 Annual Homeless Assessment Report . HUD Archives. https://archives.hud.gov/news/2020/pr20-003.cfm Lee, E., Lee, W., & Duncan, S. (2022). Understanding service navigation pathways and service experiences among homeless populations. Qualitative Social Work , 22 (5), 1031–1047. https://doi.org/10.1177/14733250221114477

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13 Miler, J. A., Carver, H., Foster, R., & Parkes, T. (2020). Provision of peer support at the intersection of homelessness and problem substance use services: A systematic ‘state of the art’ review. BMC Public Health , 20 (1). https://doi.org/10.1186/s12889-020-8407-4 Moore-Nadler, M., Clanton, C., & Roussel, L. (2019). Storytelling to capture the health care perspective of people who are homeless. Qualitative Health Research , 30 (2), 182–195. https://doi.org/10.1177/1049732319857058 Olivet, J., Wilkey, C., Richard, M., Dones, M., Tripp, J., Beit-Arie, M., Yampolskaya, S., & Cannon, R. (2021). Racial inequity and homelessness: Findings from the SPARC study. The ANNALS of the American Academy of Political and Social Science , 693 (1), 82–100. https://doi.org/10.1177/0002716221991040 O’Regan, K. M., Ellen, I. G., & House, S. (2021). How to address homelessness: Reflections from research. The ANNALS of the American Academy of Political and Social Science , 693 (1), 322–332. https://doi.org/10.1177/0002716221995158 Schneider, D. A., Cretella, J., Ranaudo, S., Constantino, D., & Cota, C. F. (2019). Voices should be heard: What personal stories of homelessness teach us about practice. Families in Society: The Journal of Contemporary Social Services , 100 (3), 317–327. https://doi.org/10.1177/1044389419837069 Shuman, T., Johnson, K., Lively Cookson, L., & Gilbert, N. (2020). Creative interventions for preparing and disclosing trauma narratives in group therapy for Child sexual abuse. Journal of Child Sexual Abuse , 31 (1), 127–146. https://doi.org/10.1080/10538712.2020.1801931

14 Sleet, D. A., & Francescutti, L. H. (2021). Homelessness and public health: A focus on strategies and solutions. International Journal of Environmental Research and Public Health , 18 (21), 11660. https://doi.org/10.3390/ijerph182111660 Sullivan, G., Burnam, A., Koegel, P., & Hollenberg, J. (2000). quality of life of homeless persons with mental illness: Results from the course-of-homelessness study. Psychiatric Services , 51 (9), 1135–1141. https://doi.org/10.1176/appi.ps.51.9.1135

SWK 661 6.2 Assignment Literature Review

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