Assessing the relationship between housing and health among medically complex, chronically homeless individuals experiencing frequent hospital use in the United States.
Adult
Case Management
Community Mental Health Services
/ statistics & numerical data
Female
Health Services Accessibility
/ statistics & numerical data
Ill-Housed Persons
/ psychology
Humans
Male
Middle Aged
Public Housing
/ statistics & numerical data
Social Work
/ organization & administration
Substance-Related Disorders
/ psychology
United States
addiction
chronic illness
complex interventions
housing
mental health
social and health services
Journal
Health & social care in the community
ISSN: 1365-2524
Titre abrégé: Health Soc Care Community
Pays: England
ID NLM: 9306359
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
10
02
2019
revised:
14
08
2019
accepted:
19
08
2019
pubmed:
3
9
2019
medline:
1
12
2020
entrez:
3
9
2019
Statut:
ppublish
Résumé
In the United States and abroad, health systems have begun to address housing insecurity through programs that adhere to the Housing First model. The model provides permanent supportive housing without disqualification due to current mental health problems or substance use, along with optional case management services. This study used qualitative methods to explore how housing stability affected chronic disease management and social and community relationships among individuals with complex health and social needs and patterns of high hospital utilisation who were housed as part of a scattered-site Housing First program in a mid-size city in the northeastern United States. 26 individual, semi-structured interviews were conducted with Housing First clients in their homes or day program sites between March and July 2017. Interviews were digitally recorded and transcripts were analysed using a qualitative descriptive methodology until thematic saturation was reached. Findings suggest that housing provided the physical location to manage the logistical aspects of care for these clients, and an environment where they were better able to focus on their health and wellness. Study participants reported less frequent use of emergency services and more regular interaction with primary care providers. Additionally, case managers' role in connecting clients to behavioural health services removed barriers to care that clients had previously faced. Housing also facilitated reconnection with family and friends whose relationships with participants had become strained or distant. Changes to physical and social communities sometimes resulted in experiences of stigmatisation and exclusion, especially for clients who moved to areas with less racial and socioeconomic diversity, but participation in the program promoted an increased sense of safety and security for many clients.
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
91-99Informations de copyright
© 2019 John Wiley & Sons Ltd.
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