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Homelessness is a global challenge.

The United Nations Human Settlements Program estimates that 1.1 billion people live in inadequate housing, and the best data available suggest that more than 100 million people have no housing at all.

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8. Homeless Youth, Nutritional Vulnerability, and Community Food Assistance Programs

Naomi Dachner

Valerie Tarasuk

This chapter begins with an examination of the nutritional vulnerability of homeless youth and the many strategies they employ in their efforts to satisfy basic food needs. We also explore the meaning of food for youth who are homeless and unable to choose food they prefer. This section of our chapter draws heavily from dietary intake assessments (analyses of the level of nutrition in a diet), survey interviews, and in-depth...

4. Childhood Stress and Mobility Among Rural Homeless Youth

Stephanie Baker Collins

In this chapter I will report on a longitudinal study of homeless youth in Niagara, a region in Ontario with a unique mix of rural, small town and urban settings. Forty homeless youth participated in the study and 30 youth were followed for an average of 7 months.The findings from this study help examine the causes of youth homelessness, while the characteristics of homeless youth in Canada are reviewed in order to evaluate...

‘‘Because Somebody Cared about Me. That’s How It Changed Things’’: Homeless, Chronically Ill Patients’ Perspectives on Case Management

Elizabeth Davis

Aracely Tamayo

Alicia Fernandez

Case management programs for chronically ill, homeless people improve health and resource utilization by linking patients with case managers focused on improving management of medical and psychosocial problems. Little is known about participants’ perspectives on case management interventions. This qualitative study used in-depth, one-on-one interviews to understand the impact of a case management program from the perspective...

Circumstances of first injection among illicit drug users using a medically supervised safer injection facility

There have been concerns that safer injecting facilities may promote initiation into injection drug use. We examined length of injecting career and circumstances surrounding initiation into injection drug use among 1065 users of North America's first safer injecting facility and found that the median years of injection drug use were 15.9 years, and that only 1 individual reported performing a first injection at the safer...

Mental health, concurrent disorders, and health care utilization in homeless women

This study assessed lifetime and current prevalence rates of mental disorders and concurrent mental and substance use disorders in a sample of homeless women. Current suicide risk and recent health service utilization were also examined in order to understand the complex mental health issues of this population and to inform the development of new treatment strategies that better meet their specific needs. Methods. A cross-...

The Association Between Childhood Maltreatment Subtypes and Current Suicide Risk Among Homeless men and Women

This study explored self-reports of five childhood maltreatment (CM) subtypes and their associations with current suicide risk in a sample of 500 homeless persons. Participants completed the Childhood Trauma Questionnaire and the Mini-International Neuropsychiatric Interview. Individual, unique, and cumulative associations of CM subtypes and subtype combinations with suicide risk (no vs. low vs. moderate/high) were examined....

The Convergent and Concurrent Validity of Trait-Based Prototype Assessment of Personality Disorder Categories in Homeless Persons

Douglas B. Samuel

Adrian J. Connolly

Samuel A. Ball

The DSM-5 proposal indicates that personality disorders (PDs) be defined as collections of maladaptive traits but does not provide a specific diagnostic method. However, researchers have previously suggested that PD constructs can be assessed by comparing individuals’ trait profiles with those prototypic of PDs and evidence from the five-factor model (FFM) suggests that these prototype matching scores converge moderately with...

Childhood Abuse, Criminal Victimisation, Sex Work, and Substance Use Among Homeless Street Youth: An Application of General Strain Theory

Nicolas A. Swagar

Robert Agnew’s general strain theory proposes that strain leads to crime and deviance. Substance use is a specific type of criminal behavior that the theory attempts to explain. This thesis uses general strain theory to examine how a number of specific types of strain – homelessness, childhood abuse, criminal victimization, and sex work – are related to substance use. In addition, the relationships between strain and...

Prevalence of Metabolic Syndrome in a Predominantly Cuban, Psychiatrically Ill, and Homeless Population

Rafael A. Rivas-Vazquez

This study examined the prevalence of metabolic syndrome among a group of psychiatric outpatients enrolled in a homeless program that is located in a predominantly Hispanic geographic area of South Florida. Data for this retrospective, cross-sectional analysis were obtained from a record review of 122 adult patients who received full medical and psychiatric assessments based on DSM-IV criteria during participation in our...

Psychache and Suicide Ideation among Men Who Are Homeless: A Test of Shneidman's Model

Allisha A. Patterson

Ronald R. Holden

Suicide ideation among the homeless is 10 times more common than in the general population. Cognitive theories of depression and hopelessness propose to explain suicidality; however, as yet, none of these fully account for the phenomenon. Shneidman has suggested a theory of psychache or unbearable psychological pain to explain suicidality. This theory has found support among low-risk populations but has not been extensively...

An Ecological Systems Comparison Between Homeless Sexual Minority Youths and Homeless Heterosexual Youths

Maurice N. Gattis

This study examined risk and protective outcomes by comparing homeless sexual minority youths to heterosexual homeless youths regarding family, peer behaviors, school, mental health, stigma, discrimination, substance use, and sexual risk behaviors. Structured interviews were conducted with individuals aged 16 to 24 years old in Toronto. Bivariate analyses indicated statistically significant differences between homeless...

Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care

The objective of this study was to assess thecosts of a housing and case management program in a novel sample-homeless adults with chronic medical illnesses. The study used data from multiple sources: (1) electronic medical records for hospital, emergency room, and ambulatory medical and mental health visits; (2) institutional and regional databases for days in respite centers, jails, or prisons; and (3) interviews for days...

Concurrent Mental Health and Substance Use Problems among Street-Involved Youth

Marritt Kirst

Tyler Frederick

Patricia G. Erickson

Among marginalized populations, homeless adults are known to have elevated rates of mental health and substance use problems compared to the general population, but less is known about their youthful homeless counterparts. While few studies currently exist, what research has been conducted among street-involved youth has confirmed high rates of comorbidity among this population. However, few of these studies explore...

The Administration and Criminalization of the Homeless: Notes on the Possibilities and Limits of Bureaucratic Engagement

Lorne Sossin

This article argues that successfully addressing social problems such as homelessness requires that the vast and often hidden discretion afforded public officials be exposed, rehabilitated, and expanded. A more proactive bureaucratic role in implementing social welfare legislation ought to be tied to explicit normative underpinnings. State intervention to eliminate homelessness will only succeed if its goals are clear, if...

The New Homelessness Revisited

Barrett A. Lee

Kimberly A. Tyler

James D. Wright

The new homelessness has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since...

Assessing Health, Promoting Wellness: Common Health Issues Among People Experiencing Homelessness

Ken Kraybill

Sharon Morrison

While PATH providers often do not have medical training, they regularly encounter consumers who face health issues. This section of Assessing Health, Promoting Wellness provides an overview of common health issues among people experiencing homelessness. Homelessness is a marker for illness. People living on the streets and in shelters are more likely to get sick, their health issues are more likely to be severe, and they are...

Using common themes: Cost-effectiveness of permanent supported housing for people with mental illness

T.C. McLaughlin

This article examines the cost-effectiveness of providing permanent supported housing to homeless people with mental illness. Through the use of billing records and frequency of use charts, researchers were able to map the service usage of a cohort of 268 homeless individuals from both urban and rural communities. The results suggest that significant cost savings can be achieved by establishing supportive housing programs...

Exploring gender and sexual minority status among street-involved youth

This article compares heterosexual and sexual minority street-involved youth across a number of sociodemographic, risk and current mental health, victimization and delinquency measures with a particular focus on gender differences. The sample consists of 147 homeless and street-involved young men and women aged 16-21 years in Toronto, Ontario, Canada. Bivariate analyses indicate that many of the differences between the...

Forced Evictions and Human Rights

International human rights law establishes norms and principles touching on virtually all facets of life. This is reflected in the consistent reaffirmation by the international community of the indivisibility and interdependence of all human rights, whether civil, cultural, economic, political or social. The indispensable equality of all human rights, now firmly entrenched in the provisions of international human rights...

Substance use comorbidity among veterans with posttraumatic stress disorder and other psychiatric illness

I.L. Petrakis

R. Rosenheck

R. Desai

There is considerable concern about the emergence of significant substance abuse among younger veterans of war in the Middle East, especially among those with Posttraumatic Stress Disorder (PTSD), but little information exists on the magnitude of this problem. Using national administrative data from the Department of Veterans Affairs (VA) (n = 1,001,996), this study examined rates of diagnosed substance use disorders in...

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