«DiscoVeriNg HomelessNess Volume 13, Number 1 • 2011 U.S. Department of Housing and Urban Development | Office of Policy Development and Research ...»
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68 Discovering Homelessness From Exclusion to Destitution: Race, Affordable Housing, and Homelessness Jackman, Mary R., and Robert W. Jackman. 1980. “Racial Inequalities in Home Ownership,” Social Forces 58 (4): 1221–1234.
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Massey, Douglas S., and Nancy A. Denton. 1993. American Apartheid: Segregation and the Making of Underclass. Cambridge, MA: Harvard University Press.
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Wright, Talmadge. 1997. Out of Place: Homeless Mobilizations, Subcities, and Contested Landscapes.
Albany: State University of New York Press.
70 Discovering Homelessness
From Street Life to Housing:
Consumer and Provider Perspectives on Service Delivery and Access to Housing Tatjana Meschede Brandeis University Abstract The goal of this qualitative study was to demonstrate the achievements and failures of services that attempt to reach those most likely to be left out of the homeless-services delivery model—the chronically homeless street population. In 36 interviews with current and former chronically homeless street dwellers and the people who serve them, this study analyzed the service needs of chronically homeless street dwellers and the successes and failures of street-based medical and substance abuse services intersecting with the predominant continuum-of-care (CoC) model for homeless individuals, thus connecting chronically homeless street dwellers with services and housing. Using Grounded Theory as the guiding principle for analysis (Strauss and Corbin, 1998), the results of this study emphasize important differences between providers’ and consumers’ perceptions and theories on homelessness, service needs of homeless street dwellers, and service provision. Program and policy recommendations for ending chronic homelessness include the need to increase the affordable housing stock, enhance support systems for successful transition to housing and continuous support, and reduce bureaucratic barriers to housing.
Cityscape 71 Cityscape: A Journal of Policy Development and Research • Volume 13, Number 1 • 2011 U.S. Department of Housing and Urban Development • Office of Policy Development and Research Meschede Introduction A large proportion of the homeless population (about 80 percent) is able to move back into housing within a short time (Kuhn and Culhane, 1998). But some among them struggle for many years, adapting their lifestyle to the streets and facing numerous barriers to leaving their homeless plight behind. Years of life on the streets, accompanied by malnutrition, lack of health care, and most often also extensive substance abuse, take a toll on their health and place them at increased risk of death (Hwang, 2000). Because of the multiple problems these chronically homeless individuals face, as a group, they use up to one-half of all homeless-services resources (Kuhn and Culhane, 1998). The prominent public policy response is incremental: providing services aimed at reducing the harm evoked by experiencing homelessness for unsheltered individuals rather than comprehensively addressing its root causes. Similar to other U.S. social policies, U.S. programs for homelessness lack a comprehensive system of care (DiNitto, 2000).
Focusing on street-based medical and substance-abuse services, the primary purpose of this qualitative study was to assess the contribution of these services in connecting chronically homeless street dwellers at risk of death to housing. Although the quantitative analysis of this research project points to a very small effect of these services on housing outcomes (Meschede, 2010), this qualitative research aims to answer the following four questions to illuminate the experience of
providers and street dwellers contributing to these small effects:
1. What are homeless-services providers’ theories of homelessness and assumptions about how their services may improve the housing, health, psychiatric disability, and employment of the street homeless?
2. What factors enable homeless street dwellers to attain and maintain housing?
3. What are the barriers to connecting homeless street dwellers with services so that they can better attain and maintain housing?
4. What changes in the service delivery approach for homeless street dwellers at risk of death would improve housing and other outcomes?