“I can’t remember the last time I was comfortable about being home”: lived experience perspectives on thriving following homelessness

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.

KEYWORDS:

• Social justice
• health equity
• housing
• health systems
• poverty
• community integration
• meaningful activity
• mental health
• substance use

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The work was supported by the Canadian Institutes of Health Research [PJT 166132]

Notes on contributors

Carrie Anne Marshall

Carrie Anne Marshall is an assistant professor at Western University whose research focuses on the transition to housing for persons experiencing homelessness using both qualitative and mixed methods approaches.

Brooke Phillips

Brooke Phillips is a research coordinator in the Social Justice in Mental Health Research Lab (SJMH Lab) at Western University.

Julia Holmes

Julia Holmes, Corinna Easton, Rebecca Goldszmidt, Chelsea Shanoff, Suliman Aryobi and Shauna Perez are research assistants in SJMH Lab.

Eric Todd

Eric Todd, River Hill and George Panter are lived experience consultants in SJMH Lab.

Terry Landry

Terry Landry, Sarah Collins, Tom Greening, Ashley O’Brien, Marlo Jastak, Rebecca Ridge, and Alexandra Carlsson are organizational leaders and practitioners in agencies that support persons who experience homelessness in the Kingston and London communities.

Debbie Laliberte Rudman

Jessica Szlapinski, Rozelen Carrillo-Beck and Nicole Pacheco were students in the MSc. Occupational Therapy program at Western University, who were completing a research-focused placement as a part of their degree requirements.

Jessica Szlapinski

Debbie Laliberte Rudman is a professor at Western University whose research focuses on occupation and well-being among a range of population groups who experience oppression, and a methodological expert in qualitative methods.

Abe Oudshoorn

Abe Oudshoorn is an associate professor at Western University whose research focuses on issues related to homelessness and mental health.