Occupation, Homelessness, and the Transition to Becoming Housed Among Chronically Homeless Persons

Abstract

Background: Existing homelessness research focuses on psychological and social aspects of this experience. There is limited literature focusing on the daily occupations of those who are chronically homeless, and particularly during the transition to becoming housed. Purpose: This research was carried out in 3 Phases. Phase I aimed to synthesize the current literature contributing to an understanding of occupational transition during the process of becoming housed among homeless persons. Phase II aimed to develop an understanding of the experience of occupational engagement of chronically homeless persons in a medium-sized city in Ontario, Canada. Phase III aimed to develop an enhanced understanding of the experience of occupational engagement of chronically homeless persons as they made the transition to becoming housed. Method: Phase I used a scoping review methodology (Arksey & O’Malley, 2005) to explore existing literature contributing to an understanding of occupational transition during an exit from homelessness. Interpretive phenomenology guided Phases II and III, which involved gathering data through semi-structured interviews with 12 participants who were chronically homeless (Phase II), and 11 participants with a history of chronic homelessness who had recently become housed (Phase III). Data collected in Phases II & III were analyzed using a modified version of the method suggested by Colaizzi (1978). Results: Phase I uncovered the relative paucity of literature focusing on the occupations of homeless persons as they exit homelessness. Phase II identified the unique occupational experiences of chronically homeless persons in a medium-sized city. Chronically homeless persons experienced occupational alienation caused by a lack of participation in mainstream society, and a deep and pervasive boredom that adversely influenced their mental health and drove substance misuse. Phase III identified that as participants transitioned to becoming housed, slow changes in their occupational repertoire positively influenced their mental health and well-being. Implications: Taking a broad view of the occupations of chronically homeless persons reveals several unique aspects of their experiences that can inform interventions designed to support this population as they exit homelessness. Incorporating an occupational approach in concert with a housing first philosophy may lead to a more comprehensive strategy to addressing chronic homelessness.