Social Relationships of Dually Diagnosed Homeless Adults Following Enrollment in Housing First or Traditional Treatment Services.
Social Relationships of Dually Diagnosed Homeless Adults Following Enrollment in Housing First or Traditional Treatment Services.
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DOI：
10.1086/682583
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发表时间：
2015-09
影响因子：
1.8
通讯作者：
Padgett DK
中科院分区：
文献类型：
--
作者：
Henwood BF;Stefancic A;Petering R;Schreiber S;Abrams C;Padgett DK
强有力和有效的社会支持是心理健康恢复的关键因素，但无家可归的成年人往往缺乏社会支持。这项研究考察了新参加住房第一（HF）方案的参与者的社交网络差异（即，通过持续的消费者驱动的支持服务提供立即获得永久住房的机会）或治疗优先（TF）方法（即，传统的临床医生驱动的楼梯模式，在进入永久性住房之前需要临时或过渡性住房和治疗安置）。我们使用混合方法的社会网络分析方法，以评估75个人的程序类型（HF或TF）和程序保留的基础上的组差异。定量结果表明，与TF相比，HF参与者在其网络中的工作人员比例更大。TF参与者比HF参与者更有可能维持混合质量的关系（即，与支持和冲突要素的关系）。与留在项目中的参与者相比，那些脱离项目的参与者有更大比例的混合关系和疏远的关系。定性分析表明，HF参与者认为住房提供了一个稳定的基础，从重新连接或恢复破碎的关系。然而，HF参与者对亲密关系持谨慎态度，因为担心由于他们新获得的公寓而受到剥削。专题工作队参与者报告说，由于专题工作队方案的时间有限性，他们不太愿意与同行或工作人员建立新的关系。这些研究结果表明，HF参与者并不比传统护理中的参与者更孤立。实践，政策和未来的研究的影响进行了讨论。
Strong and effective social support is a critical element of mental health recovery, yet social support is often lacking for adults experiencing homelessness. This study examines differences in the social networks of participants newly enrolled in programs that use either a Housing First (HF) approach (i.e., provides immediate access to permanent housing with ongoing consumer-driven support services) or a treatment first (TF) approach (i.e., traditional clinician-driven staircse model that requires temporary or transitional housing and treatment placements before accessing permanent housing). We use a mixed-methods social network analysis approach to assess group differences of 75 individuals based on program type (HF or TF) and program retention. Quantitative results show that compared with TF, HF participants have a greater proportion of staff members in their network. TF participants are more likely than HF participants to maintain mixed-quality relationships (i.e., relationships with elements of support and conflict). As compared with participants who remain in a program, those who disengage from programs have a greater proportion of mixed relationships and relationships that grow distant. Qualitative analyses suggest that HF participants regard housing as providing a stable foundation from which to reconnect or restore broken relationships. However, HF participants are guarded about close relationships for fear of being exploited due to their newly acquired apartments. TF participants report that they are less inclined to develop new relationships with peers or staff members due to the time-limited nature of the TF programs. These findings suggest that HF participants are not more socially isolated than those in traditional care. Implications for practice, policy and future research are discussed.