Society for Social Work and Research 18th Annual Conference: Research for Social Change: Addressing Local and Global Challenges

January 15 - 19, 2014

The promise of mental health recovery is amply supported by empirical evidence but psychiatric consumers still confront numerous obstacles, especially those with histories of homelessness and substance abuse.  Their lives marred by cumulative adversity from childhood, these men and women must contend with previous traumas and depletions of social and human capital as well as serious mental illness.

Research on mental health recovery has shown objective benchmarks such as management of psychiatric symptoms, having a job and engaging in fulfilling social relationships. However, measures of recovery often fall short in capturing progress in less tangible domains. Quantitative studies document the ‘what’ of recovery but are less useful in the ‘how’ and ‘why’ of the positive and negative experiences of individuals. After the setbacks of being homeless (including physical health and trauma), attaining stable housing is presumed to be an adequate platform for recovery potential.

This symposium will consist of qualitative research on obstacles to and accomplishments of recovery among formerly homeless adults with serious mental illness. Drawing upon Maslow’s hierarchy of needs, we examine how individuals pursue recovery after having the basic need of housing met. In particular, we explore individual and structural factors that impede and incentivize recovery.

The first paper reviews Maslow’s theory and applies it to mental health recovery through self-reports of needs by 57 formerly homeless adults enrolled in two program types, one permanent housing (‘housing first’) and the other transitional housing (‘treatment first’), at baseline and 12 months later. The effect of having permanent housing can be seen in changes in perceived needs over time. The second paper addresses a major life goal of obtaining employment as experienced by 20 clients enrolled in supported employment training within a ‘housing first’ program. Using a longitudinal design and multiple interviews surrounding ‘key events’,  the study draws on Maslow’s pyramid to describe the pursuit of work juxtaposed against other needs. The third paper broadens out to include varied forms of meaningful activity, including work but also the pursuit of social relationships. Drawing on in-depth interviews with 40 formerly homeless consumers, the study highlights program-related obstacles as well as the lingering effects of negative past influences. The fourth and final paper describes a methodological innovation—photo-elicitation interviewing—that offered enhanced and deeper portrayals of life experiences while empowering participants to control the camera and accompanying narratives. In this study, 18 formerly homeless consumers provided 285 photos that revealed their current life status as well as past and future concerns.