Use of Ethnographic Methods in Research on Homeless Services: Challenges of Integration and Interpretation (Part 1-Clients)

Introduction: This report discusses the use of diverse sources of observational and interview data in a longitudinal qualitative study of mental health recovery among formerly homeless individuals with serious mental illness enrolled in supported housing programs in New York City. In addition to in-depth interviews with clients and their case managers, we used: 1) participant observation of program operations (site visits, ride-alongs on home visits) and of participants’ daily routines (walk-along interviews); and 2) respondent-controlled photo elicitation interviewing (PEI). This first of two papers will focus on the client-related observation and PEI findings. Research questions guiding this inquiry include: 1) how are multiple techniques of qualitative data collection coordinated using ethnographic methods? 2) how complementary are these data sources during analysis and interpretation?

Methods: 53 formerly homeless adults were recruited through their housing programs for an 18-month follow-up study of mental health recovery funded by NIMH. In-depth interviews at baseline are used in this report and supplemented by purposive sampling of a subset of study participants for walk-along interviews (N=8) and photo-elicitation interviews (PEIs) (N=17). Walk-along interviews involved 3-5 hours of accompanying client participants on daily activities and recording field notes as data. PEIs enabled clients to visually portray their lives and control the narratives and photos that resulted. Interviewers who conducted the baseline interviews also carried out shadowing and PEIs. PEI photos were geo-coded and mapped to document mobility, destination and photographic content. Field notes, photographs, maps and PEI transcripts were incorporated into cross-case analyses of each participant. Following Patton (2002), the analyses were guided by memoing and thematic development drawing on raw data as well as case summaries and a case matrix.

Findings:   Juxtaposition of observational with interview data revealed no contradictions but complementary or deepened perspectives on participants’ lives. Patterns of mobility demonstrated in the PEIs and geo-coded maps favored local settings but also included extra-local travel to depict social relationships, service use and public art. Cross-case analyses of all data revealed five themes: comforts of home, restrictions in mobility/access, social relationships, access to services, and new possibilities.

Discussion: Though labor-intensive, the collection and integration of multiple forms of interview and observational data created a more complete portrayal of client’s lives as they pursued a more stable life. Understanding of mental health recovery is enhanced when in-depth interviews are supplemented by participant-controlled observation from walk-along encounters and photo elicitation interviews. Critical theory as an interpretive frame reveals the significance of structural barriers rooted in the inaccessibility of services, poverty, and low-income neighborhood environments.