The Path Towards Independent Housing for Individuals Experiencing Homelessness and Mental Health or Co-Occurring Disorders: A Qualitative Focus Group Study

Background and Purpose

Homelessness has been identified as a major public health concern in the U.S., and is often associated with negative outcomes such as mental health and substance use problems, poor health, incarceration, and premature mortality. Several federal- and state-funded housing programs assist individuals experiencing homelessness, such as the Healthy Community Collaborative (HCC) program, a program administered by the Texas Health and Human Services Commission (HHSC) to provide housing and wraparound services for individuals experiencing homelessness and mental health or co-occurring disorders. However, few studies have examined the experiences of individuals in such programs. This study uses a focus group research method to elicit the experience of vulnerable and often marginalized homeless individuals’ experience in the HCC program, history with homelessness, and their path towards obtaining independent housing.

Methods

Five focus groups were conducted with 24 homeless HCC clients (ages 19 to 65) from four HCC locations (Austin, Dallas, San Antonio, and Forth Worth). Guided by the grounded theory approach, focus group data was transcribed verbatim and thematically analyzed to identify themes across group discussions.

 

Results

Preliminary findings from this study are composed of 3 broad themes and 4 subthemes; 1) Need patience and take initiative about your housing, 1-a) Road to housing takes a long time and requires patience, 1-b) Personal Responsibility, you can’t wait for the services to come to you; Theme 2) I feel anxious thinking about making it on my own, 2-a) I will miss the community that has supported me in the shelter—transitioning into independent housing is often difficult, 2-b) Finding a good apartment and then keeping it on my own is anxiety provoking—housing is expensive; Theme 3) Things that matter for myself and my family, but are often overlooked, 3-a) Transportation services, 3-b) Daycare and play spaces, 3-c) Shelters and meals specific for families and children. Themes constructed reveal the essence of the experiences of the individuals are interconnected, and not independent of one another.

Conclusions and Implications

Study results revealed the strengths of the clients and their insight into the often slow-moving and convoluted housing process, but suggest a potential areas of improvement in supporting clients: community and aftercare. Resources need to be allocated to improve and intentionally create community support to aid individuals, particularly during times of transition into independent housing. Furthermore, efforts to improve care post-housing may support clients sustain housing. Results also highlighted the shifted needs of individuals experiencing homelessness—several were families experiencing homelessness. Many shared difficulties fulfilling the housing requirements, such as gaining and keeping employment while caring for their children, particularly without adequate childcare and transportation support. Further research is needed to explore the interconnected needs of homeless families to better inform policy makers and community agencies.