This article presents findings from in-depth qualitative interviews conducted with 20 long-term unsheltered homeless adults who had recently been placed into housing by Street to Home (S2H), a housing-focused outreach program in New York City. S2H places individuals directly into transitional and permanent housing, breaking from the prevailing linear treatment and housing models that require a demonstration of ‘housing readiness’ via sobriety and psychiatric stability prior to permanent housing placements. The major themes identified were: (1) negative perceptions of homeless services and service resistance; (2) readiness to leave the street; (3) believable housing options as triggers for change; (4) adapting to new surroundings and discovering benefits; and (5) the importance of knowing supports are in place. Fulfilling promises in the wake of past disappointments and providing an ongoing sense of support appear to be the key elements that have enabled the program to engage and maintain clients.
Applewhite, S.L. ( 1997) ‘Homeless Veterans: Perspectives on Social Service Use’, Social Work42: 19-30.
2.
Asmussen, S.M., Romano, J., Beatty, P., Gasarch, L. and Shaughnessey, S. ( 1994) ‘Old Answers for Today’s Problems: Helping Integrate Individuals Who are Homeless with Mental Illnesses into Existing Community-based Programs’, Psychosocial Rehabilitation Journal17: 17-34.
3.
Bernard, H.R. ( 1994) Research Methods in Anthropology: Qualitative and Quantitative Approaches. Thousand Oaks, CA: SAGE.
4.
Brunette, M.F., Mueser, K.T. and Drake, R.E. ( 2004) ‘A Review of Research on Residential Programs for People with Severe Mental Illness and Co-occurring Substance Use Disorders’ , Drug and Alcohol Review23(4): 471-81.
5.
Bybee, D., Mowbray, C.T. and Cohen, E.H. ( 1995) ‘Evaluation of a Homeless Mentally Ill Outreach Program: Differential Short-term Effects’, Evaluation and Program Planning18(1): 13-24.
6.
Carling, P.J. ( 1990) ‘Major Mental Illness, Housing and Supports: The Promise of Community Integration’, American Psychologist45: 961-75.
7.
Charmaz, K. ( 2000) ‘Grounded Theory: Objectivist and Constructivist Methods’, in Denzin N. K. and Lincoln Y. S. (eds) Handbook of Qualitative Research, Second Edition. Thousand Oaks, CA: SAGE, 509-35.
8.
Charmaz, K. ( 2006) Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Thousand Oaks, CA: SAGE.
9.
Corbin, J. and Strauss, A. ( 2008) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory, 3rd edn. Thousand Oaks, CA: SAGE.
10.
Culhane, D., Metraux, S. and Hadley, T. ( 2001) ‘The Impact of Supportive Housing for Homeless People with Severe Mental Illness on the Utilization of the Public Health, Corrections and Emergency Shelter Systems: The New York-New York Initiative’, Housing Policy Debate5: 107-40.
11.
Dickson-Gomez, J., Convey, M., Jilario, H., Corbett, A.M. and Weeks, M. ( 2007) ‘Unofficial Policy: Access to Housing, Housing Information and Social Services Among Homeless Drug Users in Hartford, Connecticut’, Substance Abuse Treatment, Prevention, and Policy2: 8.
12.
Fisk, D., Rakfeldt, J. and McDormick, E. ( 2006) ‘Assertive Outreach: An Effective Strategy for Engaging Homeless Persons with Substance Use Disorders into Treatment’, American Journal of Drug and Alcohol Abuse32: 479-86.
13.
Geertz, C. ( 1973) The Interpretation of Cultures: Selected Essays. New York: Basic Books.
14.
Glaser, B.G. and Strauss, A.L. ( 1967) The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine.
15.
Hopper, K. ( 2006) ‘Redistribution and its Discontents: On the Prospects of Committed Work in Public Mental Health and Like Settings’, Human Organizations65(2): 218-26.
16.
Hopper, K., Jost, J., Hay, T., Welber, S. and Haugland, G. ( 1997) ‘Homelessness, Severe Mental Illness and the Institutional Circuit’, Psychiatric Services48(10): 659-65.
17.
Levitt, A.J., Culhane, D.P., DeGenova, J., O’Quinn, P. and Bainbridge, J. ( 2009) ‘Health and Social Characteristics Homeless Adults in Manhattan Who Were Chronically or Not Chronically Unsheltered’, Psychiatric Service60: 978-81.
18.
Lipsky, M. ( 1980) Street-Level Bureaucracy: Dilemmas of the Individual in Public Services. New York: Russell Sage Foundation.
19.
Lofland, J. and Lofland, L.H. ( 1995) Analyzing Social Settings. Belmont, CA: Wadsworth Publishers.
20.
May, J. ( 2000) ‘Of Nomads and Vagrants: Single Homelessness and Narratives of Home as Place’, Environment and Planning Digest: Society and Space18: 737-59.
21.
Metraux, S., Marcus, S. and Culhane, D.P. ( 2003) ‘The New York-New York Housing Intiative and Use of Public Shelters by Persons with Severe Mental Illness’, Psychiatric Services54(1): 67-71.
22.
Miles, M.B. and Huberman, A.M. ( 1994) Qualitative Data Analysis. Thousand Oaks, CA: SAGE Publications.
23.
Morse, G.A., Calsyn, R.J., Miller, J., Rosenberg, P., West, L. and Gilliland, J. ( 1996) ‘Outreach to Homeless Mentally Ill People: Conceptual and Clinical Considerations’, Community Mental Health Journal32(3): 261-74.
24.
New York City Department of Homeless Services. ( 2003) Homeless Outreach Population Estimate: HOPE2003.
25.
Osher, F. and Drake, R. ( 1996) ‘Reversing a History of Unmet Needs: Approaches to Care for Persons with Co-Occurring Addictive and Mental Disorders’ , American Journal of Orthopsychiatry66: 4-11.
26.
Padgett, D. ( 2007) ‘There’s No Place Like (a) Home: Ontological Security Among Persons with Serious Mental Illness in the United States’ , Social Science & Medicine64: 1925-36.
27.
Padgett, D., Henwood, B., Abrams, C. and Davis, A. ( 2008) ‘Engagement and Retention in Services Among Formerly Homeless Adults with Co-Occurring Mental Illness and Substance Abuse: Voices from the Margins’, Psychiatric Rehabilitation Journal31(3): 226-33.
28.
Randall, G. and Brown, S. ( 2002) Helping Rough Sleepers Off the Streets. London, UK: Office of the Deputy Prime Minister.
29.
Ridgeway, P. and Zipple, A.M. ( 1990) ‘The Paradigm Shift in Residential Services: From the Linear Continuum to Supported Housing Approaches’, Psychosocial Rehabilitation Journal13: 11-31.
30.
Rosenblum, A., Nuttbrock, L., McQuistion, H., Magura, S. and Joseph, H. ( 2002) ‘Medical Outreach to Homeless Substance Users in New York City: Preliminary Results’, Substance Abuse & Misuse37(8-10): 1269-73.
31.
Rosenheck, R.A. and Lam, J. ( 1997) ‘Client and Site Characteristics as Barriers to Service Use by Homeless Persons with Serious Mental Illness’, Psychiatric Services48(3): 387-90.
32.
Rosenheck, R.A., Lam, J., Morrissey, J.P., Calloway, M.O., Stolar, M. and Randolph, F.the ACCESS National Evaluation Team. (2002 ) ‘Service Systems Integration and Outcomes for Mentally Ill Homeless Persons in the ACCESS Program’, Psychiatric Services53(8): 958-66.
33.
Rowe, M., Fisk, D., Frey, J. and Davidson, L. ( 2002) ‘Engaging Persons with Substance Use Disorders: Lessons From Homeless Outreach’, Administration and Policy in Mental Health29(3): 263-73.
34.
Rubin, H.J. and Rubin, I.S. ( 1995) Qualitative Interviewing: The Art of Hearing Data. Thousand Oaks, CA: SAGE Publications.
35.
Sandelowski, M. ( 2000) ‘Whatever Happened to Qualitative Description? ’ Research in Nursing & Health23: 334-40.
36.
Schutt, R.K. and Goldfinger, S.M. ( 1996) ‘Housing Preferences and Perceptions of Health and Functioning Among Homeless Mentally Ill Persons’, Psychiatric Services47(4): 381-6.
37.
Sosin, M.R. and Grossman, S.F. ( 2003) ‘The Individual and Beyond: A Socio-Rational Choice Model of Service Participation Among Homeless Adults with Substance Abuse AProblems’, Substance Use & Misuse38(3-6): 503-49.
38.
Strauss, A.L. and Corbin, J. ( 1990) Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: SAGE.
39.
Stefancic, A. and Tsemberis, S. ( 2007) ‘Housing First for Long-Term Shelter Dwellers with Psychiatric Disabilities in a Suburban County: A Four-Year Study of Housing Access and Retention’, Journal of Primary Prevention28: 265-79.
40.
Substance Abuse and Mental Health Services Administration. ( 2007) National Registry of Evidence-Based Practices and Programs , United States Department of Health and Human Services , http://www.nrepp.samhsa.gov/programmfulldetails.asp?PROGRAM_ID=195, (consulted 15 November 2008).
41.
Susser, E., Valencia, E., Conover, S., Felix, A., Wei-Yann, T. and Wyatt, R.J. ( 1997) ‘Preventing Recurrent Homelessness Among Mentally Ill Men: A ‘‘Critical Time’’ Intervention After Discharge From Shelter’, American Journal of Public Health87: 256-62.
42.
Tommasello, A.C., Myers, C.P., Gills, L., Treherne, L.L. and Plumhoff, M. ( 1999) ‘Effectiveness of Outreach to Homeless Substance Abusers’, Evaluation and Program Planning22(3): 295-303.
43.
Tsemberis, S. ( 1999) ‘From Streets to Homes: An innovative Approach to Supported Housing for Homeless Adults with Psychiatric Disabilities’ , Journal of Community Psychology27: 225-41.
44.
Tsemberis, S., Gulcur, L. and Nakae, M. ( 2004) ‘Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals with Dual Diagnosis’, American Journal of Public Health94(4): 651-6.
45.
US Department of Housing and Urban Development. ( 2006) A Guide to Counting Unsheltered Homeless People Revised . [AQ: info details].
46.
van Manen, M. ( 1977) ‘Linking Ways of Knowing With Ways of Being Practical’ , Curriculum Inquiry6(3): 205-8.
47.
Ware, N.C., Tugenberg, T. and Dickey, B. ( 2004) ‘Practitioner Relationships and Quality of Care for Low-Income Persons with Serious Mental Illness’, Psychiatric Services55(5): 555-9.
