Psychological Needs Of Homeless Shelter Residents In Interaction With The Education Of Social Workers
High demands are placed on social workers in shelters in relation to the mental state of their occupiers, which often do not care correspond with the social workers´ education. Research question: What educational demands are placed on social workers in relation to mental state of the occupiers of shelters? The aim of the research is to map and analyze the mental health of the occupiers of shelters and the resulting demands on the education of social workers. The contribution is based on the qualitative research with the occupiers of shelters in four regions in the Czech Republic. The research was attended by 30 communication partners, out of these 13 women from shelters. The research was carried out in the form of semi-structured interviews and subsequent analysis using the constructivist grounded theory of K. Charmaz. The results of the survey point to the often poor mental state of the occupiers of shelters and their specific needs in the field of social counselling, psychological care, psychotherapy or crisis interventions that are perceived in the context of accumulation of roles. Assistance to people in the field of mental health in shelters is often considered insufficient. The solution seems to be a combination of several options: the first is the supervision, the second is the extension of the education of social workers in the field of psychological disciplines, and the third is the cooperation with external experts.
Keywords: Homelessnesspsychological needseducationsocial workers
The issue of helping people without their homes is a highly current topic on a global level. In 2011, 11,496 persons (CZSO, 2011) were registered homeless in the Czech Republic, although source analyses show that homelessness in the Czech Republic is a highly dynamic phenomenon and the number of homeless people will continue to increase (MLSA, 2015). In the Czech Republic, there is currently no legislative anchorage to help homeless people. The system solutions to homelessness are also non-existent. The state shifts primary responsibility for helping homeless people onto social services, in particular, onto homeless shelters. The Act no. 108/2006 on Social Services, Section 57, describes the homeless shelter as follows: "
Homeless people form a very diverse group in terms of their personal stories, interests, behaviours, health problems, the factors preceding homelessness, the social context homeless people come from and other variables on the part of society (Piechowicz, Piotrowski & Paswa-Wojciechowska, 2014). Despite all the above differences, they share a home loss experience, which is per se perceived as a very stressful factor that greatly affects their mental health (Skinner, 2009). Research by Laporte et al. (2010) shows that up to one third of the homeless population suffers from severe psychological problems (psychotic illness, depression and/or anxiety). A German study (SEEWOLF-Study, 2014) talks about the fact that up to two thirds of homeless people who participated in the research suffered from mental illness, and in most cases from more illnesses simultaneously. Furthermore, Bassuk et al. (2010) point out that the most significant risk factor of homelessness is excessive alcohol or other addictive substance consumption followed by addiction to these substances. Problems with the drug or alcohol abuse in non-homeless people have been associated with a significantly worse health, especially mental health condition (similarly, see SEEWOLF-Study, 2014). Poor psychological state of the homeless shelter population places increased demands on social workers working in such facilities (Glumbíková, 2017). There is a number of studies devoted to the mental state/health of homeless people, however, the studies linking this state to the demands regarding social workers’ qualification, are almost absent.
Based on the problem statement, this paper aims to answer the following research questions: (1) What is the mental state of the homeless shelter population/residents? (2) What demands does this state place on the education of social workers?
Purpose of the Study
The data presented are partial data from the research study entitled Health and Use of Healthcare Services by Shelters’ Users. The aim of the study was to: (1) Analyze and describe the perceived impact of homelessness on the health of the homeless shelter population. (2) Analyze and describe the perceived impact of the shelter environment on the health of its residents. (3) Make recommendations for homeless shelters based on the research findings. Based on partial data, the aim of this study is to map and analyze psychological (mental) health of the population of shelters and demands placed on the professional training of social workers.
The research was implemented using a qualitative research strategy. Qualitative research is an approach utilizing the principles of unrepeatability and uniqueness, processuality, contextuality and dynamics, and within this framework we are deliberately working with the reflexive nature of any exploration (Hendl, 2016). The goal of the researcher is to understand the situation as understood by the actors themselves (i.e. "
In terms of data analysis, we used a constructivist approach to the grounded theory by Charmaz (2006, 2012). Data analysis was performed using initial coding where the codes are created and assigned; focused coding, which is based on searching for similarities and selecting "
Mental health of homeless shelter users
As part of mental health, the communication partners described the feelings of "mentally hitting the bottom." "I mentally hit rock bottom. I got divorced, then when you loose your job, it also makes you depressed, then you have no money to purchase what you need and to live on. Then you start receiving some welfare benefits and that's not enough for you, it knocks you down on your knees" (CPV6). "Well, no, my physical health was rather okay, but it was hard on my psychological health, it was so unpleasant. I was kind of mentally at the bottom, that I left all my worries behind, and stopped carrying about anything" (CPT3). Some research participants associated the "mental bottom” with their life on the street. "When I realized that I hit rock bottom, I was on the street. And it really freaked me out and I took some pills, the doctor gave me some anxiety medication..." (CPM1). Some communication partners directly associated their poor mental state with stress from the loss of housing and from uncertain housing. "Well, you know I have because I do not have a home. A contract ends here in a month. I don’t have a permanent address here, so finding a flat is a terrible problem. Excitingly. Since you can not sleep in the evening, you do not even know where to go with that baby. Well, I've been treating nerves and psyche too for years, so, I'm going to a psychiatrist now"(CPH4). "Well, I see a doctor every month, the psychiatrist, because what happened was that it turned out to be too much for me and I wasn’t doing very well. It all was just starting to fall on me. I am only human, as they say, so I go to see a doctor every month, take medicine and try to deal with my loss of flat. Social workers here are helping me too" (CPH4). The clients were also connecting their poor mental condition with the loss of beloved ones. "I was supposed to complete my army service in four or five months, when they took my father’s leg, so I went to the hospital, and then my father passed away in a month or two. And it got me" (CPM1). "Well, when my baby died I used to go to see someone, it was before, when I was still with my husband" (CPP1). Or they are connecting it with a fear from the loss of beloved ones. "I'm afraid that my mom will pass away, I wouldn’t be able to do anything about it right now. It put me totally down." (CPM1).
In addition, communication partners talked about depressions. "I had hiked for about three weeks in the mountains. I already had a depression. When I was in the woods, I didn’t feel so much like I was depressed. I've always had some sort of depression where I felt like I didn’t care about anything and just wanted to be somewhere alone. So I walked a lot, and didn’t even eat. Life didn’t matter to me" (CPV4). Communication partners also often described insomnia (sleep issues) and fatigue associated with it. "No, I'm rather tired from all this here" (CPH1). One communication partner described phobia. "I have a phobia to cross the smooth pavement. As I’m approaching the smooth pavement, I see it and I start feeling sick and I'm shaking too" (CPT2). Some communication partners spoke openly about the fact that they had previously considered suicide. "After all that, one thinks to himself that he should just end it. I personally wanted to do it" (CPV3). "I had thoughts of death in the past, that it would finally give me peace, it was too much of suffering, really" (CPZ2). "When I had that buddy of mine, I wanted to hang myself once, yeah. But he cut the rope, yeah" (CPT1). One of the communication partners spoke about her child in connection with mental health. "I have a son who has been sexually abused, yeah. We already went to see a psychologist and we’ll go to see a psychiatrist, because he may have to permanently take medication to calm down, since he’s been diagnosed with ADHD, hyperactivity and concentration disorder" (CPZ1). In relation to the psychological problems of children, it must be emphasized that children can often be more sensitive to changes, meaning that mothers living in a shelter must cope not only with their own mental situation but also with the mental state of their children.
Communication partners often talked about the interconnectedness of mental and physical health. An interesting fact was that it was women who were more likely to talk about "
Mental health is especially in women associated with their past experience of domestic violence. "He wanted half of the house, beat me, even took an axe to me. Since I’ve once done kung-fu, I used it so he wouldn’t kill me, you see" (CPT2). "He turned me into a completely fat, distrustful person, who was just killing the self in me" (CPV1).
Two of the communication partners have connected their poor mental health after experiencing domestic violence with their "
The environment of the homeless shelter and mental health
The shelter environment is perceived by communication partners as somewhat stressful, especially during their first stay in the facility. "
The first downside was connected with the need to adapt to the facility’s regime, which was compared by two communication partners to a "
An important downside that communication partners associated with staying in a shelter and their health condition was the lack of privacy and the need to share space. "
As part of staying in the shelter, an important topic was sharing space with other residents and being a roommate in general as well as frequently ambiguous relations with other residents of the shelter. "
The necessity of sharing space with other people has been associated with the spread of diseases by the communication partners. "
Assistance provided in a homeless shelter
A social worker is perceived in a shelter as a primary source of support in an area of mental health.
Types of assistance provided by social workers in a shelter
In terms of their relationship with social workers, the communication partners talked about many methods/types of assistance the social workers provide or what they would need them to provide. In their narrations, the following methods/types of assistance could be identified: (social) counselling (including the provision of social benefits, setting up debt repayments, setting up a system of investigation...), provision of healthcare, sorting out relevant documents, computer literacy assistance, assistance with seeking housing, jobs, information about healthy nutrition online and helping with tutoring children. Particular emphasis was put by the communication partners on the accompaniment, which was especially perceived as a source of social support: "
Some communication partners talked about their perceived need for a personal change counselling. Some associated this counselling with their past alcohol addiction. "
In relation to a personal change counselling, some communication partners confused the work of a social worker with the work of a psychotherapist or a psychologist. "
Perceived needs related to the nature of the relationship with the social worker
In terms of their relationship with social workers, the communication partners perceived establishment of a good relationship to be very important. "
Accumulative roles of a social worker
Given the above needs of the clients, it is obvious that the role of a social worker in a homeless shelter is accumulative. The accumulation of these roles may be in conflict with clients' requests and expectations in relation to assistance (see Glumbíková & Gojová, 2015). In relation to the above-mentioned possibility to talk openly, some communication partners pondered about whether they could afford "
Homeless people living in shelters have talked about a number of psychological problems. In relation to the assistance provided by social workers from homeless shelters, the communication partners have, therefore, multi-disciplinary and multi-activity demands. Social workers mediate the following services for them: counselling, "
In order to help homeless people living in shelters, a combination of several options seems to be the solution on a social worker's part. The first option is that coping with the described accumulation of roles could be facilitated by the regular supervision and intervision of social workers. Another option that could help reduce the impact of role accumulation is an increase of a number of social workers in shelters. In relation to the frequently present psychological disorder described by the communication partners, training of social workers on the basics of diagnostics of the most common mental illnesses of homeless people (e.g. depression, anxiety, post-traumatic stress disorder, phobias, etc.) could lead to the improvement in prompt identification of those who may need mental health assistance. In relation to the accumulation of social worker roles and increased demands placed on him/her in relation to the frequently occurring mental illnesses of their clients, social workers could benefit in their work from further education, for example, in the form of crisis intervention or trauma-oriented approaches.
As for the health condition of shelter residents, the networking of particular social services appeared to be particularly important, both in the field social work, which often directly led the clients to a homeless shelter, and in the area of networking of services targeting a specific target group such as Bílý kruh bezpečí [
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16 October 2017
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Education, educational psychology, counselling psychology
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Glumbíková, K., & Gřundělová, B. (2017). Psychological Needs Of Homeless Shelter Residents In Interaction With The Education Of Social Workers. In Z. Bekirogullari, M. Y. Minas, & R. X. Thambusamy (Eds.), ICEEPSY 2017: Education and Educational Psychology, vol 31. European Proceedings of Social and Behavioural Sciences (pp. 511-520). Future Academy. https://doi.org/10.15405/epsbs.2017.10.49