Psychological Needs Of Homeless Shelter Residents In Interaction With The Education Of Social Workers

Abstract

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

Introduction

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: " Shelters provide temporary accommodation services for persons in an unfavourable social situation associated with the loss of housing ". The Social Services Act states that " the Service referred to in Paragraph 1 includes the following basic activities: a) provision of food or assistance in the provision of food, b) provision of accommodation, c) assistance in enforcing rights, legitimate interests and in the procurement of personal affairs ". The Act on Social Services (108/2006) further stipulates that " the persons pay a fee for the provision of social services in shelters... " The stay in a shelter is limited in time, most frequently for a period of one year. Each shelter has its own system of rules and its own regime, usually including the scheduling and management of regular cleaning chores, room sharing, visiting hours, permitted outings, rules for sharing common areas, keeping animals in the facility, alcohol consumption ban, etc..

Problem Statement

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.

Research Questions

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.

Research Methods

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. " obtain a subject's perspective ") (Denzin & Lincoln, 2011). The research was carried out in cooperation with 30 communication partners from four regions of the Czech Republic – 13 women and 17 men. Communication partners were selected using intentional selection through the institution. Intentional selection through institutions is the method when we use a certain type of service or activity of some institution that is intended for the target group we are focused on in the research. This type of intentional selection is used in this research because it is the people (men, women, single parents and families) using the services of a given institution (the shelter for homeless women and mothers with children) who are the core population of research. The data were collected using semi-structured interviews. For a semi-structured interview, a clearly defined purpose, a certain pre-determined structure of the interview, and a great diversity of the information acquisition process as a whole are distinctive.

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 " the most useful " codes and their re-testing in relation to other open codes. This phase is followed by " comparing data with codes and codes with data " and detailing of the codes. The next coding phase was axial coding that led to the creation of categories and subcategories. Table 1 lists individual codes and categories related to the research questions in this paper.

Findings

Conclusion

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, " therapy ", " substitution " of psychologists, providing crisis intervention, while helping to find housing, do networking with other services for their clients, mediating healthcare, etc. Social workers are thus put under a great deal of stress. 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

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 [ White Circle of Safety ] (domestic violence) or Renarkon (drug abuse). Several communication partners directly mentioned the need for psychological help. In relation to psychological help, the views of the communication partners differed on whether the shelter should have their " own " psychologist (e.g. part-time) or whether it would be better for the clients to see an outpatient therapist. " It's hard ... I'd rather go somewhere out of the shelter than here... since that information is spreading here " (CPH4). " Well, it would also be good to have a psychologist in this facility " (CPV3).

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