2. Which special populations are at high risk of homelessness?
The public perception of homelessness is often that of an unkempt adult man sleeping on the sidewalk, with a paper cup next to him for collecting coins. It is true that many people who experience homelessness â and particularly visible forms of homelessness â are single adult cisgender men. Their experiences and needs are important for Social Workers to understand and consider. However, beyond that, there are other special populations that require consideration.
The use of the word âspecialâ here is not to connote a sense that they are more important but rather that their experiences and needs are unique and cannot be addressed using the standard models and approaches that have been created for single adult men. In other chapters, we consider some of these special populations, such as youth, Indigenous persons, women, and LGBTQ2S+ persons. We can see that for these groups, who are at increased risk of homelessness, their needs differ from single men. For instance, youth may not be able to live independently, Indigenous persons might need cultural supports related to intergenerational trauma, women might have additional childcare responsibilities or risk factors, and LGBTQ2S+ persons might be threatened and discriminated against in social service settings. These special populations are discussed further in the chapters on Child & Youth Studies, Indigenous Studies, and Gender & Queer Studies, respectively.
However, there are additional special populations who are at high risk of homelessness and whose experiences and needs will vary. Before you continue, we encourage you to pause here and reflect on the role of Social Workers in supporting a diverse range of people experiencing homelessness. What special populations might Social Workers encounter, and what makes their experiences separate or distinct from others?
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We would like to begin this section with a note about the importance of intersectionality. This means that people may fall into multiple overlapping categories at the same time. Consider the special populations above, for instance. A person may be young, identify as a transgender woman, and be of Indigenous ancestry. Rather than thinking of these identity markers as simply being layered on top of one another, we need to consider how they interact in dynamic ways that shape a personâs experiences of homelessness. In this brief video, American Civil Rights advocate and UCLA Professor KimberlĂŠ Crenshaw explains intersectionality further.
In the first video, Dr. Cheryl Forchuk explains that many special populations are among the hidden homeless and that it is essential we understand how their unique experiences require specialized and tailored responses. When providing support for people experiencing homelessness, there is no âone size fits allâ approach.
Dr. Cheryl Forchuk: Which special populations are at high risk of homelessness?
In this video, filmed at a hospital during the COVID-19 pandemic, Dr. Cheryl Forchuk speaks about her research identifying hidden homeless populations. Dr. Forchuk argues that hidden homelessness is always contextual but that some groups are more commonly reported to be in this category than others, such as Indigenous peoples, youth, and women or families fleeing domestic violence. She discusses the increasing rates of first-time homelessness in rural communities, resulting from pandemic job losses and the rising cost of the housing market. While it may be tempting to try to find one solution to homelessness that meets the needs of all individuals, Dr. Forchuk cautions that it is often more effective to tailor our responses to the needs of communities, subpopulations, and individuals. This video is 2:30 in length and has closed captions available in English.
Key Takeaways â Dr. Cheryl Forchuk: Which special populations are at high risk of homelessness?
- Hidden homelessness is contextual and so it is always important to study and understand it at a community-level.
- There are some populations that are more commonly identified among the hidden homeless, including Indigenous peoples, youth, and women or families fleeing domestic violence.
- Reports of first-time homelessness have increased in rural communities because people with lower incomes have been less able to deal with issues such as pandemic job losses and rent increases due to market value changes.
- There may be a tendency to want to identify one solution that will solve homelessness for everyone, but research shows that the solutions for one group do not necessarily work for another. The more specific we can be for communities, subgroups, and even individuals the more tailored and effective our responses will be.
Social Workers can best support their clients by understanding that their unique characteristics require equally unique responses. As Dr. Forchuk noted, what works for one group will not necessarily work for another. This is evident with the rise in family homelessness that has occurred throughout Canada in recent years. Factors such as a lack of affordable housing, increasing housing and rent costs, and job losses due to COVID-19 all have the potential to create housing instability for families. Low-income families, in particular, are often precariously housed or at risk of homelessness because of the disparities between their income and the costs of living (Paradis, Wilson, & Logan, 2014). Family homelessness is not often the result of addiction, but poor mental health and high levels of stress have been found to be prevalent amongst family members residing in shelters (Sylvestre et al., 2017). There are also gendered pathways into family homelessness, such as for single mothers caring for children (Milaney, Lockerbie, Fang, & Ramage, 2019).
Sylvestre et al., (2018) have interviewed people experiencing family homelessness and found that their experiences prior to residing in a shelter were characterized by vulnerability, instability, and isolation. Their research further showed that once residing in an emergency shelter, these families faced new challenges related to living in an environment that was restrictive, noisy, chaotic, and lacking in privacy. These family members described disruptions in their lives, relationships, and routines but also had hope about the future.
What do you think?
Emergency shelters offer an important service but are not ideal locations for families to live in long-term, in part because they are stressful places (Polillo et al., 2018). If you were a Social Worker who was supporting a family experiencing homelessness, what steps could you take to help them move into stable and secure affordable housing of their own? What challenges do you think you might encounter in connecting families (and individual members) with supports in the community? How might working with a family be different than working with a single adult?
As you consider the questions above, we invite you to watch this brief video from âThe Columbianâ about a woman and her children residing in an emergency shelter in Vancouver. We encourage you to think critically from the perspective of the individual family members, as well as from the perspective of a Social Worker who may be asked to offer support through case management.
Family homelessness may be the result of a specific incident, such as a job loss or eviction, or it may be rooted in intergenerational experiences of deep poverty. Families may access social assistance, such as governmental income support programs, across multiple generations within a family (Baker Collins, Smith-Carrier, Gazso, & Smith, 2020). It is important to understand that what Gazso et al., (2019) call the âgenerationingâ of social assistance interacts within broader contexts of gender, race, Indigeneity, and class. We see this in the next video in which Dr. Nick Kerman discusses findings from research he and his colleagues have conducted about families experiencing homelessness.
Dr. Nick Kerman: Which special populations are at high risk of homelessness?
In this video, Dr. Nick Kerman discusses the characteristics associated with family homelessness in Canada. Among Canadian-born families there is a high rate of single-mothers with children, which comprises one of the groups at highest risk of homelessness in terms of the family unit. Among newcomer and immigrant families, it is more common to see two-parent headed families that may have been initially supported in the process but were not connected with housing that would remain affordable and stable over time. This video is 1:59 and has closed captions available in English.
Key Takeaways â Dr. Nick Kerman: Which special populations are at high risk of homelessness?
- There are recognizable characteristics associated with family homelessness, particularly related to where people are born and how they have come to be in Canada.
- Many Canadian-born families experiencing homelessness fall into the camp of single-headed families that consist of mothers with young children. This is one of the groups that is at highest risk for homelessness in terms of the family unit.
- It is more common to see two-parent families with children among immigrant and newcomer families in Canada. The processes through which people migrate to Canada, and are initially supported, may be short-term and do not always lead to permanent affordable housing.
Compared to other populations, Jadidzadeh and Falvo (2019) have found that families exiting Calgaryâs homeless system of care required support for the least amount of time. The length and types of support that families need will differ from other populations, such as single adults, and what one family needs will be different than what another family needs. This becomes apparent when we consider the experiences of immigrant and refugee families. In a study of 75 families experiencing homelessness in Ottawa, researchers found a large number of newcomer families, who were larger and more likely to have two-parent structures compared to Canadian-born families experiencing homelessness (Sylvestre et al., 2017). An ethnographic participatory action research study, also conducted in Ontario, explored the experiences of 11 immigrant families with housing challenges and found five key themes emerged, related to life challenges, lack of understanding of the system, difficulty with conflict resolution, escaping as a solution for hardship, and the need to reduce family homelessness amongst immigrants (Forchuk et al., 2021b).
To study pathways for refugeesâ descent into homelessness in Edmonton, St. Arnault and Merali (2019a) conducted interviews with 19 adult refugees from various countries who experienced homelessness after their arrival and also conducted focus groups with housing providers in the area. They found that there were several key critical incidents that could contribute to homelessness after arrival, such as interpersonal conflicts with their sponsor, service provision interruptions with their case worker, or housing issues such as increased rent, discrimination from landlords or the community, and inhabitable housing conditions. The authors note that these critical incidents are exacerbated by the lack of available affordable housing, language barriers, and limited knowledge about housing systems in Canada which compound the critical incident, resulting in homelessness (St. Arnault & Merali, 2019a).
Findings from a Toronto-based study found that newcomer youth were diverse in country of origin, racial and ethnic background, sexual orientation, level of education, and pathways into homelessness (Ratnam, Fitzpatrick, & Thang, 2018). Yet, despite this diversity there are many negative stereotypes and generalized discrimination that immigrants and refugees face within Canada. Researchers who undertook a systematic review of the literature found that refugeesâ well-being is negatively impacted by societal discrimination, leading to feelings of helplessness, mistrust, and anger, which may lead to avoiding health care and social services even when needed (da Silva Rebelo, FernĂĄndez, & Achotegui, 2018).
The struggles of immigrants and refugees often overlap with the challenges of other racialized populations within Canada. For instance, institutional ethnography shows that growing up in social housing (re)produces conditions of oppression that can exacerbate housing precariousness and exclusion, including a belief among economically marginalized and racialized youth that the state is not invested in their safety (Nichols & Braimoh, 2018). In the next video, Dr. David Firang discusses challenges of racialized and newcomer Canadians as they pertain to housing precarity.
Dr. David Firang: Which special populations are at high risk of homelessness?
In this video, Dr. David Firang discusses the increased risk of homelessness among Northern-located Indigenous communities and racialized or newcomer Canadians. He cautions that the way we understand the concept of being âat-riskâ depends on the definition of homelessness that we use. This video is 3:06 in length and has closed captions available in English.
Key Takeaways â Dr. David Firang: Which special populations are at high risk of homelessness?
- The first thing we need to do to understand which sub-populations are at risk of homelessness is to consider the definition of homelessness we are using.
- Northern Indigenous communities face particular challenges, such as access to shelter space in the winter.
- Racialized and newcomer Canadians may be at higher risk of homelessness as well, particularly in relation to contact with child welfare authorities.
What do you think?
Immigrants, refugees, and racialized Canadians are at increased risk of homelessness. If you were a Social Worker whose role involved supporting clients within these populations, how could you use a culturally informed approach to identify and connect them with appropriate, respectful, and inclusive services? What would you do if there were no culturally specific services located in your community? What tools and resources could you turn to for guidance?
Social Workers are well-positioned to support immigrant, refugee, and racialized Canadians in identifying and accessing supports within their communities and more broadly through resource networks. Dr. Firang, for instance, has studied the impact COVID-19 has had on the financial and emotional stability of international students in Canada and argues that Social Workers can improve the situation by serving as strategist / brokers (to identify underlying structures that marginalize international students and help connect them with community supports), advocate / activist (to provide leadership and help create compassionate institutional arrangements), and educator / coordinator (to provide information and resources to raise awareness about international student challenges, such as the risk of housing loss) (Firang, 2020).
The needs of racialized and newcomer Canadians will differ from non-racialized Canadian-born citizens. Whether at risk of losing housing due to pandemic closures or residing in a shelter after fleeing violence in oneâs homeland, these differences require tailored responses from Social Workers. Ratnam et al., (2018) encourage people in helping professions to engage the voices and experiences of their newcomer clients at all stages of the service continuum including casework, program planning, and systems planning. Hasford, Amponsah, and Hylton (2018) have similarly written that when working with African Canadian young people, service providers need to engage with critical reflexivity and praxis as a means of connecting with young people and helping them access culturally relevant resources while advocating for structural and systems level change.
Social Workers have an important role to play, not only in advocating and supporting racialized and newcomer clients, but also in recognizing the strengths and resourcefulness they bring to challenging circumstances. Researchers examining how people cope with the compounding stressors of racial discrimination, homelessness, and mental illness found that participants described hope, optimism, self-esteem, confidence, insight into their challenges, and spirituality as being instrumental in overcoming their challenges (Paul et al., 2018). St. Arnault and Merali (2019b) also similarly found four interrelated pathways refugees in Canada use for exiting the cycle of homelessness, including drawing on religiosity and spirituality, using creative problem-solving, asking for help, and engaging in self-advocacy.
As professionals working with refugees and immigrants, in particular, Social Workers should use social justice orientated approaches to help their clients realize their fundamental human right to safe and secure housing (St. Arnault & Merali, 2019b). As much as possible, Social Workers should develop their expertise in working with refugee and new Canadians, as research has demonstrated this promotes better experiences for clients, in their migration journey (Oudshoorn et al., 2020). Key to this work is understanding how the range of issues these individuals face put them at higher risk of homelessness. We must consider their housing career, such as the places they have lived, beginning with their experiences in their homeland (Firang, 2019). We must also remember the importance of intersectionality. In the video that follows Dr. Katrina Milaney further explores the connections between people at risk of homelessness, including racialized individuals and other potentially vulnerable groups.
Dr. Katrina Milaney: Which special populations are at high risk of homelessness?
In this video, Dr. Katrina Milaney urges us to consider the common threads that connect groups of people who are at high-risk of homelessness, such as racialized individuals, people with mental health issues, people living in poverty, women, children and youth, and people with disabilities. Notably, the themes that cross-sect these groups are higher rates of trauma, limited access to social supports, potentially unhealthy relationships, and a lack of access to affordable housing. Dr. Milaney identifies seniors as a high-risk group, whose vulnerability to homelessness can be increased or decreased in accordance with their level of social support and community involvement. This video is 2:14 in length and has closed captions available in English.
Key Takeaways â Dr. Katrina Milaney: Which special populations are at high risk of homelessness?
- There are some commonly recognized equity-seeking groups who experience high rates of homelessness, such as racialized individuals, people with mental health issues, people living in poverty, women, children and youth, and people with disabilities.
- Within these groups, the common threads that increase the risk of homelessness are higher rates of trauma, limited access to social supports, potentially unhealthy relationships, and a lack of affordable housing.
- Seniors are a high-risk group because they have limitations associated with the resources they can access, such as around income and employment. Their level of risk can be increased or decreased in accordance with their social support, including considerations of who they have in their network within the community and what services they are accessing.
As Dr. Milaney explained, older adults have specific shelter and housing needs (Humphries & Canham, 2021). We encourage you here to pause for a moment and consider two questions. First, what specific needs do you think older adults might have related to their housing? Second, what do you think qualifies as the age of an âolderâ adult? Researchers examining the first question â of what needs exist â have tended to use 50 as the age at which a person experiencing homelessness is considered an older adult. The reason for this, as discussed in more detail in the chapter on Primary Care & Nursing, is that homelessness impacts peopleâs health in such a negative way that many experience chronic illness at a much younger age than the housed population and tend to have significantly shorter life expectancies (Hwang et al., 2009). Experiencing homelessness at age 50 is comparable to being an advanced age.
In the preceding video, Dr. Milaney spoke about the reasons seniors are a high-risk group that require special consideration. She and her team recruited 300 participants from a Calgary-based shelter, of whom 142 were 50 or older and 158 were under 50 (Milaney, Kamran, & Williams, 2020). They found that older participants reported complex health issues and faced significant barriers to accessing care, such as pertaining to waitlists, insufficient finances, and not receiving help even after asking. Dr. Milaney and her colleagues (2020) further found that older respondents reported trauma in their childhoods at rates 2 ½ times the general population and required culturally appropriate and trauma-informed interventions to address the diversity of their needs.
In another study, Burns and Sussman (2019) conducted in-depth interviews with 15 adults who were 50 or older to learn about the pathways into late-life homelessness. Through this research they identified two divergent pathways. In the first pathway, some people had a gradual entry into homelessness in which they endured many years of struggle related to poor housing, a lack of social support, and social distress. The authors note that these individuals have often reached out for support but had limited success, indicating these adultsâ risk of homelessness may be reduced by strengthening social supports. The second pathway was a rapid entry into homelessness, in which people reported that multiple unanticipated losses threatened their economic and social resources with little warning. While these individuals reported having social networks that could help buffer the effects of loss, they resisted asking for help to protect their independence.
Social Workers play a vital role in supporting older people who are experiencing homelessness to connect with supports within their community. Consider the gradual and rapid pathways (Burns & Sussman, 2019) as you watch this video entitled, âBeyond Housingâ about seniors experiencing homelessness. Again, we encourage you to consider this video from the perspective of the individuals experiencing homelessness, as well as from the perspective of a Social Worker who might be advocating and facilitating connections on their behalf.
Experiencing homelessness later in life can evoke feelings of grief, shock, despair, and anger which must be acknowledged and validated for the person to address and move beyond them (Burns, Sussman, & Bourgeois-GuĂŠrin, 2018). When people experience homelessness at the age of 50 or beyond, their primary needs are for accessible housing that can be adapted to their health challenges, income supports, access to health care and/or homecare, reliable transportation, and non-discriminatory support services (Canham et al., 2018).
Accessible housing and supports are important for people over the age of 50, but they also are needed for people of all ages with disabilities as well. Government financial assistance programs may not adequately meet the cost of living for people with disabilities (Roy et al., 2020), even though they may be the sole source of income for those who are unable to work. When people do not have adequate access to income supports, their risk of homelessness increases. It is noteworthy that in a study of 172 adults with mental illness residing in a Toronto-based emergency shelter, the 16% whose standardized test scores indicated borderline or lower intellectual functioning also had lifetime homelessness lengths that were nearly double those in the study with higher intellectual functioning (Durbin et al., 2018). Social Workers can support people living with disabilities by connecting with Housing First programs. Research has shown that for adults living with intellectual and developmental disabilities, participating in cross-sector interventions that offer immediate access to housing and supports results in housing stability and increased quality of life (Reid et al., 2021).
Access to secure and affordable housing is critical to the wellness of all persons experiencing homelessness, but the special populations discussed in this section require housing that is tailored to their specific needs. We have seen how families, racialized and newcomer Canadians, seniors, and persons with disabilities have different pathways into homelessness, experiences in the system, and needs for transitioning out of homelessness. The final special population that Social Workers might engage with, through case management or other frontline activities, are Veterans. Analysis of the physical health of Veterans enrolled in the At Home / Chez Soi study found that they presented with 5 physical health problems on average, including dental problems, head injuries, musculoskeletal injuries, and foot problems (Bourque et al., 2017). In the next video, Dr. Cheryl Forchuk discusses her teamâs work implementing Housing First interventions for Veterans, and the lessons they learned.
Dr. Cheryl Forchuk: Canadian Veterans experiencing homelessness
In this video, filmed at a hospital during the COVID-19 pandemic, Dr. Cheryl Forchuk discusses her ground-breaking research on Veterans who experience homelessness. While research out of the United States often cites PTSD as a contributing factor, in Canada homelessness is more often linked to alcoholism that develops over time as a part of socializing within the military. When Canadian Veterans experiencing homelessness are asked what supports they need, they identify structure, re-establishing a sense of self-concept, and peer-support from others who have similar experiences. As Dr. Forchukâs research shows, when Canadian Veterans are listened to, and the supports they identify are put in place, they can successfully exit homelessness. This video is 7:13 in length and has closed captions available in English.
Key Takeaways â Dr. Cheryl Forchuk: Canadian Veterans experiencing homelessness
- The reasons veterans experience homelessness in Canada are different than the United States.
- Most of the literature on Veterans experiencing homelessness comes out of the United States and cites Post-Traumatic Stress Disorder (PTSD) from active combat as being a contributing factor.
- In Canada, Veterans who experience homelessness often report alcoholism as a contributing factor. This is largely because they began drinking socially during their time in the military, as a way of spending time with their comrades.
- While drinking may not have been considered a problem while in the military, after discharge Veterans report turning to alcohol as a means of acclimating to civilian life, often increasing over a period of several years.
- Canadian Veterans experiencing homelessness self-identify unique support needs.
- Canadian Veterans want structured services because structure is an important part of the military experience that they carry into civilian life.
- Strategies need to focus on reclaiming their sense of identity, self-concept, and self-esteem. Being part of the military was for many something they valued and were proud of but had stopped openly identifying because of the shame they felt their alcoholism brought to the organization.
- Peer-support from people who understand the bridging of the military and civilian worlds is essential for Canadian Veterans experiencing homelessness. They may feel stuck between the two worlds and need peer support from someone who has navigated and understood those very different perspectives and realities, to help them reclaim the one identity and appreciate that they are in a âcultural between place.â
- Canadian Veterans can be housed permanently, when they are listened to and supports that meet the needs they identify are put in place.
After hearing Dr. Forchuk discuss her teamâs work with Veterans, we invite you to learn more about the project in this sectionâs featured reading from the Journal of Military, Veteran and Family Health.
Featured Reading:
Forchuk, C., Richardson, J., Atyeo, H., & Serrato, J. (2021a). Qualitative findings from a housing first evaluation project for homeless veterans in Canada. Journal of Military, Veteran and Family Health. Advance Access Article.
Veterans are a special population who have unique experiences that require tailored responses. Dr. Forchuk and her team (2021a) have evaluated the effectiveness of Housing First, with different types of supports, over a two-year study in Toronto, London, Calgary, and Victoria. They have found that along with permanent housing, the Veterans who participated identified a need for harm reduction support, more mental health programming, and peer support from others with military experience (Forchuk et al., 2021a). Additional analysis of the data from this study further indicated that Veterans prefer regimented structures in support agencies and want services that are located close enough to access but not in an area associated with known substance use (Marsella, Forchuk, & Oudshoorn, 2020).
When engaging Veterans in case management, such as aligning services and housing supports, it is important that Social Workers understand and incorporate their preferences into the support plans. Consider this as you watch the next video, âFunctional Zero Veteran Homelessnessâ from the Canadian Alliance to End Homelessness.
We began this section by asking you to consider what special populations are at higher risk of homelessness. This question is important to consider because Social Workers need to be able to adjust their approach to individual clients to offer tailored support. We noted that the common perception of a single adult cisgender man experiencing homelessness is perfectly valid. However, what works for him will not work for everyone. A common theme throughout this book â that emerged clearly in this section â is that there is no âone size fits allâ approach for supporting people who are experiencing homelessness. Rather, we need to think about their individual needs and what will help them personally.
We considered families as a special population and saw that family homelessness is often the result of factors like job loss and financial strain that overwhelms the familyâs ability to maintain stable housing. We learned that there are a high percentage of refugee and immigrant families experiencing homelessness, and that they are best served when Social Workers use culturally sensitive approaches that connect them to meaningful services and supports within the community. We then considered the needs of older adults, which in relation to this population means those 50 and above and saw that there are different pathways that lead to later life homelessness, requiring different solutions or pathways back out. Similarly, we discussed how people with disabilities are an over-represented group amongst people experiencing homelessness, in large part because of an inability to work and limited financial assistance. Finally, we considered Veterans as a special population who benefit from Housing First approaches augmented with harm reduction and peer support.
There are additional special populations discussed throughout this book as well, including youth, Indigenous persons, LGBTQ2S+ persons, and women. A key takeaway message here is that people who experience homelessness in Canada are diverse. Social Workers can help these individuals best by recognizing their diversity of backgrounds, experiences, and unique needs.
Podcast: Which special populations are at high risk of homelessness? (17:57)
Click the link below to listen to all of the researchers answer the question âWhich special populations are at high risk of homelessness?â in audio format on our podcast!
