Making choices: Increased choice opportunities are linked with better-perceived health among people experiencing homelessness
Abstract
The aim of this study is to evaluate whether the level of perceived choice and the frequency of use of services is associated with the perceived health of people experiencing homelessness (PEH), accounting for the possible mediating role of resignation. A convenience sample was recruited by homeless services in the Municipality of a major Italian city. Data were collected with self-reported questionnaires from 43 people living on the street or shelters (self-identified as male = 83.7%; mean age = 52.7; SD = 12.2). Perceived choice and use of services were inserted as independent variables, resignation as the mediator, and perceived health as the outcome. A path analysis tested the hypothesized model, and the mediation was tested through the bootstrapping method. A higher level of perceived choice was associated with a lower sense of resignation that, in turn, was associated with better perceived general health. The frequency of service use was not significantly related to resignation. Choice is associated with increased control and autonomy and a reduced sense of resignation. Thus, transition is desirable on a service-level to person-centered, choice-oriented approaches.
References
Apolone, G., & Mosconi, P. (1998). The Italian SF-36 Health Survey: translation, validation and norming. Journal of clinical epidemiology, 51(11), 1025-1036.
Batterham, D. (2019). New theoretical directions: The capabilities approach and its application to homelessness. Parity, 32(7), 13-15.
Curiale, C., Lenzi, M., Gaboardi, M., Vieno, A., & Santinello, M. (2020). Libertà di scelta e senso di controllo: impatto sui sintomi psichiatrici in persone senza dimora. [Freedom of choice and sense of control: impact on psychiatric symptoms in homeless people.] Psicologia di Comunità, 1, 13-28. https://doi.org/10.3280/PSC2020-001002
Funk, A. M., Greene, R. N., Dill, K., & Valvassori, P. (2022). The Impact of Homelessness on Mortality of Individuals Living in the United States: A Systematic Review of the Literature. Journal of Health Care for the Poor and Underserved, 33(1), 457-477.
Gaboardi, M., Santinello, M., & Shinn, M. (2021). Beyond behaviour: rethinking integration for people experiencing homelessness. Health & Social Care in the Community, 29(3), 846-855.
Greenwood, R. M., Schaefer-McDaniel, N. J., Winkel, G., & Tsemberis, S. J. (2005). Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. American Journal of Community Psychology, 36(3), 223-238.
Greenwood, R. M., & Manning, R. M. (2017). Mastery matters: Consumer choice, psychiatric symptoms and problematic substance use among adults with histories of homelessness. Health & Social Care in the Community, 25(3), 1050-1060.
Greenwood, R. M., Manning, R. M., O’Shaughnessy, B. R., Vargas-Moniz, M. J., Auquier, P., Lenzi, M., ... & Home_EU Consortium. (2022). Structure and agency in capabilities‐enhancing homeless services: Housing first, housing quality and consumer choice. Journal of Community & Applied Social Psychology, 32(2), 315-331.
Jӧreskog, K.G., & Sӧrbom, D. (1996). LISREL 8: User’s reference guide. Chicago: Scientific Software International.
La Motte‐Kerr, W., Rhoades, H., Henwood, B., Rice, E., & Wenzel, S. (2020). Exploring the association of community integration in mental health among formerly homeless individuals living in permanent supportive housing. American Journal of Community Psychology, 66(1-2), 3-13.
Manning, R. M., & Greenwood, R. M. (2019). Recovery in homelessness: The influence of choice and mastery on physical health, psychiatric symptoms, alcohol and drug use, and community integration. Psychiatric rehabilitation journal, 42(2), 147.
Marinucci, M., & Riva, P. (2021). Surrendering to social emptiness: Chronic social exclusion longitudinally predicts resignation in asylum seekers. British Journal of Social Psychology, 60(2), 429-447.
Marinucci, M., Riva, P., Lenzi, M., Lasagna, C., Waldeck, D., Tyndall, I., & Volpato, C. (2023). On the lowest rung of the ladder: How social exclusion, perceived economic inequality and stigma increase homeless people's resignation. British Journal of Social Psychology, 62(4), 1817-1838.
Marinucci, M., Mazzoni, D., Pancani, L., & Riva, P. (2022). To whom should I turn? Intergroup social connections moderate social exclusion's short-and long-term psychological impact on immigrants. Journal of Experimental Social Psychology, 99, 104275.
O’Shaughnessy, B. R., & Michelle Greenwood, R. (2020). Empowering features and outcomes of homeless interventions: A systematic review and narrative synthesis. American Journal of Community Psychology, 66(1-2), 144-165.
Paudyal, V., MacLure, K., Forbes‐McKay, K., McKenzie, M., MacLeod, J., Smith, A., & Stewart, D. (2020). ‘If I die, I die, I don’t care about my health’: Perspectives on self‐care of people experiencing homelessness. Health & Social Care in the Community, 28(1), 160-172.
Pleace, N., Baptista, I., Benjaminsen, L., & Busch-Geertsema, V. (2018). Homelessness services in Europe: EOH comparative studies on homelessness. Research Report. Brussels, Belgium: FEANTSA.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior research methods, instruments, & computers, 36, 717-731.
Riva, P., Montali, L., Wirth, J. H., Curioni, S., & Williams, K. D. (2017). Chronic social exclusion and evidence for the resignation stage: An empirical investigation. Journal of Social and Personal Relationships, 34(4), 541-564.
Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48, 1–36.
Shinn, M. (2010). Homelessness, poverty, and social exclusion in the United States and Europe. European Journal on Homelessness, 4, 19-44.
Srebnik, D., Livingston, J., Gordon, L., & King, D. (1995). Housing choice and community success for individuals with serious and persistent mental illness. Community Mental Health Journal, 31(2), 139-152.
Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94(4), 651-656.
Williams, K. D. (2009). Ostracism: A temporal need‐threat model. Advances in Experimental Social Psychology, 41, 275-314.
Full Text: PDF
Refbacks
- There are currently no refbacks.