Homelessness, Mental Health and Psychologically Informed Environments : Qualitative Exploration with People Experiencing Homelessness and Staff

Pitts, Rosa and Hodge, Suzanne and Duxbury, Anna and Gallagher, Colm (2023) Homelessness, Mental Health and Psychologically Informed Environments : Qualitative Exploration with People Experiencing Homelessness and Staff. PhD thesis, Lancaster University.

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Abstract

This thesis consists of three sections: a systematic literature review (SLR), an empirical paper, and a critical appraisal. The research focuses on people experiencing homelessness (PEH), to understand experiences of accessing and engaging with mental health support, in addition to exploring psychologically informed environments (PIEs) in homelessness services. The SLR explores the perspectives of adults who have experienced homelessness in accessing support for their mental health. A systematic literature search identified 15 papers, synthesised using a meta-ethnographic approach to develop a line of argument synthesis. The results highlight many challenges faced by PEH when accessing mental health support. Themes included the intersectionality of stigma, the importance of relationships, service pressures, and feeling connected. The review recommends that services include people with lived experience of homelessness in service design and increase integration and collaboration across the system. The empirical paper explores what contributes to a successful PIE in a homelessness service from the perspectives of psychologists, staff, and service users. Qualitative semi-structured interviews and a grounded theory methodology captured participants’ accounts and developed a model to illustrate the components of a functioning PIE, the driving forces of systemic and engagement factors, and the service user and staff experiences at the centre. The theory highlights the importance of the relationship between the different elements; when the various factors worked together, a PIE was more stable for the service users and staff at the centre. The results highlight the complexity of implementing a PIE in a homelessness service. Recommendations for services include considering the wider contextual and systemic influences surrounding homelessness. The critical appraisal reflects on the research process and the role of the researcher at different stages of design, data collection, analysis, and interpretation. Further clinical implications and areas for future research are also explored.