Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Substance Abuse Treatment, Prevention, and Policy
Published in: Substance Abuse Treatment, Prevention, and Policy 1/2007

Open Access 01-12-2007 | Research

Unofficial policy: access to housing, housing information and social services among homeless drug users in Hartford, Connecticut

Authors: Julia Dickson-Gomez, Mark Convey, Helena Hilario, A Michelle Corbett, Margaret Weeks

Published in: Substance Abuse Treatment, Prevention, and Policy | Issue 1/2007

Login to get access

Abstract

Background

Much research has shown that the homeless have higher rates of substance abuse problems than housed populations and that substance abuse increases individuals' vulnerability to homelessness. However, the effects of housing policies on drug users' access to housing have been understudied to date. This paper will look at the "unofficial" housing policies that affect drug users' access to housing.

Methods

Qualitative interviews were conducted with 65 active users of heroin and cocaine at baseline, 3 and 6 months. Participants were purposively sampled to reflect a variety of housing statuses including homeless on the streets, in shelters, "doubled-up" with family or friends, or permanently housed in subsidized, unsubsidized or supportive housing. Key informant interviews and two focus group interviews were conducted with 15 housing caseworkers. Data were analyzed to explore the processes by which drug users receive information about different housing subsidies and welfare benefits, and their experiences in applying for these.

Results

A number of unofficial policy mechanisms limit drug users' access to housing, information and services, including limited outreach to non-shelter using homeless regarding housing programs, service provider priorities, and service provider discretion in processing applications and providing services.

Conclusion

Unofficial policy, i.e. the mechanisms used by caseworkers to ration scarce housing resources, is as important as official housing policies in limiting drug users' access to housing. Drug users' descriptions of their experiences working with caseworkers to obtain permanent, affordable housing, provide insights as to how access to supportive and subsidized housing can be improved for this population.
Appendix
Available only for authorised users
Literature
1.
Baum AS, Burnes DW: A Nation in Denial: the truth about homelessness. 1993, Boulder, CO, Westview Press
2.
Lamb HR: Deinstitutionalization and the homeless mentally ill. Hospital and Community Psychiatry. 1984, 35: 153-170.
3.
Royse D, Leukefeld C, Logan TK, Dennis M, Wechsberg W, Hoffman J, Cottler L, Inciardi J: Homelessness and gender in out-of-treatment drug users. American Journal of Drug and Alcohol Abuse. 2000, 26: 283-296. 10.1081/ADA-100100605.CrossRefPubMed
4.
Fischer PJ, Breakey WR: The epidemiology of alcohol, drug, and mental disorders among homeless persons. American Psychologist. 1991, 46: 1115-1128. 10.1037/0003-066X.46.11.1115.CrossRefPubMed
5.
Stahler GJ, Shipley TE, Bartelt D, Westcott D, Griffith E, Shandler I: Retention issues in treating homeless polydrug users: Philadelphia. Alcoholism Treatment Quarterly. 1993, 10: 201-215. 10.1300/J020V10N03_16.CrossRef
6.
Dennis JL, Bray RM, Iachan R: Drug use and homelessness. Comparative epidemiology: Examples from the DC Metropolitan Area Drug Study. Edited by: Bray RM and Marsden ME. 1998, San Francisco, Sage, 79-123.
7.
Lehman AF, Cordrey DS: Prevalence of alcohol, drug and mental disorder among the homeless: one more time. Contemp Drug Problems. 1993, 355-386.
8.
Johnson TP, Freels SA, Parsons JA, Vangeest JB: Substance abuse and homelessness: social selection or social adaptation?. Addiction. 1997, 92: 437-445. 10.1111/j.1360-0443.1997.tb03375.x.CrossRefPubMed
9.
Spinner GF, Leaf PJ: Homelessness and drug abuse in New Haven. Hospital and Community Psychiatry. 1992, 43: 166-168.PubMed
10.
Winkleby MA, Rockhill B, Jatulis D, Fortman SP: The medical origins of homelessness. American Journal of Public Health. 1992, 82: 1395-1398.
11.
Blau J: The visible poor: homelessness in the U.S. 1992, New York, Oxford University Press
12.
Harrington M: The new American poverty. 1984, New York, Penguin Books
13.
Booth BM, Sullivan G, Koegel P, Burnam A: Vulnerability factors for homelessness associated with substance dependence in a community sample of homeless adults. Am J Drug Alcohol Abuse. 2002, 28: 429-452. 10.1081/ADA-120006735.CrossRefPubMed
14.
Koegel P, Burnam MA: Getting nowhere: homeless people, aimless policy. Urban America--Policy choices for Los Angeles and the nation. Edited by: Steinberg J, Lyon D and Vaiana M. 1992, Santa Monica, CA, RAND
15.
Burt MR: Over the edge: the growth of homelessness in the 1980s. 1992, New York, Russel Sage Foundation
16.
Cohen CI, Thompson KS: Homeless mentally ill or mentally ill homeless?. Am J Psychiatry. 1992, 149: 816-823.CrossRefPubMed
17.
Shinn M: Homelessness. What is a psychologist to do?. Am J Community Psychology. 1992, 20: 1-24. 10.1007/BF00942179.CrossRef
18.
19.
Crane J, Quirk K, van der Straten A: "Come back when you're dying": - the commodification of AIDS among California's urban poor. Social Science & Medicine. 2002, 55: 1115-1127. 10.1016/S0277-9536(01)00252-0.CrossRef
20.
Anderson TL, Shannon C, Schyb L, Goldstein P: Welfare reform and housing: assessing the impact to substance abusers. Journal of Drug Issues. 2002, 32: 265-296.CrossRef
21.
Drug Policy Alliance: State of the states: drug policy reforms: 1996-2002. 2003, New York,
22.
Lipsky M: Street-level bureaucracy: dilemmas of the individual in public services. 1980, New York, Russel Sage Foundation
23.
Zlotnick C, Tam T, Robertson MJ: Disaffiliation, substance use, and exiting homelessness. Substance Use & Misuse. 2003, 38: 577-599. 10.1081/JA-120017386.CrossRef
24.
Nyamathi A, Leake B, Keenan C, Gelberg L: Type of social support among homeless women: Its impact on psychosocial resources, health and health behaviors, and use of health services. Nurs Res. 2000, 49: 318-326. 10.1097/00006199-200011000-00004.CrossRefPubMed
25.
Nwakeze PC, Magura S, Rosenblum A, Joseph H: Homelessness, Substance Misuse, and Access to Public Entitlements in a Soup Kitchen Population. Substance Use & Misuse. 2003, 38: 645-668. 10.1081/JA-120017388.CrossRef
26.
Dohan D, Schmidt L, Henderson S: From enabling to bootstrapping: welfare workers' views of substance abuse and welfare reform. Contemp Drug Problems. 2005, 32: 429-455.
27.
Hopper K, Barrow S: Two genealogies of supported housing and their implications for outcome assessment. Psychiatric Services. 2003, 54: 50-54. 10.1176/appi.ps.54.1.50.CrossRefPubMed
28.
Hopper K, Jost J, Hay T, Welber S, Haugland G: Homelessness, mental illness and the institutional circuit. Psychiatric Services. 1997, 48: 659-665.CrossRefPubMed
29.
Srebnik D, Livingston J, Gordon L, King D: Housing choice an community success for individuals with serious and persistent mental illness. Community Mental Health Journal. 1995, 31: 139-152. 10.1007/BF02188763.CrossRefPubMed
30.
Tsemberis S, Gulcur L, Nakae M: Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health. 2004, 94: 651-656.PubMedCentralCrossRefPubMed
31.
Andersen A, University of Pennsylvania Health System DP, Sherwood KE: Final Program Evaluation Report. 2002, New Haven, Ct, Connecticut Supportive Housing Demonstration Program
32.
Dickson-Gomez J, Weeks M, Martinez M, Radda K: Reciprocity and Exploitation: social dynamics in private drug use sites. Journal of Drug Issues. 2003, in review:
33.
Weeks MR, Clair S, Singer M, Radda K, Schensul JJ, Wilson DS, Martinez M, Scott G, Knight G: High risk drug use sites, meaning and practice: Implications for AIDS prevention. J Drug Issues. 2001, 31: 781-808.
34.
Weeks M, Dickson-Gomez J, Mosack K, Convey M, Martinez M, Clair S: The Risk Avoidance Partnership: Training active drug users as Peer Health Advocates. Journal of Drug Issues. 2006, 36: 541-570.PubMedCentralCrossRefPubMed
35.
Weeks M, Singer M, Schensul JJ, Jia Z, Grier M: Project COPE: Preventing AIDS among injection drug users and their sex partners: descriptive data report. Institute for Community Research. 1991, Hartford, CT,
36.
Muhr T: Atlas-ti: The knowledge workbench. 2000
37.
Kingfisher C: Producing disunity: the constraints and incitements of welfare work. The new poverty studies: The ethnography of power, politics, and impoverished people in the United States. Edited by: Goode J and Maskovsky J. 2001, New York, New York University Press
38.
Piven FF: Welfare reform and the economic and cultural reconstruction of low wage labor markets. The new poverty studies: The ethnography of power, politics, and impoverished people in the United States. Edited by: Goode J and Maskovsky J. 2001, New York, New York University Press
39.
Seals BF, Sowell RL, Demi AS, Moneyham L, Cohen L, Guillory J: Falling through the cracks: Social service concerns of women infected with HIV. Qualitative Health Research. 1995, 5: 496-515. 10.1177/104973239500500410.CrossRef
40.
Sowell RL, Phillips KD, Seals BF, Julious CH, Rush C, Spruill LK: Social service and case management needs of HIV-infected persons upon release from prison/jail. Lippincott's Case Management. 2001, 6: 157-168. 10.1097/00129234-200107000-00005.CrossRefPubMed
41.
Sowell RL, Seals BF, Moneyham L, Guillory J, Demi AS, Cohen L: Barriers to health-seeking behavior for women infected with HIV. Nursing Connections. 1996, 9: 5-17.PubMed
Metadata
Title
Unofficial policy: access to housing, housing information and social services among homeless drug users in Hartford, Connecticut
Authors
Julia Dickson-Gomez
Mark Convey
Helena Hilario
A Michelle Corbett
Margaret Weeks
Publication date
01-12-2007
Publisher
BioMed Central
Published in
Substance Abuse Treatment, Prevention, and Policy / Issue 1/2007
Electronic ISSN: 1747-597X
DOI
https://doi.org/10.1186/1747-597X-2-8

Other articles of this Issue 1/2007

Substance Abuse Treatment, Prevention, and Policy 1/2007 Go to the issue

Methodology

Therapeutic emails

Short Report

Liver transplant and hepatitis C in methadone maintenance therapy: a case report

Research

African-American crack abusers and drug treatment initiation: barriers and effects of a pretreatment intervention

Review

The prevalence and significance of substance use disorders in bipolar type I and II disorder

Research

Cocaine treatment admissions at three sentinel sites in South Africa (1997–2006): findings and implications for policy, practice and research

Short Report

Does higher cost mean better quality? evidence from highly-regarded adolescent drug treatment programs