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. 2021 Jul 9:9:661517.
doi: 10.3389/fpubh.2021.661517. eCollection 2021.

A Comprehensive Assessment to Enable Recovery of the Homeless: The HOP-TR Study

Coline Van Everdingen  1 , Peter Bob Peerenboom  2 , Koos Van Der Velden  3 , Philippe A E G Delespaul  1   4
Affiliations

A Comprehensive Assessment to Enable Recovery of the Homeless: The HOP-TR Study

Coline Van Everdingen et al. Front Public Health. .

Abstract

Background: Homelessness is an increasing problem in Western European countries. In the Netherlands, policy reforms and austerity measures induced an urgent need for management information on local homeless citizens. Municipal authorities initiated cross-sectional reviews of Homeless Service (HS) users. The resulting Homeless People Treatment and Recovery (HOP-TR) study developed a health and needs assessment strategy over different domains to comprehensively assess individuals and care networks with the perspective on recovery. Methods: Dutch HS users were selected using a naturalistic meta-snowball sampling. Semi-structured interviews provided the primary data source. The interview content was partly derived from the InterRAI Community Mental Health questionnaire and the "Homelessness Supplement." Using the raw interview data, algorithmic summary scores were computed and integrating clinical parameters assessed. The data describe health and needs in a rights-based, recovery-oriented frame of reference. The mental health approach is transdiagnostic. The positive health framework is used for structuring health and needs aspects in relation to the symptomatic (physical and mental health), social (daily living, social participation), and personal (quality of life, meaning) dimensions of recovery. Results: Recruitment (between 2015 and 2017) resulted in a saturated sample of 436 HS users in 16 facilities and seven cities. Most participants were long-term or intermittently homeless. The sample characteristics reveal the multi domain character of needs and the relevance of a broad, comprehensive approach. Local authorities used the reports to reflect and discuss needs, care provision, access, and network cooperation. These dialogs incited to improve the quality of care at various ecosystem levels. Discussion: This paper describes new recruitment strategies and data collections of comprehensive data domains, to improve our knowledge in the field of homelessness. Traditional epidemiological literature on homelessness is often domain specific and relies on administrative sources. The HOP-TR study uses an analytical epidemiological approach. It shifts the assessment focus from problem-centered marginalization processes toward a comprehensive, three-dimensional recovery-oriented vision of health. Different perspectives are integrated to explore the interaction of homeless people with care networks.

Keywords: InterRAI Community Mental Health questionnaire; healthcare ecosystem approach; homelessness; human rights; public health policy; recovery; severe mental illness; transdiagnostic mental health strategy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Decision tree to assess Mental Health Related Care Needs.
Figure 2
Figure 2
Additional information by subsample.
Figure 3
Figure 3
Comprehensive assessment of symptomatic, social, and personal dimensions and conditions to enable recovery.
See this image and copyright information in PMC

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