Improving Cross-Sector Collaborations between Healthcare and Housing: Challenges and Strategies Identified by Unhoused People with Complex Health Needs

Abstract

There is growing recognition of the need for collaboration between the healthcare and housing sectors to address the needs of people experiencing homelessness. This study explores how these cross-sector collaborations can be improved from the perspective of those with histories of homelessness and complex health needs. In-depth, semi-structured qualitative interviews (N = 23) were used to (1) understand the challenges faced by people with complex health needs when navigating services at the intersection of healthcare and housing and (2) identify strategies for improving these services. While some participants reported accessing cross-sector services, many found those efforts to be lacking and ineffective. Participants reported receiving support with healthcare needs from housing providers more frequently than assistance with housing needs from healthcare providers. They described challenges related to provider turnover, perceived stigma and discrimination, and insufficient resources. Proposed solutions included modernizing and centralizing care, providing an effective balance of in-person and virtual offerings with an emphasis on in-person services, and improving provider sensitivity to reduce stigma against service recipients. These findings align with existing research on cross-sector collaborations in other fields and highlight the need for comprehensive, compassionate care tailored to the unique needs of people experiencing homelessness. The study also underscores the urgent need for more effective implementation and evaluation of these cross-sector efforts to improve outcomes for this vulnerable population.

Keywords: Cross-sector; Health; Homeless; Qualitative.