Social capital and mental health in homeless people
Lead Research Organisation:
Queen Mary University of London
Department Name: Sch of Medicine & Dentistry
Abstract
Whilst the European Parliament have recently increased efforts to promote access to good quality care and to reduce health inequalities, homelessness across Europe is on the rise. Homelessness comprises: (a) rooflessness (b) houselessness (c) living in insecure housing and (d) living in inadequate housing.
In England, estimates suggest that 4,000 people in 2016 were sleeping rough on any given night, up 21% from 2015. In London, rates of rooflessness have shown an estimated 3% - 7% increase over the last year. Homelessness has been waell documented to have detrimental effects on mental health. Homeless people display elevated rates comparatively to the general public, of problems such as, depression, alcohol/drug dependence and psychoses. Mortality is also substantially increased in homeless people and mental health problems are implicated in these high rates. Despite their need for care, homeless people experience many barriers when trying to access services.
As rates of homelessness are rising, it is increasingly important to develop an effective strategy to alleviate mental distress in those affected and to reduce homelessness. One innovative and unexplored avenue is to explore homelessness through the lens of social capital theory. Social capital refers to the social relationships within groups and communities. It comprises: bridging (ties amongst individuals within a homogenous group), bonding (ties amongst individuals of heterogeneous groups) and linking (ties with institutions of authority and power e.g. the government). Bonding helps people to get by and provides essential social cohesion and support, bridging helps people to get ahead and promotes societal respect and solidarity and linking helps to mobilise political resources and power.
The little existing research on this topic indicates that homeless people are often isolated with low levels of social support and social functioning. They may have the bonding component but lack bridging and linking. However, reliance upon bonding can be problematic. For example, receiving instrumental support from street-peers (bonding) can reduce one's likelihood of engaging in employment services. The high rates of mental illness, lack of housing, chaotic lifestyle, poor motivation and shame amongst many homeless people likely contribute to difficulties in maintaining social links with acquaintances and those not in immediate and close social circles (weak ties). However, having limited weak ties may contribute to feelings of societal isolation and alienation, lack of belonging and reduced well-being.
This research will focus on those who are roofless. It aims to answer the following questions: 1) to what extent do homeless people have social capital? 2) what are the advantages/disadvantages of bridging, bonding and linking for homeless people? 3) what is the role of social capital in mental health amongst homeless people?
Stage 1: A systematic review will be conducted to help a) identify research on social capital b) synthesise this research into the framework of bridging, bonding and linking c) explore the advantages/disadvantages of each component of social capital.
Stage 2: Semi-structured interviews will be conducted with two groups; homeless people and service providers (including healthcare professionals and staff from homeless organisations). The interviews will cover the following topics 1) social capital 2) mental health 3) service use. Interviews will be audio recorded and transcribed verbatim and then thematically analysed.
Stage 3: A topic guide will be developed exploring a) findings from the first two stages and b) social capital and homelessness. There will be three focus groups (n=18, 6 in each group). Group 1 will comprise individuals who have directly experienced homelessness, Group 2, healthcare providers and Group 3, service providers from homeless organisations. These discussions will be audio recorded and analysed thematically.
In England, estimates suggest that 4,000 people in 2016 were sleeping rough on any given night, up 21% from 2015. In London, rates of rooflessness have shown an estimated 3% - 7% increase over the last year. Homelessness has been waell documented to have detrimental effects on mental health. Homeless people display elevated rates comparatively to the general public, of problems such as, depression, alcohol/drug dependence and psychoses. Mortality is also substantially increased in homeless people and mental health problems are implicated in these high rates. Despite their need for care, homeless people experience many barriers when trying to access services.
As rates of homelessness are rising, it is increasingly important to develop an effective strategy to alleviate mental distress in those affected and to reduce homelessness. One innovative and unexplored avenue is to explore homelessness through the lens of social capital theory. Social capital refers to the social relationships within groups and communities. It comprises: bridging (ties amongst individuals within a homogenous group), bonding (ties amongst individuals of heterogeneous groups) and linking (ties with institutions of authority and power e.g. the government). Bonding helps people to get by and provides essential social cohesion and support, bridging helps people to get ahead and promotes societal respect and solidarity and linking helps to mobilise political resources and power.
The little existing research on this topic indicates that homeless people are often isolated with low levels of social support and social functioning. They may have the bonding component but lack bridging and linking. However, reliance upon bonding can be problematic. For example, receiving instrumental support from street-peers (bonding) can reduce one's likelihood of engaging in employment services. The high rates of mental illness, lack of housing, chaotic lifestyle, poor motivation and shame amongst many homeless people likely contribute to difficulties in maintaining social links with acquaintances and those not in immediate and close social circles (weak ties). However, having limited weak ties may contribute to feelings of societal isolation and alienation, lack of belonging and reduced well-being.
This research will focus on those who are roofless. It aims to answer the following questions: 1) to what extent do homeless people have social capital? 2) what are the advantages/disadvantages of bridging, bonding and linking for homeless people? 3) what is the role of social capital in mental health amongst homeless people?
Stage 1: A systematic review will be conducted to help a) identify research on social capital b) synthesise this research into the framework of bridging, bonding and linking c) explore the advantages/disadvantages of each component of social capital.
Stage 2: Semi-structured interviews will be conducted with two groups; homeless people and service providers (including healthcare professionals and staff from homeless organisations). The interviews will cover the following topics 1) social capital 2) mental health 3) service use. Interviews will be audio recorded and transcribed verbatim and then thematically analysed.
Stage 3: A topic guide will be developed exploring a) findings from the first two stages and b) social capital and homelessness. There will be three focus groups (n=18, 6 in each group). Group 1 will comprise individuals who have directly experienced homelessness, Group 2, healthcare providers and Group 3, service providers from homeless organisations. These discussions will be audio recorded and analysed thematically.