The perceptions of shelter staff workers

Chapter 1: Introduction to the Study


Many veterans have no place to call home and they are relegated to finding shelter under viaducts abandoned homes, dilapidated buildings, stairways, and other inhabitable places. Millions of homeless veterans in the United States wander the streets looking to find shelter on any given night (Woolsey & Neumann, 2015). non-veteran homeless individuals and veteran homeless individuals share commonalities such as childhood instability, mental health issues, foster care, and inadequate social support, and changes in their physical health (Tsai & Cao, 2019; Tsai, Gelberg, & Rosenheck, 2019; Tsai & Rosenheck, 2013). Though risks for homeless civilian and homeless veterans are similar, homeless veterans having other co-occurring issues such as marital strife, mental health illness, and substance abuse issues (Tsai & Rosenheck, 2018; Kline et al, 2009). Veteran status adds other risk factors for homelessness such as Military Sexual Trauma (MST) and Post-Trauma Stress Disorder (PTSD) (Tsai & Rosenheck, 2012). Such trauma and mental strain experienced by veterans may be an attributing factor for veterans’ higher risks for homelessness over any other homeless group in America (Tsai & Rosenheck, 2018).

Griffth (2017) examined the perceptions of shelter staff workers regarding barriers homeless individuals face in obtaining and maintaining long-term housing. Shelter staff workers reported they perceived a lack of resources and knowledge to gain housing among other barriers homeless individuals face when attempting to gain housing (Griffth, 2017). Although literature (Hong, Matik, Lundquist, Bellach, & Kontokosta, 2018; Lee et al., 2017; Metraux, Cusack, Byrne, Hunt-Johnson, & True, 2017; Tsai & Cao, 2019) attributes risk of veteran homelessness to factors that may have existed before he or she joined the military such as foster care and childhood family abuse (McKeever, McWhirter, & Huff, 2006; Zaidi & Foy, 1994), there are limited studies that examined protective factors of veteran homelessness from the viewpoint of employees that work with the homeless veteran population including shelter works, social workers, caseworkers, etc. (Griffith, 2017; Tsai & Cao, 2019; Tsai et al., 2019; Woodall & Naumann, 2015). Kierman et al. (2017) research is needed examining employees, social workers, and case managers’ attitudes and perceptions are important because the lack of collaborative relationship will lead to a negative outcome. Griffith (2017) states few studies have examined the perceptions of shelter staff workers and futures studies should explore the “perceptions and thoughts of shelter staff” employees (p. 119). According to Woodall and Naumann (2015), further study is warranted on whether marital status (current, past) and higher education are protective factors against homelessness leaving a gap in research on possible protective factors of homelessness. Addressing the current gap in literature called by Woodall and Naumann on education and marital status might assist veterans, government agencies, and all other stakeholders.

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Background of the Study

Issues surrounding homelessness for the general population are multifaceted and even more complex for homeless veterans (Hong et al., 2018; Lee et al., 2017; McKeever et al., 2006; Metraux et al., 2017; Tsai & Cao, 2019). According to Weber, Lee, and Martsolf (2017) literature on homeless veterans began to rapidly appear from the examination of veterans who served during World War II and Vietnam Wars which began to display the need for interventions and resources for veterans in several areas such as mental health, physical health, and homelessness. The main theme of such literature was centered upon PTSD after the diagnosis was added to the Diagnostic and Statistical Manual of Mental Disorders- III (DSM-3) in the early 80s as a result of the collaboration between mental health providers and Vietnam War veterans (Helzer, Robins, & McEvoy, 1987).

Studies continued to explore risk factors of war veterans specific to PTSD and identified themes such as pre-war functioning and panic disorder risk factors for PTSD (Green, Grace, Lindy, Gleser, & Leonard, 1990). Other studies (Butler et al., 1990; Hendin, & Haas, 1991) explored psychological consequences suffered by war veterans including exaggerated startle response (Butler et al., 1990) and combat-related guilt (Hendin, & Haas, 1991). Later, literature explored additional risk factors associated with veteran status and homelessness was indicated as a major concern (Rosenheck & Fontana, 1994; Sayer et al., 2010; Sayers, 2011; Tsai & Rosenheck, 2018; Wenzel et al., 1993; Woolsey & Naumann, 2015; Tsai et al., 2019).

Once literature established that homelessness was a concern, researchers narrowed their studies to barriers of veterans and the issue of veteran status and homelessness (Tsai & Byrne, 2019). In 1993, Wenzel et al. conducted a study on 343 male veteran patients and identified weak social support, mental disorders and substance abuse, and poor work history as indicators for chronic homelessness. One year later 1994, Rosenheck and Fontana examined over 1,400 Vietnam War veterans and supported the findings from Wenzel et al. (1993) when they also identified substance abuse, post-military social isolation, and psychiatric issues as having a strong direct effect on homeless.

Although the literature on PTSD stemmed from over two decades ago such as the PTSD checklist (Weathers, Litz, Herman, Huska, & Keane, 1993), PTSD is still a relevant issue in literature today with the newer veterans from the Gulf War, Afghanistan, and Iraq Wars (Donley & Wright, 2018; Fonkoue et al., 2020). As a result, literature began to evolve to explore additional factors that lead to homeless in veterans. Researchers that explored homeless in veterans stated that many veterans who return from deployment had substance abuse issues, mental health issues, chronic health concerns, adverse child issues, social isolation, criminal charges, are in the midst of a divorce, and or have no civilian employable skills (Montgomery et al., 2013; Tsai & Rosenheck, 2015), all of which increase veterans’ risk for homelessness. A more recent study (2018) indicated that veterans with other than an honorable discharge such as those discharged for “bad conduct” had worse issues such as more sleep problems meet diagnostic criteria for major depressive disorder (Elbogen et al., 2018).

Although previous literature explored risk factors that may lead to veterans being homeless such as mental illness, traumatic brain injury during active duty, military sexual trauma and substance abuse (Sayer et al., 2010; Sayers, 2011) researchers did not examine if education and marital status serve as protective factors against homelessness (Tsai & Cao, 2019). There were a few studies that explored perceptions of employees who work with homeless veterans, however, they were in populations such as housing intervention providers, police, and VA staff liaisons and none specifically viewed the perceptions of social workers, caseworkers, and counselors regarding veteran homelessness which created the second gap in the literature (Hartmann McNamara, Crawford, & Burns, 2013; Mills, Burton, & Matheson, 2015; Molinari, Brown, Frahm, Schinka, & Casey, 2013). As a result, there remains a gap in the literature on veteran homelessness and possible protective factors against homelessness from the perceptions of employees who work with homeless veterans. Since it remains unknown if employees working with veterans perceive if education and marital status serve as protective factors against homelessness in veterans, this study plans to explore perceptions of those who work with homeless veterans such as social workers, counselors, and caseworkers regarding if they view marital status or education as protective factors against veteran homelessness (Montgomery et al., 2013; Sayer et al., 2010; Sayers, 2011; Tsai & Cao, 2019; Tsai et al., 2019; Tsai & Rosenheck, 2015; Wenzel et al., 1993; Woolsey & Naumann, 2015).

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