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Identifying Opportunities to Teach Students about Homelessness

By Amanda Aykanian, PhD

Homelessness is a topic that gains little attention in social work curriculum. Yet, it is a social problem that intersects with many of the topics (e.g., mental health, substance use, child welfare) and populations (e.g., youth and young adults, families, survivors of domestic violence) addressed consistently in coursework. 

In thinking about why homelessness is not more prominent in social work education, some immediate barriers come to mind. Programs may not have faculty with expertise in homelessness, developing curriculum integration ideas can be time consuming, and some departments have strict rules that limit the degree to which course content can be modified. One could also highlight turning points in social work’s history that have contributed to an ideological shift towards problems, topics, and populations that lend themselves more readily to direct clinical practice and traditional therapies. This shift has made homelessness (and poverty more broadly) less appealing because it requires a macro lens to address the complex policy, system, and community dynamics that contribute to individual experiences. Because of these factors, and perhaps others, homelessness has not been given consistent attention across social work curriculum and degree programs.

The good news is that the profession has made an effort to reinvigorate its commitment to homelessness—most notably is its inclusion in the Grand Challenges for Social Work initiative. The collaborative work of the Grand Challenge to End Homelessness and the National Center for Excellence in Homeless Services has also produced important resources for teaching about homelessness, such as CSWE’s Curricular Guide for Addressing Homelessness and the first social work textbook on homelessness.

In an upcoming article in the Journal of Social Work Education, Tara Ryan-DeDominicis and I present a model of low, medium, and high effort strategies for integrating homelessness into coursework. Below are some ideas and resources we discuss in that article.

  1. Start Small: You do not need to be a homelessness expert to start integrating the topic into your courses. Start with something simple, like a reading swap (see #3), and use it as an opportunity to learn alongside your students.
  2. Look for “Easy Ins”: Look for topics in your syllabus that provide an easy connection to homelessness and target changes in those areas by making reading swaps (see #3) or modifying assignments. 
  3. Swap Readings: Pick one or two areas to add or swap-in a reading that connects the course topic to homelessness. Teaching about trauma? Read about how young women with histories of victimization and homelessness perceived the value of a trauma-informed group intervention. Teaching about suicide? Read about factors that contribute to whether young adults experiencing homelessness tell friends about their suicidal thoughts. Teaching about the strengths-based perspective? Read about how that approach has been used with homeless mothers.
  4. Use Existing Resources for Inspiration: Need ideas? Check out the National Center’s journal article and non-fiction book reading lists. CSWE’s Curricular Guide for Addressing Homelessness also has reading suggestions and activity ideas for using homelessness to teach across the nine social work competencies.
  5. Use Publicly Available Videos/Webinars: The National Alliance to End Homelessness, the U.S. Interagency Council on Homelessness, the National Homelessness Law Center, the National Council on Health Care for the Homeless, and the National Low Income Housing Coalition all have publicly available webinars on topics related to service needs, service systems, and policy issues.
  6. Don’t Forget About Policy: Ending homelessness will require significant political will and large-scale changes to federal and state-level policy, including policy areas outside of housing (e.g., criminal justice reform). This makes it a topic ripe for classes on policy analysis and advocacy. Some resources to use for talking about homelessness and policy include these Policy Recommendations for Meeting the Grand Challenge to End Homelessness, these homelessness-related Policy Proposals for the 2020 Presidential Election, and NASW’s 2021 Blueprint of Federal Social Policy Priorities.
  7. Think Outside the Classroom: Service learning, research projects, and other forms of experiential learning are also great ways to connect social work topics to homelessness. A recent special issue of the Journal of Social Work Education highlights several examples.

The ideas above are just the tip of the proverbial iceberg for ways social work educators can teach students about homelessness. I imagine faculty across the National Center’s partner schools and beyond are already using creative curriculum integration strategies. Perhaps as the National Center and the Grand Challenge to End Homelessness evolve, more attention will be paid to sharing educational ideas and evaluating curricular innovations.

Amanda Aykanian, PhD is an assistant professor of social work at the University of Texas at Arlington. Her work centers on program, system, and policy implementation and community-based evaluation research. Her recent research has focused on homeless service access and understanding how communities implement federal mandates while navigating complex local, state, and federal policy arenas.

Homelessness in Higher Education during COVID-19

By Morgan Weber, Yadira Maldonado, and Rashida Crutchfield, E.d.D.

Higher education in the United States is a critical avenue for social and economic mobility. College and university degrees continue to be essential as the wage gap between individuals with and without a degree continues to widen. While beneficial in the long run, the trajectory towards this goal can be tumultuous. As the price of college attendance and cost of living increases in many parts of the country, some students are unable to support themselves and are often forced to cut costs on basic needs such as food and housing. The issue of homelessness for college and university students has emerged as a pressing across the country

As a part of our research in basic needs insecurity in higher education, we’ve spoken to hundreds of students who experience homelessness. For some, student homelessness may include street living, sleeping in their cars, or living in spaces not meant for human habitation. For many, homelessness is never having a consistent place to stay. Students “couch surf,” or move from location to location, relying on temporary stays with friends, family members, or hotels where they can’t stay long term.  Pauline, who lived in a storage unit for most of the academic year, described her experience saying, “I’m like constantly stressed out. Like, where am I going to live next month? How am I going to stay here until I need to graduate. Like, am I gonna’ have a place to live when I find a job, like, I don’t know.”

 In 2019, a national survey found that 46% of students experienced housing insecurity and 17% had reported homelessness. Research conducted in California found that 5% of University of California (UC) students, 10% of California State University (CSU) students, and 20% at California Community Colleges (CC) students experience homelessness. The COVID-19 pandemic has compounded the problem for these students. The ongoing instability and fear of homelessness is traumatic, and the pandemic, for so many students, deepens the financial and person strain. For many experiencing food and housing insecurity, their college campus served as an anchor to access resources and find support. Students utilized their campuses as a source for safe housing, food, technology, support services, and an environment to foster social connections. Statewide lockdowns and stay-at-home orders have forced campus closures, preventing students from accessing these crucial resources. Some schools have extended these precautions until the middle of next year. For instance, as of September 10th, 2020, the California State University (CSU) system announced that it would continue to primarily hold virtual learning until June 2021. 

Without access to basic needs or the ability to be highly mobility, students who experience homelessness may not be able to use the resources of support they once had. Many lost jobs that were keeping them just afloat enough to make it. Lucy and her children had found stable housing, but after layoffs, had very few choices. She said, “Luckily, we have a van, we can live in that van if that’s what it is.” Students who are highly mobile often do not have a safe space to “shelter in place”. They can be forced to make very difficult choices, risking living in places they may not feel safe or spend more time exposed to open environments which may lead to COVID-19 exposure, negative experiences with police, and food insecurity. Some steps have been taken to better support students experiencing homelessness. 

Campuses and communities can still support students who face homelessness. California State University, Long Beach (CSULB) offered and extensive Basic Needs Program prior to the COVID-19 outbreak. This included a case management approach, allowing students to tell their story only once and referring them to appropriate programs, services and resources like emergency grants, Supplemental Nutrition Assistant Program (SNAP) application assistance, emergency housing and, most recently, access to a Rapid ReHousing program that supports long term housing support. The campus also had open library hours, on-campus employment, use of the gym showers and lockers, after-hours study hall, counseling services, and a food pantry. The Basic Needs Program is still responding to students and application for this support have skyrocket. 

However, many programs are saturated or limited given the amount of current need, and the quick shifts to primarily off-campus learning to ensure the safety of students does not always take into account what students in the greatest need might be living. Sam had been living in his car prior to COVID but gained emergency housing on his campus. When the closures hit and campus housing did not account for what that meant for him, he suffered. He said, “Then COVID happened here and then I had to worry about all over again of like, oh my God.” Sam fought to stay on campus, but systems must be put in place to avoid retraumatizing students.

Since the outbreak of COVID-19, the availability and access to resources on college campuses has decreased; however, students persist in their efforts to earn degrees. In fact, though some campuses are seeing worrisome decreases in matriculation rates, many campus are still seeing surges in online enrollment. Many students are aware that, without college and with limits on available employment, their outlook is dependent on the long-term investment in education despite persistent burdens of getting their basic needs met.

Students experiencing homelessness have had to quickly adapt and research new ways to meet the needs once provided by campus resources. This could force some students to choose between using their savings or financial aid on their basic needs or their academics. Many work or continue to work in employment that is low paying, but high risk for contracting COVID like the food industry. Communities and campuses have opportunities to address these issues. Offer available resources to students and communicate with care and concern. Consider hosting students experiencing homelessness in recently vacated housing units. Bridge links between students and off-campus resources and invest in case management models for referrals to resources on- and off-campus. Advocate for state and federal financial aid allocations for students who need it.

The COVID-19 pandemic has illuminated the existing epidemic of student homelessness in higher education, which has been exacerbated due to closures and economic vulnerability. They have had to reimagine their daily lives and utilize crucial survival skills to juggle meeting their basic needs while continuing their education. It is imperative to acknowledge the resilience and dedication displayed by these students, and it is just as important for staff, educators, and administrators to continue providing aid and support in their journey for a higher education in the time of COVID-19. Campuses are strongly encouraged to consider how students experiencing homelessness and think creatively to address basic needs insecurity. 

“I strongly believe that education is the greatest investment that the society can put upon itself, an investment in us, which is the future, which is the next generation, is the most rewarding for an economy, for research, for science, for literature, for culture, the arts, and for any budget cuts to be coming towards us will dramatically affect us. They affect our health, they affect our future, they affect our progression out of poverty.”

-Tom (CSU Student who experienced homelessness)

Authors:

Morgan Weber is an undergraduate student activist pursuing her bachelor’s degree in Sociology at California State University, Long Beach.  She is the founder of The Butterfly Effect, a social movement tackling basic needs awareness in higher education through outreach and community engagement.

Yadira Maldonado is a master of social work student at California State University, Long Beach. She is a research technician for the study of student basic needs for the CSU.

Dr. Rashida Crutchfield is an associate professor in the School of Social Work at California State University, Long Beach. Her continued research and advocacy on basic needs for students has garnered statewide and national attention. She is a co-author of Addressing Homelessness and Housing Insecurity in Higher Education: Strategies for Educational Leaders.

Surveying Tenants of Permanent Supportive Housing in Skid Row about COVID-19

By: Ben Henwood, PhD

We analyzed survey results collected from 532 Permanent Supportive Housing (PSH) tenants in Los Angeles, California during the 4th week of March in 2020. Results show that nearly all tenants were aware of COVID-19 and 65% considered it to be a very serious health threat, which was a strong predictor of taking protective measures (i.e. hand washing and social distancing).

Living in shelters or on the streets makes protective measures including social distancing and handwashing difficult and high rates of underlying health conditions, including obstructive lung disease, increases vulnerability. In 2019, the United States had more than 369,000 PSH units that can provide an opportunity for social distancing. Older units such as single-room occupancy (SRO) with shared bathroom facilities, however, may make social distancing more challenging.

In our study, staff members from one of the largest providers of PSH in Los Angeles conducted phone surveys with tenants who lived in either a studio apartment or an SRO with shared bathroom facilities. Tenant responses were inputted to a survey tool and analyzed to guide programmatic response to tenant needs. Our findings indicate that targeted outreach may be needed further to reduce risk. For example, we found that male tenants had lower odds of perceiving COVID-19 as a serious health threat, which is consistent with prior literature. We also found that tenants with a mental health diagnosis, in particular, had lower odds of washing their hands consistently, which may speak to the need for increased mental health support and interventions that target daily functioning.

Our paper recognizes, while lack of capacity may result in symptom-triggered testing approaches in PSH, recent reports from shelter settings demonstrates that universal testing would be required to identify the high proportion of mild, pre-symptomatic, and asymptomatic cases, which are suspected to play a major role in COVID-19 transmission. The fact that PSH tenants exhibit premature aging, early onset of geriatric conditions, and require in-home supports suggests that risk within PSH may be elevated, particularly in single-site programs where all tenants in the same building receive support services, as opposed to scatter-site programs where units are located in the community by private landlords. Yet single-site may PSH may also facilitate access to healthcare and COVID-19 information. Our team has designed a study to examine the comparative effectiveness of single- versus scatter-site PSH in reducing COVID-19 risk behaviors and transmission.

Benjamin Henwood, PhD, LCSW, is a recognized expert in health and housing services research whose work connects clinical interventions with social policy. Dr. Henwood has specific expertise in improving care for adults experiencing homelessness and serious mental illness, as well as in the integration of primary and behavioral health care.

Being a Social Worker in a Time of Social Distancing

By: Tara Ryan-DeDominicis, LCSW 

With 3,446,291 confirmed cases of COVID-19 worldwide and 1,092,815 confirmed cases in the United States, I do not think any of us would have believed the statistics we are seeing now even one month ago (Center for Disease Control,  2020). There are currently 123,717 confirmed cases in my home state of New Jersey where I am a social worker in the field of homelessness (CDC, 2020). There are currently 8,864 people in the state of New Jersey who are considered homeless (NJ211, 2020).  Considering the difficulties accessing this population, that number is considered a low estimate by many of us who work in this field. Persons who are homeless are already at greater risk than their non homeless peers for significant health issues including pulmonary disease, respiratory infections, tuberculosis, and HIV (Hwang, 2001). Additionally, before this pandemic, persons who are homeless experience hospitalization five times more than the general community (Hwang, 2001). These medical disparities and lack of general wellness including lack of access to nutritious meals, insufficient sleep and inability to properly social distance (National Alliance to End Homelessness, 2020) make for a very at risk population during the time of COVID-19. Even those who are in homeless shelters during this time are unable to properly remain socially distant due to shelter overcrowding and with bunk beds, in many cases less than two feet apart (Jan & Johnson, 2020). In this post I hope to share my first hand perspective as a social worker in homeless services during the time of COVID. 

I am in the field of homelessness and am often a resource to answer questions specifically about unemployment, health insurance and health care, housing assistance etc. Although sometimes difficult, I could always find an answer. Currently, finding answers has become increasingly difficult. Myself and many social workers are facing questions we do not know how to respond to and have been introduced to a problem so large it has changed the systems we once knew how to navigate. “All the shelters are closing their doors, where do I go?” “ I cannot get through to unemployment on the phone, what do I do now?” “ How do I socially distance myself in a tent city?”. These are but a few examples of how the homeless population is struggling with an already limited amount of resources in the face of the pandemic. 

 While I spend my days trying to get my guests the best and most honest answers I can to their questions, I keep glancing at the sticky note I placed on my laptop: “Physically distant. NOT emotionally distant. NOT spiritually distance, NOT compassionately distant.”  In this time of unprecedented uncertainty, I put all my efforts into what I can control for myself and for guests. I am no longer able to offer the warmth and safety of our large dining room, where guests can charge their phones, wash up in the restroom or escape the rain. I am no longer able to offer interactions between our guests and our staff and volunteers who are a source of comfort and socialization while they enjoy a hot meal. During this time of social distancing we are able to provide bagged lunches and groceries to the line of socially distanced individuals standing six feet apart outside our door, as new restrictions prevent guests from entering our facility. My agency was often a place where guests were able to have a hot meal, socialize, and most importantly were offered a break from the elements of living outside–this shift has been an adjustment for our guests, but also the social workers and how we work with them. We are able to provide the meals in white paper bags instead of large blue plates and we are still providing social services via text message or phone call instead of sitting side by side. Both provider and guest have acknowledged that this is not the same. However, despite not being able to be near them, it does not mean we cannot remain close to them.

I am trying to do whatever can be done to maintain connection with my population during this time of crisis–a population already facing loneliness and isolation (Dej, 2016). For me that has ranged from FaceTiming a guest to make sure they are taking their medicine to praying the rosary with a scared guest over the phone. Showing I am still here by putting a cupcake in a guest’s lunch because she is turning thirty years old today with no one to celebrate with and using petty cash to send dog food to a guest who is unable to go to the store for her pet. These attempts to remain connected to my guests on an individual level are in addition to efforts on a larger scale between my agency, the county and other community resources. We all have the same goal  to access testing for the homeless population, locate any available shelter or motel beds and ensure anyone living outside has the supplies they need. In an effort to remain as consistent as possible with services already available to this population, the state of New Jersey has taken measures such as extending all emergency assistance through April 30th, working with shelters to enhance cleaning policies recommended by the CDC and covering all COVID- 19 related services and testing through NJ FamilyCare/Medicaid (N.J.Department of Human Services, 2020).

These times are uncertain and I cannot promise my guests as much as I would like. I am unable to provide our individual mindfulness counseling to our guests who struggle with trauma or our music therapy that so many of our guests look forward to. It takes me longer to navigate the systems that are put in place to assist this population such as benefit enrollment and direct service connection.  I am still searching, researching, and sitting with many questions I hope to be able to answer for them. What I can promise them is that I will be there, I will answer the text, I will pray with them, cry with them, and laugh with them until we are together again. I will advocate to the local government and community for their needs and spend hours on the phone adjusting our systems to allow for easier access and more complete services for all our vulnerable guests. What I can promise is in this time of social distancing, is I will still be there.  

References: 

Center for Disease Control and Prevention. Cases of coronavirus disease (COVID-19) in the U.S. (2020). Cases in the U.S. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

Dej, E. (2016). Psychocentrism and homelessness: The pathologization / responsibilization paradox. Mental Health & Distress as a Social Justice Issue, 10(1), 1-19. https://doi.org/10.26522/ssj.v10i1.1349 

Hwang,S.W. (2001) Homelessness and health. Canadian Medical Association Journal, 164 (2), 229-233. Retrieved from www.cmaj.ca/content/cmaj/164/2/229.full.pdf

Jan, T., & Johnson, J. (2020, April 14). Hotels sit vacant during the pandemic. But some locals don’t want homeless people moving in. The Washington Post. Retrieved from https://www.washingtonpost.com/business/2020/04/14/homeless-hotels-coronavirus/

National Alliance to End Homlessness. (2020). Population At- Risk:Homelessness and the COVID-19 Crisis. Retrieved from https://endhomelessness.org/resource/fact-sheet-population-at-rick-homelessness-and-the-covid-19-crisis/

New Jersey Department of Human Services. Press Releases. (2020). NJ Human Services Works to Protect & Help Maintain Continued Benefits for Residents Amid COVID-19 Outbreak. Retrieved from https://www.state.nj.us/humanservices/news/press/2020/approved/20200318b.html 

NJ211. (2020). Homeless in New Jersey. Retrieved from  https://www.nj211.org/homeless-new-jersey

Bio: 

Tara Ryan- DeDominicis is a LCSW in New Jersey and a DSW student at Rutgers University.  Tara is the Director of Programs and Services at nourish.NJ and serves on the social work advisory councils for Sacred Heart University and the College of Saint Elizabeth.

Recent Publication: Ryan-DeDominicis, T. A Case Study Using Shame Resilience Theory: Walking Each Other Home. Clin Soc Work J (2020) doi:10.1007/s10615-019-00745-9

Collaborative, Proactive Approaches to Mitigating the Spread of COVID-19 among Individuals Experiencing Homelessness – An Example from the Field

By Courtney Conley, P.h.D.

One of the most feared eventualities of COVID-19 recently became a reality when San Francisco reported on April 11 the novel coronavirus had begun to spread through its homeless population. The institutional living environments which characterize most emergency shelters mean that containing the spread, in the absence of widespread testing, is particularly challenging. Moreover, individuals who are experiencing homelessness maybe some of those at greatest risk of death due to the novel coronavirus as they often have multiple co-morbidities, such as Type II diabetes, hypertension, respiratory illnesses, and obesity and malnutrition, all which compromise the immune system. 

Homeless service providers have long mitigated the risk of infectious diseases in emergency shelter environments through rigorous testing procedures that control the spread of viral infections such as tuberculosis, HIV/AIDS, and hepatitis A and C. In the absence of adequate supplies of testing for COVID-19, however, homeless service providers in communities throughout the US were caught scrambling to respond. In further irony, the strategy of social distancing means that individuals experiencing homelessness have nearly nowhere to go and their access to opportunities, already limited, have been nearly eliminated. For many, unresolved trauma could mean that the social isolation and psychological stress of the pandemic could further weaken the immune system and physical resilience. In sum, homeless service providers are tasked with flattening the curve in the homeless population, before it even begins.

The City of Knoxville in East Tennessee has demonstrated impressive success in facing these challenges. Responding proactively and in a coordinated manner, Knoxville funded The Guest House in early April as an 18-room COVID-19-dedicated shelter for individuals experiencing homelessness who may test positive for COVID-19. The coordinated, city-wide approach has meant that individuals shelters are not duplicating efforts, and the community is maximizing the efficiency of its housing and funding resources. Moreover, HUD has issued clear guidelines on how to utilize homeless management information systems (HMIS) proactively to track cases, while maintaining client privacy.  The Knoxville-Knox County CoC has long partnered with the Social Work Office of Research and Public Service at the University of Tennessee to operate a robust HMIS with nearly 100% participation among service providers. This proactive coordination enabled the KnoxHMIS staff to swiftly adapt the system as a tool for communication and collaboration among area emergency shelter, street outreach, and healthcare workers to communicate symptomology and testing specific to persons who are experiencing homelessness and may be eligible for The Guest House.  Basic demographic and testing status information are included in the program’s data set.  Along with limited demographic information, there is basic reporting that aids in daily communication of discharge status. This program has locked visibility in KnoxHMIS and is only shared with emergency shelter, street outreach, and participating partner healthcare facilities.  

The nature of public health is that the most successful efforts are often invisible – it’s hard to prove what didn’t happen. Still, if local communities like Knoxville continue their proactive and collaborative efforts, we can limit the spread of COVID-19 in our most vulnerable populations. 

As for homeless research, the time is now for more scenario planning, as well as how to mitigate social isolation among already marginalized communities in the context of a pandemic and widespread social distancing. COVID-19 has revealed just how interconnected humans are across the globe, and how supporting all members of our communities makes us all more resilient, physically, psychologically, and emotionally. 

Author Biography: Dr. Courtney Cronley is an Associate Professor at the University of Tennessee, Knoxville College of Social Work. Her research centers on the impact of trauma in the lives of women experiencing homelessness, health disparities, and changing the built environment to promote better outcomes for individuals experiencing homelessness. She teaches graduate research methods courses and statistics, as well as health policy and social justice.