title: Lost points of intervention in pathways to single adult homelessness in Hamilton, New Zealand

authors: McMinn, Carole Ann

subjects: Homeless

abstract: Homelessness is a serious problem in New Zealand, with many social, health, human rights, and economic ramifications. Despite a broad consensus in international literature about contributing factors which raise the risk of homelessness, many misconceptions still remain about which specific factors contribute to homelessness in New Zealand. This is in part because of limited research in this context. Many policy responses to homelessness in New Zealand focus on a person’s need for adequate housing as this is the prime presenting issue.  However, people often have complex existing background issues that also contributed, and these are equally important targets for policy responses to homelessness. 

Those who are single adults, without dependent children and homeless are often those found living in the most precarious circumstances. This cohort were the focus of this research. The objectives of this research were to determine pathways to single adult homelessness in Hamilton, New Zealand and to consider what other contributing factors and trigger events raised the risk of single adult homelessness. Robust objective quantitative and qualitative research into these contributors and triggers of homelessness is necessary to improve homelessness intervention. Further, recommendations about points of intervention were sought from those with the most knowledge about homelessness, those with lived experience. 

This research included structured questionnaires completed with 100 participants who were program participants engaged with a homeless service in Hamilton, New Zealand. Additional detailed qualitative narrative was collected by semi-structured interviews with 11 participants. One-on-one feedback interviews were conducted with six participants. A mixed method approach netted a rich and diverse body of data about single adult homelessness in Hamilton and provided for the collection of robust evidence about important points and means of intervention and prevention. 

Although everyone’s circumstances were unique, results revealed a series of commonly occurring disruptive events throughout participants’ lifetimes. A very high prevalence of adverse childhood events had resulted in an early exit from home for most participants, and time spent in state care. Instability in childhood had led to disruption, or exclusion, from schooling. Early disruption of social networks resulted in participants being isolated from natural familial and kinship support at critical points. Problematic substance use and mental health issues were common, often resulting in early institutionalization. These health and wellbeing issues had lifelong effects. 

Structural issues exacerbated circumstances for people. Participants lacked access to safe, affordable single-person private rental and public housing. Additionally, people experienced discrimination in their efforts to find housing. Participants had constrained incomes, most receiving welfare support, which further limited housing options in times of crisis. Many had high debt, particularly owed to government departments. Participants who sustained active relationships with government agencies and other organizations did not find these relationships to be a protective factor against homelessness. People sought the help of a homeless service because they felt they had nowhere else to turn. 

Participants’ recommendations provided important implications for policy responses to homelessness. A targeted reduction in family violence was advocated as a prevention opportunity.  Detecting, and supporting, those who have survived adverse childhood events was also seen as a critical point of intervention. Trauma-informed approaches to social sector support would help reduce negative assumptions and victim blaming. Social sectors were also described as needing to be supported to eliminate discrimination. 

Additional measures were advocated to prevent formerly homeless individuals returning to homelessness.  This included support to facilitate access to a home (not a room), with comprehensive support to help people maintain this tenancy. Support to attend to background issues was also advocated. Facilitated access to work (where desired) was recommended as one mechanism to help reduce high levels of debt, particularly institutional debt. The absence of important familial and kinship networks to help provide support to access housing and other resources at critical points was a key factor participants identified as raising the risk of them becoming homeless. Therefore, alternative support mechanisms, such as homeless services like The People’s Project, were advocated.

text: Lost points of intervention in pathways to single adult homelessness in Hamilton, New Zealand Homelessness is a serious problem in New Zealand, with many social, health, human rights, and economic ramifications. Despite a broad consensus in international literature about contributing factors which raise the risk of homelessness, many misconceptions still remain about which specific factors contribute to homelessness in New Zealand. This is in part because of limited research in this context. Many policy responses to homelessness in New Zealand focus on a person’s need for adequate housing as this is the prime presenting issue.  However, people often have complex existing background issues that also contributed, and these are equally important targets for policy responses to homelessness. 

Those who are single adults, without dependent children and homeless are often those found living in the most precarious circumstances. This cohort were the focus of this research. The objectives of this research were to determine pathways to single adult homelessness in Hamilton, New Zealand and to consider what other contributing factors and trigger events raised the risk of single adult homelessness. Robust objective quantitative and qualitative research into these contributors and triggers of homelessness is necessary to improve homelessness intervention. Further, recommendations about points of intervention were sought from those with the most knowledge about homelessness, those with lived experience. 

This research included structured questionnaires completed with 100 participants who were program participants engaged with a homeless service in Hamilton, New Zealand. Additional detailed qualitative narrative was collected by semi-structured interviews with 11 participants. One-on-one feedback interviews were conducted with six participants. A mixed method approach netted a rich and diverse body of data about single adult homelessness in Hamilton and provided for the collection of robust evidence about important points and means of intervention and prevention. 

Although everyone’s circumstances were unique, results revealed a series of commonly occurring disruptive events throughout participants’ lifetimes. A very high prevalence of adverse childhood events had resulted in an early exit from home for most participants, and time spent in state care. Instability in childhood had led to disruption, or exclusion, from schooling. Early disruption of social networks resulted in participants being isolated from natural familial and kinship support at critical points. Problematic substance use and mental health issues were common, often resulting in early institutionalization. These health and wellbeing issues had lifelong effects. 

Structural issues exacerbated circumstances for people. Participants lacked access to safe, affordable single-person private rental and public housing. Additionally, people experienced discrimination in their efforts to find housing. Participants had constrained incomes, most receiving welfare support, which further limited housing options in times of crisis. Many had high debt, particularly owed to government departments. Participants who sustained active relationships with government agencies and other organizations did not find these relationships to be a protective factor against homelessness. People sought the help of a homeless service because they felt they had nowhere else to turn. 

Participants’ recommendations provided important implications for policy responses to homelessness. A targeted reduction in family violence was advocated as a prevention opportunity.  Detecting, and supporting, those who have survived adverse childhood events was also seen as a critical point of intervention. Trauma-informed approaches to social sector support would help reduce negative assumptions and victim blaming. Social sectors were also described as needing to be supported to eliminate discrimination. 

Additional measures were advocated to prevent formerly homeless individuals returning to homelessness.  This included support to facilitate access to a home (not a room), with comprehensive support to help people maintain this tenancy. Support to attend to background issues was also advocated. Facilitated access to work (where desired) was recommended as one mechanism to help reduce high levels of debt, particularly institutional debt. The absence of important familial and kinship networks to help provide support to access housing and other resources at critical points was a key factor participants identified as raising the risk of them becoming homeless. Therefore, alternative support mechanisms, such as homeless services like The People’s Project, were advocated.

year: 2021

title: Health and place in historical perspective: medicine, ethnicity, and colonial identities

authors: Coleborne, Catharine

abstract: Introduction to special issue. This Special Issue includes articles ﬁrst presented as papers at a two-day symposium held at the University of Waikato, New Zealand, in February 2011. The event was designed to highlight a large Royal Society of New Zealand Marsden-funded research project, and to showcase current scholarly work in the ﬁeld of the colonial and postcolonial histories of medicine, with a focus on histories of insanity. We also included the themes of medical migration in New Zealand’s national history, the movement of medical ideas and personnel across empire, a close study of the uses of the term ‘neurasthenia’ in French-colonial Vietnam, and the relationship between place, plants, and health across South Asia and Australia in the nineteenth century.

text: Health and place in historical perspective: medicine, ethnicity, and colonial identities Introduction to special issue. This Special Issue includes articles ﬁrst presented as papers at a two-day symposium held at the University of Waikato, New Zealand, in February 2011. The event was designed to highlight a large Royal Society of New Zealand Marsden-funded research project, and to showcase current scholarly work in the ﬁeld of the colonial and postcolonial histories of medicine, with a focus on histories of insanity. We also included the themes of medical migration in New Zealand’s national history, the movement of medical ideas and personnel across empire, a close study of the uses of the term ‘neurasthenia’ in French-colonial Vietnam, and the relationship between place, plants, and health across South Asia and Australia in the nineteenth century.

year: 2012

title: Observations by and conversations with health workers and hospital personnel involved in transferring Maori patients and whānau to Waikato Hospital in Aotearoa New Zealand

authors: Masters-Awatere, Bridgette

subjects: Science & Technology

abstract: The predominant focus of Aotearoa New Zealand’s public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. Hospital staff involved in transfers to one of New Zealand’s trauma centers share their observations of whānau Māori engagement during an admission away from their home base. Sixteen key informants share their experiences, which are presented as strategies and challenges to whānau engagement. Three main themes highlight challenges within the health system that make it difficult for hospital staff to engage whānau in the desired ways and as often as both parties would like. Key informants described services and practices that are not designed with patients and their whānau in mind; instead they are designed by clinicians around the needs of administrative systems. As employees within the public health system, key informants felt powerless to challenge dominant settings. Nevertheless, employees managed to circumnavigate processes. Our findings highlight the need for continued decolonization and anti-racism work within public health settings.

text: Observations by and conversations with health workers and hospital personnel involved in transferring Maori patients and whānau to Waikato Hospital in Aotearoa New Zealand The predominant focus of Aotearoa New Zealand’s public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. Hospital staff involved in transfers to one of New Zealand’s trauma centers share their observations of whānau Māori engagement during an admission away from their home base. Sixteen key informants share their experiences, which are presented as strategies and challenges to whānau engagement. Three main themes highlight challenges within the health system that make it difficult for hospital staff to engage whānau in the desired ways and as often as both parties would like. Key informants described services and practices that are not designed with patients and their whānau in mind; instead they are designed by clinicians around the needs of administrative systems. As employees within the public health system, key informants felt powerless to challenge dominant settings. Nevertheless, employees managed to circumnavigate processes. Our findings highlight the need for continued decolonization and anti-racism work within public health settings.

year: 2020