Bedard, C., Drummond, C., Ricciardi, J., & Husband, F. (2003). Community Women’s Circle: A partnership program developed to connect and serve homeless, poor and socially marginalized women with developmental disabilities . Journal of Developmental Disabilities, 10(1), 55–59.
Brown, M., & McCann, E. (2021). Homelessness and people with intellectual disabilities: A systematic review of the international research evidence. Journal of Applied Research in Intellectual Disabilities, 34(2), 390–401. https://10.1111/jar.12815
Background
People with intellectual disabilities can experience homelessness, and some of the reasons differ from the general homeless population. Specific policy and practice responses are required.
Method
A systematic review of studies examining homelessness among people with intellectual disabilities utilizing CINAHL, MEDLINE, PsycINFO and Sociological s databases from inception to November 2019.
Results
The search produced 259 papers, and following screening, a total of 13 papers were included in the review. The themes identified were (i) pathways into homelessness, (ii) experiencing homelessness and (iii) routes out of homelessness.
Conclusions
People with ID become homeless due to multifactorial issues. The identification of people within homeless services and their care and support concerns remains challenging, impacting upon the provision of assessments, interventions, care and supports. Psychosocial assessments, interventions and supports are necessary to assist people with ID to leave homelessness.
Durban, A., Isaacs, B., Mauer-Vakil, D., Connelly, J., Steer, L., Roy, S., & Stergiopoulos, V. (2018). Intellectual Disability and Homelessness: a Synthesis of the Literature and Discussion of How Supportive Housing Can Support Wellness for People with Intellectual Disability. Current Developmental Disorders Reports, 5, 125–131. https://10.1007/s40474-018-0141-6
Lamanna, D., Lunsky, Y., Wen, S., Dubois, D., & Stergiopoulos, V. (2020). Supporting Efforts by Intellectually Disabled Adults to Exit Homelessness: Key Ingredients of a Cross-Sector Partnership. Psychiatric Services (Washington, D.C.), 71(1), 96–99. https://10.1176/appi.ps.201800590
This column describes the development of a partnership between health care, housing, and intellectual disability services to support efforts by homeless adults with intellectual disabilities to exit homelessness. Applying a Housing First approach and philosophy, the partners launched a pilot intervention, which at its first phase engaged 26 homeless adults with intellectual disabilities in Toronto. This cross-sector service model was acceptable to service users, who reported positive experiences and good program engagement. Key enablers of success included the program’s capacity to address complexity, stakeholders’ approach to choice and compromise, and fulsome collaboration and communication at every level.
Lougheed, D. C., & Farrell, S. (2013). The challenge of a “triple diagnosis”: Identifying and serving homeless Canadian adults with a dual diagnosis. Journal of Policy and Practice in Intellectual Disabilities, 10(3), 230–235.
MacNeil, F., & Roy, S. (2017). Final Report to Housing Task Force.
McKenzie, K., Murray, G., Metcalfe, D., Robson, R., Kaczmar, M., & Shirley, A. (2023). Using the learning disability screening questionnaire to help identify people with an intellectual disability in homeless services. Journal of Applied Research in Intellectual Disabilities, 36(6), 1319–1325. https://10.1111/jar.13150
Background
We explored the accuracy of using the learning disability screening questionnaire (LDSQ) in services for people experiencing homelessness in the United Kingdom.
Method
We examined the concordance between the LDSQ outcomes and assessments of intellectual disability. Seventy adults experiencing homelessness completed the LDSQ. Staff completed the LDSQ and a measure of adaptive functioning for 38 of this group. Nine participants received an intellectual assessment.
Results
Sensitivity and specificity for the LDSQ when completed by staff was 83% and 96% respectively and 50% and 92% when completed by the individual. Seven people had intellectual and adaptive functioning in the intellectual disability range.
Conclusion
The results suggest that the LDSQ would be an appropriate and beneficial screening tool to use within services for people experiencing homelessness. More accurate results would be likely if it were completed by staff.
McKenzie, K., Murray, G., Wilson, H., & Delahunty, L. (2019). Homelessness—‘It will crumble men’: The views of staff and service users about facilitating the identification and support of people with an intellectual disability in homeless services. Health & Social Care in the Community, 27(4), e514–e521. https://10.1111/hsc.12750
People with an intellectual disability (ID) face significant health inequalities and barriers to accessing appropriate support, which are made worse if the person is also homeless. An important barrier is that services may not recognise that the person has ID. This qualitative study explored the views of staff members and service users about the identification and support needs of homeless people with ID and the role of an ID screening questionnaire as a way to help improve service provision. Semi‐structured interviews were conducted with 16 staff members and 8 service users from homeless services in the South East of Scotland between March 2017 and 2018. Thematic analysis identified four themes: ‘not diagnosed or declared’, which explored the barriers to support due to the person’s ID not being identified by others or disclosed by the person; ‘It will crumble men’, which reported on the additional challenges faced by homeless people with ID; ‘disabling environment’ which identified the ways in which organisations can make support difficult for people with ID to access; and ‘It’s not against them, it’s to help them’ which explored the benefits and issues associated with screening for ID in homeless services. The results identified the complex support needs likely to be experienced by many homeless people with ID and suggested a number of implications for practice. First, the screening tool was seen as having a number of benefits, if used where there is a process to provide the person with further specialist assessment and support. Second, staff members identified a need for training in relation to identifying and supporting this group of people. Third, the screening tool was seen as a way to help provide information about the prevalence and needs of people with ID, in order to inform and shape policy, service development, and delivery.
Mercier, C., & Picard, S. (2011). Intellectual disability and homelessness. Journal of Intellectual Diability Reserach, 55(4), 441–449. https://10.1111/j.1365-2788.2010.01366.x
Metcalfe, D., McKenzie, K., Murray, G., & Shirley, A. (2024). “It does change the narrative for health and social care” views of clinical and homeless service staff about the use of intellectual disability screening tools within homeless support pathways in the north of England. Journal of Policy and Practice in Intellectual Disabilities, 21(3), n/a. https://10.1111/jppi.12522
Homelessness is a worldwide health inequality. People with intellectual disability represent a relatively high proportion of homeless people, and for many their intellectual disability is not recognised. The study intended to obtain stakeholder views about how intellectual disability screening can be integrated into the support pathway for people who are homeless. A qualitative approach was taken using Thematic Analysis. Nine staff, who work with homeless people or are involved in the intellectual disability assessment pathway, were interviewed. Analysis produced three themes, each containing two subthemes. ‘Current routes to support’ investigates experiences of the existing pathway; ‘Labels’, explores views about making intellectual disability visible; ‘Creating a pathway,’ outlines ideas about developing and implementing a screening pathway between services. The results help inform how current practices of identifying people with intellectual disability might be improved and the role of screening in this. These results, when combined with other research around screening tools, provide insight into how intellectual disability screening can be integrated within services.
Morton, L., G., & Cunningham-Williams, R. M. (2009). The capacity to give informed consent in a homeless population with developmental disabilities. Community Mental Health Journal, 45, 341–348. https://10.1007/s10597-009-9184-9
O’Donovan, M., Lynch, E., O’Donnell, L., Kelly, &., & Kathyan. (2020). The experience and risk of homelessness for people with intellectual disabilities and/or autism and their families in Dublin. A mixed methods study.
This research is a small mixed methods study that explores the experiences of people with ID and/or ASD experiencing homelessness or homelessness risk. It uses a single Service Provider in Dublin, the Daughters of Charity Disability Support Services (DOCDSS) and elicits views of staff, and service users and their families.
Oakes, P. M., & Davies, R. C. (2008). Intellectual disability in homeless adults
A prevalance study. Journal of Intellectual Disabilities, 12(4), 325–334. https://10.1177/1744629508100496
O’Donovan, M., Lynch, E., O’Donnell, L., & Kelly, K. (2024). Homelessness—The perspectives of people with intellectual disability and/or Autistic spectrum disorder and their families. Journal of Policy and Practice in Intellectual Disabilities, 21(3), n/a. https://10.1111/jppi.12519
People with intellectual disability (ID) and/or autism spectrum disorder (ASD) are over‐represented in the homelessness population. A lack of available and suitable social housing leads to an over‐reliance on a private rental market where high rents are prevalent. Yet, people with ID and/or ASD, are more at risk of living in poverty and as such excluded from the private rental market. The current study reports on the lived experience of homelessness for a sample of people with ID and/or ASD and families supporting adult /children with ID/ASD. Their stories illuminate the complexity and challenges in securing a stable, safe and secure home.
Reid, N., Kron, A., Lamanna, D., Wen, S., Durbin, A., Rajakulendran, T., Lunsky, Y., Roy, S., Dubois, D., & Stergiopoulos, V. (2021). Building Bridges to Housing for homeless adults with intellectual and developmental disabilities: outcomes of a cross‐sector intervention. Journal of Applied Research in Intellectual Disabilities, 34(1), 16. https://10.1111/jar.12779
Background
Adults with intellectual and developmental disabilities (IDD) have high rates of homelessness. This observational study evaluates Bridges to Housing, a cross-sector intervention offering immediate access to housing and supports to this population in Toronto, Canada.
Methods
Twenty-six participants, enrolled between April 2016 and December 2017, were assessed at baseline, six and 12 months post-enrolment. Descriptive statistics and generalized linear modelling evaluated quality of life (QOL) and service needs outcomes. Twenty-one service users and providers participated in semi-structured interviews between August 2017 and June 2018 to elicit their experiences of the intervention, which were analysed thematically.
Results
Twelve months post-enrolment, 24 participants were successfully housed and reported increased QOL scores (F(2,43) = 13.73, p = <.001) and decreased perceived unmet service needs (Wald χ 2 (2) = 12.93, p = .002). Individual-, intervention, and system-level characteristics facilitated housing stability in this population. Conclusions: Cross-sector approaches can improve outcomes for homeless adults with IDD and may have an important role in supporting this marginalized population.
Roberts, J. A., & Mohan, A. (2023). Housing in Delaware for the Intellectual and Developmental Disabilities Population. Delaware Journal of Public Health, 9(2), 30–33. https://10.32481/djph.2023.06.007
Individuals with intellectual and developmental disabilities (IDD) encounter numerous barriers in attempting to access housing. Those barriers – financial, physical, and cultural in nature – have been exacerbated by the COVID-19 public health emergency and the related, or co-occurring, shifts that have characterized the housing market in the United States, and Delaware specifically, over these last three years. In this brief introductory research report, we examine the system of housing supports and their availability to individuals with IDD through a subset of those served by the state’s Division of Developmental Disabilities Services through interviews with representatives across the housing support system. Our findings fall into four areas of work: scale and scope; housing availability; housing assistance; and housing supports. We find that: the estimated scale of the housing crisis (in terms of homelessness and insecurity) affecting this population is much greater than the general population, but in line with other national estimates for individuals with IDD; there is limited available housing that is accessible to individuals with IDD available in the state; there is limited assistance available for navigating the housing that might be available; and that there are too few options for providing more supports for individuals living, or trying to live, independently. We conclude with a few suggested recommendations that could provide more reliable data and tracking of need and a call for research that connects housing for individuals with IDD into the growing body of research looking at the relationship between access to housing and health.Individuals with intellectual and developmental disabilities (IDD) encounter numerous barriers in attempting to access housing. Those barriers – financial, physical, and cultural in nature – have been exacerbated by the COVID-19 public health emergency and the related, or co-occurring, shifts that have characterized the housing market in the United States, and Delaware specifically, over these last three years. In this brief introductory research report, we examine the system of housing supports and their availability to individuals with IDD through a subset of those served by the state’s Division of Developmental Disabilities Services through interviews with representatives across the housing support system. Our findings fall into four areas of work: scale and scope; housing availability; housing assistance; and housing supports. We find that: the estimated scale of the housing crisis (in terms of homelessness and insecurity) affecting this population is much greater than the general population, but in line with other national estimates for individuals with IDD; there is limited available housing that is accessible to individuals with IDD available in the state; there is limited assistance available for navigating the housing that might be available; and that there are too few options for providing more supports for individuals living, or trying to live, independently. We conclude with a few suggested recommendations that could provide more reliable data and tracking of need and a call for research that connects housing for individuals with IDD into the growing body of research looking at the relationship between access to housing and health.
Roy, S., Svoboda, T., Issacs, B., Budin, R., Sidhu, A., Biss, R. K., Lew, B., & Connelly, J. (2020). Examining the cognitive and mental health related disability rates among the homeless: Policy implications of changing the definition of disability in Ontario. Canadian Psychology/Psychologie Canadienne, 61(2), 118–126.
Spence, S., Stevens, R., & Parks, R. (2004). Cognitive dysfunction in homeless adults: a systematic review. Journal of the Royal Society of Medicine, 97, 375–379.
Van Straaten, B., Rodenburg, G., Van de Laan, J., Boersma, S. N., Wolf, J., R.L.M., & Van de Mheen, D. (2017). Self-reported care needs of Dutch homeless people with and without a suspected intellectual disability: a 1.5-year follow-up study. Health & Social Care in the Community, 25(1), 123. https://10.111/hsc.12287
Van Straaten, B., Schrijvers, C. T. M., Van de Laan, J., Boersma, S. N., Rodenburg, G., Wolf, J., R.L.M., & Van de Mheen, D. (2014). Intellectual Disability among Dutch Homeless People: Prevalance and Related Psychosocial Problems. Plos One, 9(1), 1.
