A Question of Housing? The Drug Pathways of Homeless Young People

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  • 1. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 A Question of Housing? The Drug Pathways of Homeless Young People Paula Mayock, School of Social Work and Social Policy & Children’s Research Centre, Trinity College Dublin pmayock@tcd.ie Mary-Louise Corr, School of Life, Sport and Social Sciences, Edinburgh Napier University M.Corr@napier.ac.uk
  • 2. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Acknowledgements  Young peoplewho have participated in the research.  Services and service providerswho have helped us to establish and maintain contact with the study’s young people.  Funders  Department of Children and Youth Affairs (DCYA): funding for Phase I of the research.  Dublin Region Homeless Executive (DRHE): funding for Phase II of the research.  DCYA & DRHE: funding for Phase III of the research.
  • 3. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug Use and Homelessness  The link has been documented in Ireland and elsewhere throughoutEurope (Avramov, 1998; Fountain & Howes, 2002; Neale, 2001; Winicup et al (2003), the US (Clatts et al., 1998; Greene et al., 1997), and Australia (Mallet et al., 2003).  However, despite striking similarities in the risk factors for homelessnessand substance misuse, the relationship between drug use and homelessness is extremely complex (Hutson & Liddiard,1994; Fitzpatrick et al., 2000; Neale, 2001).  This complexity creates a “doublejeopardy”(Neale, 2001), making young people moresusceptible to risk behaviour and ill-health.  Existing research has tended to focus on the direction of the relationship between drug use and homelessness, that is, on seeking to establish drug use as a cause or consequenceof homelessness.
  • 4. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug Use and Homelessness  It is increasing recognised that, even if drug use is present, it cannot be viewed in isolation of other experiences that culminate in a homeless experience (Neale, 2001).  Thus,one-dimensionalperspectives on the link between drug use and homelessness have been replaced by “an awareness of moresubtle and complex relationships”(Doherty& Stuttaford, 2007:247).  While the causal link between drug use and homelessness has attracted considerableresearch interest, much less attention has focused on the intersection of homeless and drug careers, particularly over time.
  • 5. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Overview of the Study  Longitudinal study of homeless young people in Dublin initiated in 2004 and conducted over a six-year period (three data sweeps).  Research set out to generate an in-depth understanding of the process of youth homelessness.  A key aim was to identify young people’s pathways or trajectories into, through and out of homelessness.  Informed by a pathways approach
  • 6. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Methodology Phase I (September 2004 – January 2005)  Life history interviews conducted with 40 homeless young people (23 males and 17 females)  Criteria: 1. Homeless or insecure accommodation 2. Between 14 and 22 years 3. Living in the Dublin metropolitan area for 6 months Phase II (September2005 – August 2006)  Tracking process  Information attained on the living situation of 37 of the 40 young people interviewed at Phase I.  Follow-up interviews were conducted with 30 young people (16 males and 14 females)
  • 7. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Phase I Phase II Phase III Young Men 23 16 15 Young Women 17 14 13 Total 40 30 28 Phase III (August 2009 – December 2010) Second tracking process Information attained on the living situation of 32 of the 40 young people interviewed at Phase I. Interviews were conducted with 28 young people, including 5 young people who were not interviewed at Phase II. Young People Interviewed over the Course of the Study
  • 8. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Sample Overview Age of Respondents,Phases I to III Phase I (2004-05): Aged 14 -22 years. Phase II (2005-06): Aged 15 - 24 years. Phase III (2009-10): Aged 18 - 27 years.
  • 9. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug Use and the Process of Young People Becoming Homeless Three Pathways ‘Into’ Homelessness Pathway I: Care History (40%) Pathway II: Household Instability and Family Conflict Pathway III: Negative Peer Associations and ‘Problem Behaviour’  Drug use did feature in the young people’slife stories.  Only 7 of the 40 young peoplehad not used an illegal drug at the time baseline interviews were conducted in 2004.  20 (13 young men and 7 young women) reported life time heroin use.  At Phase I, almost all (19) of the study’s heroin users acknowledged that their drug use was problematicto the degree that it had become a dependency.
  • 10. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug Use and the Process of Young People Becoming Homeless  Drug use was not identified as a discrete pathway ‘into’ homelessness’but was nonetheless sometimes implicated in the process of young people becoming homeless. “I was getting into troubleand taking drugs.I used to live with my Grandad when I was a kid. He died in 1996. After that, I don’treally know, you just start getting into trouble… I wouldn’tblameit on anyone but, I would blame it, like the peopleI used to hang around with used to take drugs… That’s the main reason I used to stay out, you know what I mean” (Declan, 19, P.1). “Therewas too much fighting going on in my housewith my Ma and me Da. They were too strict, fighting every single day, I couldn’thandleit, you know” (Declan, 19, P.1).  Challenging family dynamics moreinfluential than his personaldrug use in propellinghim into homelessness.
  • 11. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Young People’s Housing and Homeless Pathways  At Phase I, all of the young people were homeless or recently homeless.  By Phase II, a range of housing (as well as non-housing) transitions were reported.  Transitions to (more) stable housing were categorised as:  Independent Exits (family home, private rental sector accommodation) [n=7]  Dependents (transitional housing, state care) [n=10] (See Mayock et al., 2008; 2011)  Other young people remained homeless at Phase II [n=13]
  • 12. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 YOUNG PEOPLE’S HOUSING AND HOMELESS PATHWAYS, PHASES I, II, III PHASE I HOMELESS = 40 PHASE II (n=30) CONTINUED HOMELESSNESS = 13 EXIT HOMELESSNESS = 17 Ind. Exit = 7 Dep. Exit = 10 PHASE III (n=28) CONTINUED HOMELESSNESS = 13 EXIT HOMELESSNESS = 15 D.E. = 3Ind. Exit = 12 EXIT: N=17 HOMELESS: n=13 EXIT: N=15 HOMELESS: N=13
  • 13. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Young People’s Drug ‘Journeys’  Young peoplehad usually initiated drug use prior to first experience of homelessness.  Typical accounts locate the transition to serious or ‘heavy end’ drug use during the period following the first episode of homelessness.  Assessing whether drug use increased/decreased over time was complex: initiating new drugs,drug-taking practices, (repeated) engagementwith treatment services, (failed) attempts to ‘get clean’.  Drug use escalated for practically all of the young peopleas their ‘careers’ in homelessness progressed:this pattern was evident, even at Phase I.  Of the 15 who had exited at Phase III, all indicated that that their drug use followed an overall trend of reduced use.  All who remained homelessat Phases II and III continued to use drugs.
  • 14. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug and Homeless Pathways: The Case of Exiting Homelessness  Young people’snarratives of exiting homelessness and/or sustaining housing invariablyreferenced transition and changeacross a number of domainsof experience: education & training/dailyroutines/peer and family relationships.  All who reported ‘problem’drug usehad engaged in treatment, a transition which coincided with, rather than preceded, the move out of homelessness.  The move to stable housing emerged as a ‘turning point’that supported other positive transitions.  Housing conferred meaning that facilitated change across other domains. “When we got the house we kind of changed it around and said, ‘We have a housenow, we could kind of do something with our life … And just kind of maturity, kind of independent… We said, ‘Okay we have to kind of cop on [be responsible],like we’re living in a house now…” (Emma, 22, P.3).
  • 15. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug and Homeless Pathways: The Case of Exiting Homelessness  Critically, exiting homelessness was an incremental processwith risks attached.  Housing can be hard to maintain in cases were young peopleare struggling financially and/or recovering from a substance use problem. Sarah: Had exited homelessnessby P. 2 (living in family home), subsequently returned to homelessness, and was living in private rented accommodationby P.3. “I was in hostels for a while because of like using [heroin].So eventually, me and him [partner] got a rented place … and it was just, the drugsyou know, just spiralled out of controlreally … We ended up getting thrown out of that place ….” “I eventually then got locked up … I wanted to get locked up … I just couldn’tcope” “I’m here now(private rented apartment) .. I’m over the moon here.It’s amazing,it really is, it’s great like … The way things are at the moment… I genuinelyfeel I won’t go back on drugs[pause] because of [baby]. Because I just want to be in his life” (Sarah, 26, P.3)
  • 16. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug Use and Continued Homelessness  All who remained homelessby Phase III had progressed to heavier patterns of drug use and the vast majority had long since transitioned to injecting drug use.  Mostly male, they had spent years moving throughsystems (under-1s8 and adult) of emergency or crisis intervention,a trajectory which was set in motion early in their homeless ‘careers’.  Often by Phase II, and certainly by Phase III, all were heavily enmeshed in drug use and related criminalactivity.  By Phase III, 12 of the 13 who remained homeless had been incarcerated at some stage (often on multipleoccasions) and 5 were currently in prison. “I’ve just, I’ve be locked up an awful lot since then (referring to Phase 2 interview). About16 times since I last seen you” (Fergal, 23, P.3).
  • 17. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Drug Use and Continued Homelessness  The ‘doublejeopardy’of homelessness and drug use (Neale, 2001) is starkly apparentin their narratives over the course of the study.  Many had attempted to address the matter of their drug consumptionbutthese efforts were constantly hampered by the absence of a stable place to live. “They put peoplethat were strung out to bits, using needles, and then they put like clean peoplein that’s trying to get clean and then … peoplethat are on drugsor whatever, they start selling drugsand you’reonly after coming off them and the temptation is too much ‘cos it’s right there where you’reliving like. It’s in your sitting room literally, where you’regetting your dinner” (Colm, 25, P.3).  Most who remained homeless viewed drug use as virtually inevitable, bound of in the wider experiences of accessing the most unstable accommodationtypes. “It’s [heroin] a fuckin’ horribledrug.I need it now to survive every day. I wouldn’tbe able to do other things.I need gear to actually do what I have t do duringthe day” (Fergal,19, P.2)
  • 18. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Conclusion: A Question of Housing?  Access to stable housing:a ‘turning point’experiencefor young peopleand a strong enabler to reducing,or abstaining from, drug use. Housing enabled young peopleto engagewith drug treatment and maintain a regime of abstinence (Mayock & Corr,2012).  Housing conferred meaningsthat supported transition and change across other domains(education,training,family and peer relationships). In this sense, home had broader meaning than simply providing shelter (Dyb, 2009).  The importanceof speedy exits from homelessness: young men in particular had spent years navigating a system of emergencyprovision (Mayock et al., 2013).  Stable housingis increasinglyrecognised as an essential prerequisiteto effective drug treatment outcomes (FEANTSA,2010; Somers et al., 2008; Zeger, 2012).  Housing alonenot sufficient, particularly for young peoplewith complexhistories and needs: the importanceof ‘housingsupport’(Jones and Pleace, 2010; Quilgars et al., 2008) following the move to stable accommodation.
  • 19. EUROPEAN RESEARCH CONFERENCE Housing First. What’s Second? Berlin, 20th September 2013 Relevant Publications  Mayock, P., Corr, M.L. & O’Sullivan, E. (2013)Moving on, not out: When young people remain homeless. Journalof Youth Studies, 16,(4), 2013,p441 – 459  Mayock, P. & Corr, M.L., Young People's Homeless and Housing Pathways:Key Findings from a Six-yearQualitaitve LongitudinalStudy,Dublin, Department of Children and Youth Affairs,2013  Mayock, P., Corr, M.L. & O’Sullivan, E. (2012)Young People Exiting Homelessness:The Role of Family Supportin, editor(s)Lynch,D. and Burns, K. , Children’sRightsand ChildProtection: CriticalTimes,CriticalIssuesin Ireland,Manchester, Manchester University Press.,2012,pp184 – 201.  Mayock, P. & Corr, M.L. (2012)The meaning of drug use among homeless young people:A longitudinal pathways analysis in, editor(s)M. Wouters,J. Fountain & D.J. Korf , The Meaning of High:Variations According to Drug,Set, Setting and Time,Berlin, Pabst Science Publishers, 2012,pp132– 148.  Mayock, P., Corr, M.L. and E.O'Sullivan, Homeless young people,families and change: family supportas a facilitator to exiting homelessness, Child and Family SocialWork,16, (4), 2011,p391 – 401.  Mayock, P., E.O'Sullivan and M.L. Corr, Young People Exiting Homelessness:An Exploration of Process,Meaning and Definition, Housing Studies,26,(6), 2011,p803 – 826.  Mayock, P., Corr, M.L. & O'Sullivan (2008) Young People'sHomelessPathways,Dublin, The Homeless Agency.  Mayock, P. O'Sullivan, E. (2007) Livesin Crisis:Homeless Young Peoplein Dublin.Dublin:The Liffey Press. , Dublin, The LiffeyPress.