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Cohort study amongst homeless people in
   Amsterdam, The Hague, Rotterdam and
                                Utrecht

                                    Onderzoekscentrum maatschappelijke zorg
                                “gedreven door kennis, bewogen door mensen”

                  Jorien van der Laan, Marjolein Maas and Judith Wolf
                                          Research centre for social care
                  In collaboration with IVO Addiction Research Institute

            EUROPEAN RESEARCH CONFERENCE
      Homelessness, Migration and Demographic Change in
                           Europe
Onderzoekscentrum maatschappelijke zorg




Overview
•   Introduction
•   Background
•   Aims
•   Method
    •   Participants
    •   Procedure                         Onderzoekscentrum maatschappelijke zorg
    •   Measures                      “gedreven door kennis, bewogen door mensen”

•   Results
•   State of the art


                  EUROPEAN RESEARCH CONFERENCE
            Homelessness, Migration and Demographic Change in
                                 Europe
Onderzoekscentrum maatschappelijke zorg




     Introduction - Research team
                       Research centre for social care




Jorien van der Laan,MSc.        Dr. Marjolein Maas            Prof. Dr. Judith Wolf

                          IVO Addiction Research Institute maatschappelijke zorg
                                         Onderzoekscentrum
                                          “gedreven door kennis, bewogen door mensen”




Barbara van Straaten, Msc. Dr. Carola Schrijvers              Prof. Dr. Dike van de Mheen

                      EUROPEAN RESEARCH CONFERENCE
                Homelessness, Migration and Demographic Change in
                                     Europe
Onderzoekscentrum maatschappelijke zorg




Introduction

Longitudinal cohort study

Do homeless people benefit from a person centered
   approach?

Why (not)?                              Onderzoekscentrum maatschappelijke zorg
                                    “gedreven door kennis, bewogen door mensen”


Issued and subsidised by the Ministry of Health, Well-
   being, and Sport.

                EUROPEAN RESEARCH CONFERENCE
          Homelessness, Migration and Demographic Change in
                               Europe
Onderzoekscentrum maatschappelijke zorg




Background
The Dutch government and the 4 largest cities kicked off
the Strategy Plan for Social Relief.

Aim:
• To improve the situation of homeless people;
• To reduce nuisance caused by this group.
                                         Onderzoekscentrum maatschappelijke zorg
                                     “gedreven door kennis, bewogen door mensen”
By:
• Person-oriented approach with individual assistance
    programmes;
• A sound chain approach of all collaborating parties.
                 EUROPEAN RESEARCH CONFERENCE
           Homelessness, Migration and Demographic Change in
                                Europe
Onderzoekscentrum maatschappelijke zorg




Background

Annual monitor (Maas & Planije, 2009):
• Homeless people off the streets;
• People receive (integral) care;
• Nuisance reduced.

                                        Onderzoekscentrum maatschappelijke zorg
                                    “gedreven door kennis, bewogen door mensen”

Does it work from clients’ perspectives?



                EUROPEAN RESEARCH CONFERENCE
          Homelessness, Migration and Demographic Change in
                               Europe
Onderzoekscentrum maatschappelijke zorg




Aims
Getting more insight into;
• The needs and urges of homeless people;

•   (Predictors of) improvements in the quality of life;

•   Housing transitions as well as possible predictors of stable
       housing;                   Onderzoekscentrum maatschappelijke zorg
                                       “gedreven door kennis, bewogen door mensen”

•   Perceived benefits of the Strategy Plan for Social Relief from
       perspective of homeless people


                   EUROPEAN RESEARCH CONFERENCE
             Homelessness, Migration and Demographic Change in
                                  Europe
Onderzoekscentrum maatschappelijke zorg




Method - partcipants

Homeless people
• 500 homeless people;
• Eighteen years or above;
• All actually homeless or temporarily housed;
• Registered at a central access point in Amsterdam,
                                Onderzoekscentrum maatschappelijke zorg
  Rotterdam, The Hague or Utrecht. kennis, bewogen door mensen”
                            “gedreven door


Social workers
• Closest to the respondents

                  EUROPEAN RESEARCH CONFERENCE
            Homelessness, Migration and Demographic Change in
                                 Europe
Onderzoekscentrum maatschappelijke zorg




Method - procedure
Homeless people
Structured interviews

People who are registered at
   a central access point

•   Baseline (T0)                        Onderzoekscentrum maatschappelijke zorg
                                     “gedreven door kennis, bewogen door mensen”
•   After 6 months (T1)
•   After 18 months (T2)
•   After 30 months (T3)


                 EUROPEAN RESEARCH CONFERENCE
           Homelessness, Migration and Demographic Change in
                                Europe
Onderzoekscentrum maatschappelijke zorg




Method - procedure
Homeless people                          Social workers
Structured interviews                    An internet questionnaire


People who are registered at             Identified by the homeless
   a central access point                people


•   Baseline (T0)                        Onderzoekscentrum maatschappelijke zorg
                                     “gedreven door kennis, bewogen door mensen”
•   After 6 months (T1)                  •After 6 months (T1)
•   After 18 months (T2)                 •After 18 months (T2)
•   After 30 months (T3)


                 EUROPEAN RESEARCH CONFERENCE
           Homelessness, Migration and Demographic Change in
                                Europe
Onderzoekscentrum maatschappelijke zorg




Method - measures

Homeless people
• Quality of life
• Housing
• Work alliance
• Health & addiction                   Onderzoekscentrum maatschappelijke zorg
                                   “gedreven door kennis, bewogen door mensen”
• Goals and motivation
• Improvements in life



               EUROPEAN RESEARCH CONFERENCE
         Homelessness, Migration and Demographic Change in
                              Europe
Onderzoekscentrum maatschappelijke zorg




Method - measures

Homeless people                      Social workers
• Quality of life                    •Quality of life
• Housing                            •Housing
• Work alliance                      •Work alliance
• Health & addiction                   Onderzoekscentrum maatschappelijke zorg
                                   “gedreven door kennis, bewogen door mensen”
• Goals and motivation
• Improvements in life



               EUROPEAN RESEARCH CONFERENCE
         Homelessness, Migration and Demographic Change in
                              Europe
Onderzoekscentrum maatschappelijke zorg




Results
Insight into:
• subgroups and risk profiles;
• housing transitions;
• changes in life domains.

Information about predictors ofOnderzoekscentrum and stable zorg
                                quality of life maatschappelijke
                            “gedreven door kennis, bewogen door mensen”
    housing.

Experiences of homeless people with the person centered
   approach.
                  EUROPEAN RESEARCH CONFERENCE
            Homelessness, Migration and Demographic Change in
                                 Europe
Onderzoekscentrum maatschappelijke zorg




Results
Implementation

Further development of the person centered approach.
In close collaboration with:
• homeless people;
• Fieldworkers;                  Onderzoekscentrum maatschappelijke zorg
                             “gedreven door kennis, bewogen door mensen”
• policy makers.




                  EUROPEAN RESEARCH CONFERENCE
            Homelessness, Migration and Demographic Change in
                                 Europe
Onderzoekscentrum maatschappelijke zorg




State of the art



Baseline measures (T0)

First follow-up interviews (T1)
                                          Onderzoekscentrum maatschappelijke zorg
                                      “gedreven door kennis, bewogen door mensen”




                  EUROPEAN RESEARCH CONFERENCE
            Homelessness, Migration and Demographic Change in
                                 Europe
Onderzoekscentrum maatschappelijke zorg




State of the art
What is your most important goal for the coming 6 months?

 General quality of life                                                   2
 Housing                                                                  59
 Study & work                                                             19
 Depts & Income                                                            9
 Physical health                                                      2
                                           Onderzoekscentrum maatschappelijke zorg
 Addiction                             “gedreven door kennis, bewogen 2
                                                                      door mensen”

 Psychological well-being                                                  6
 Intimate relationship                                                     5
 Children                                                                  7

                   EUROPEAN RESEARCH CONFERENCE
             Homelessness, Migration and Demographic Change in
                                  Europe
Onderzoekscentrum maatschappelijke zorg




State of the art
“I want a house of my own with a garden and a cat.”

“I would really like to have my own room or apartment,
    even a small room would do, and as soon as possible.
    Because for people like me (without addiction or
    psychological problems), the longer it takes, the bigger
                                  Onderzoekscentrum maatschappelijke zorg
    the chance you will relapse.”
                              “gedreven door kennis, bewogen door mensen”


“I want to live on my own with support nearby.”


                   EUROPEAN RESEARCH CONFERENCE
             Homelessness, Migration and Demographic Change in
                                  Europe
Contact

                                              orien van der Laan



                                                 31243610790



                                                  arjolein Maas
                                    Onderzoekscentrum maatschappelijke zorg
                                “gedreven door kennis, bewogen door mensen”


                                                  3124368448



            EUROPEAN RESEARCH CONFERENCE
      Homelessness, Migration and Demographic Change in
                           Europe

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The Homeless’ Perspective on Quality of Life and Housing: a Cohort Study amongst Homeless People in four Cities in the Netherlands

  • 1. Cohort study amongst homeless people in Amsterdam, The Hague, Rotterdam and Utrecht Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Jorien van der Laan, Marjolein Maas and Judith Wolf Research centre for social care In collaboration with IVO Addiction Research Institute EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 2. Onderzoekscentrum maatschappelijke zorg Overview • Introduction • Background • Aims • Method • Participants • Procedure Onderzoekscentrum maatschappelijke zorg • Measures “gedreven door kennis, bewogen door mensen” • Results • State of the art EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 3. Onderzoekscentrum maatschappelijke zorg Introduction - Research team Research centre for social care Jorien van der Laan,MSc. Dr. Marjolein Maas Prof. Dr. Judith Wolf IVO Addiction Research Institute maatschappelijke zorg Onderzoekscentrum “gedreven door kennis, bewogen door mensen” Barbara van Straaten, Msc. Dr. Carola Schrijvers Prof. Dr. Dike van de Mheen EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 4. Onderzoekscentrum maatschappelijke zorg Introduction Longitudinal cohort study Do homeless people benefit from a person centered approach? Why (not)? Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Issued and subsidised by the Ministry of Health, Well- being, and Sport. EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 5. Onderzoekscentrum maatschappelijke zorg Background The Dutch government and the 4 largest cities kicked off the Strategy Plan for Social Relief. Aim: • To improve the situation of homeless people; • To reduce nuisance caused by this group. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” By: • Person-oriented approach with individual assistance programmes; • A sound chain approach of all collaborating parties. EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 6. Onderzoekscentrum maatschappelijke zorg Background Annual monitor (Maas & Planije, 2009): • Homeless people off the streets; • People receive (integral) care; • Nuisance reduced. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Does it work from clients’ perspectives? EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 7. Onderzoekscentrum maatschappelijke zorg Aims Getting more insight into; • The needs and urges of homeless people; • (Predictors of) improvements in the quality of life; • Housing transitions as well as possible predictors of stable housing; Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” • Perceived benefits of the Strategy Plan for Social Relief from perspective of homeless people EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 8. Onderzoekscentrum maatschappelijke zorg Method - partcipants Homeless people • 500 homeless people; • Eighteen years or above; • All actually homeless or temporarily housed; • Registered at a central access point in Amsterdam, Onderzoekscentrum maatschappelijke zorg Rotterdam, The Hague or Utrecht. kennis, bewogen door mensen” “gedreven door Social workers • Closest to the respondents EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 9. Onderzoekscentrum maatschappelijke zorg Method - procedure Homeless people Structured interviews People who are registered at a central access point • Baseline (T0) Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” • After 6 months (T1) • After 18 months (T2) • After 30 months (T3) EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 10. Onderzoekscentrum maatschappelijke zorg Method - procedure Homeless people Social workers Structured interviews An internet questionnaire People who are registered at Identified by the homeless a central access point people • Baseline (T0) Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” • After 6 months (T1) •After 6 months (T1) • After 18 months (T2) •After 18 months (T2) • After 30 months (T3) EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 11. Onderzoekscentrum maatschappelijke zorg Method - measures Homeless people • Quality of life • Housing • Work alliance • Health & addiction Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” • Goals and motivation • Improvements in life EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 12. Onderzoekscentrum maatschappelijke zorg Method - measures Homeless people Social workers • Quality of life •Quality of life • Housing •Housing • Work alliance •Work alliance • Health & addiction Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” • Goals and motivation • Improvements in life EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 13. Onderzoekscentrum maatschappelijke zorg Results Insight into: • subgroups and risk profiles; • housing transitions; • changes in life domains. Information about predictors ofOnderzoekscentrum and stable zorg quality of life maatschappelijke “gedreven door kennis, bewogen door mensen” housing. Experiences of homeless people with the person centered approach. EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 14. Onderzoekscentrum maatschappelijke zorg Results Implementation Further development of the person centered approach. In close collaboration with: • homeless people; • Fieldworkers; Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” • policy makers. EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 15. Onderzoekscentrum maatschappelijke zorg State of the art Baseline measures (T0) First follow-up interviews (T1) Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 16. Onderzoekscentrum maatschappelijke zorg State of the art What is your most important goal for the coming 6 months? General quality of life 2 Housing 59 Study & work 19 Depts & Income 9 Physical health 2 Onderzoekscentrum maatschappelijke zorg Addiction “gedreven door kennis, bewogen 2 door mensen” Psychological well-being 6 Intimate relationship 5 Children 7 EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 17. Onderzoekscentrum maatschappelijke zorg State of the art “I want a house of my own with a garden and a cat.” “I would really like to have my own room or apartment, even a small room would do, and as soon as possible. Because for people like me (without addiction or psychological problems), the longer it takes, the bigger Onderzoekscentrum maatschappelijke zorg the chance you will relapse.” “gedreven door kennis, bewogen door mensen” “I want to live on my own with support nearby.” EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe
  • 18. Contact orien van der Laan 31243610790 arjolein Maas Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” 3124368448 EUROPEAN RESEARCH CONFERENCE Homelessness, Migration and Demographic Change in Europe

Notes de l'éditeur

  1. Introduction FEANTSA Information from FEANTSA’s members Specific look at some countries (not IE and UK)
  2. Hier zou je iets kunnen zetten dat je achtereenvolgens wat gaat vertellen over wie de studie uitvoeren, de achtergrond wat de beoogde doelen zijn, de uitvoer etc. Dan geef je een overzichtwvan de info die gegeven gaat worden. Daar kun je dan later weer op aanhaken.
  3. We conduct a longitudinal study in which we will follow 500 homeless people during three years. Assessing their living situation, quality of life and service needs A m ultisite study in Amsterdam, Rotterdam, The Hague and Utrecht (the 4 largest cities). Issued and subsidised by the Ministry of Health, Well-being, and Sport. Main aims are: Do the homeless benefit from a person centered approach? Why (not)? What is a person centered approach? (Go to next slide)
  4. In 2006 the Dutch government and the four largest cities kicked off the Strategy Plan for Social Relief. A person-oriented approach with individual assistance programmes and a personal client manager: Existing and new clients receive programme plans focussed on their individual care needs.
  5. Daarna kan op dezelfde slide weergegeven worden dat het op beleidsmatig (policy) niveau werkt (meer mensen van de straat en in zorg), maar dat de vraag rees of dat ook zo was op het niveau van de cliënten zelf (homeless people). Toelichting die je dan kunt geven is dat er geluiden uit het veld naar voren kwamen dat dat niet zo leek te zijn.
  6. The needs and urges of homeless people; and to specify these for subgroups with different background characteristics Improvements in the objective and subjective quality of life; Housing transitions as well as possible predictors of stable housing and improved quality of life Perceived benefits by homeless people of the Strategy Plan for Social Relief Do they experience an improvement in their quality of life? Essential to obtain information at the level of homeless people themselves . Without this, it is not possible to say from the perspectives of homeless people whether individual assistance programmes really work.
  7. Homeless people Selected when they register at a central access point That is baseline Social workers homeless people identify their closest social worker Identified at T1 and T2 (can be different)
  8. Homeless people Selected when they register at a central access point That is baseline Social workers homeless people identify their closest social worker Identified at T1 and T2 (can be different)
  9. Homeless Ook demografische variabelen Housing transitions and desires Health: physical & mental, also drug use and other addictions Goals and motivation (Ryan & Deci, 2000) – what do people want to change in their life? Who is the appropriate person to do so? Are the necesarry conditions available (autonomy, relatedness & competence?) Working relationship with social workers (Horvath & Greenberg, 1989) Social workers Quality of life Housing Working relationship
  10. Homeless Ook demografische variabelen Housing transitions and desires Health: physical & mental, also drug use and other addictions Goals and motivation (Ryan & Deci, 2000) – what do people want to change in their life? Who is the appropriate person to do so? Are the necesarry conditions available (autonomy, relatedness & competence?) Working relationship with social workers (Horvath & Greenberg, 1989) Social workers Quality of life Housing Working relationship
  11. Still early for results, challenge to collect the data. What do we want to do? Vraagstellingen: (1) Wat is het profiel van de populatie dakloze personen met een persoonsgerichte aanpak, en van subgroepen in deze populatie, en wat is het profiel van de daklozen waarbij het traject niet tot stand komt of voortijdig wordt afgebroken? (2) Is er een verbetering van de objectieve kwaliteit van leven (onderdak, inkomen, dagbesteding, zorgcontact) en subjectieve kwaliteit van leven van daklozen met een persoonsgericht traject? Bij welke (sub)groepen wel, bij welke niet? (3) Wat zijn de voorspellers van een verbeterde subjectief ervaren levenskwaliteit? Doet de persoonsgerichte aanpak ertoe? (4) Welke transities in soorten onderdak doen zich voor bij dakloze personen met een persoonsgericht traject? (5) Wat zijn de voorspellers van het krijgen van stabiele huisvesting? Doet de persoonsgerichte aanpak ertoe? (6) Wat is de ervaring of voldoening van daklozen met het geboden persoonsgerichte traject? Will lead articles, reports and to two theses on the care for homeless people
  12. Willen ook dat het geimplementeerd wordt
  13. Baseline measures (T0): Recruitment of homeless people is a challenge iets dat ik al kan laten zien is dat uit de interviews naar voren komt dat als we mensen vragen naar hun doelen dat veel aangeven een woning te willen (paar quotes indien mogelijk, 3 ofzo) Follow up: Mee begonnen. De grote uitdaging hierin is wel dat we de mensen blijven bereiken. Er is sprake van natuurlijk verloop, anderen moeten we vasthouden, kort iets zeggen over hoe we dat doen. Bonding: people start calling for second interview. Follow up: erg benieuwd zijn hoe het er over de tijd uit zal komen te zien. Zal het gaan veranderen over de tijd, kunnen ze het halen, hoe snel stromen ze door op de woonladder etc etc. Dat is wat we gaan zien in deze studie. De grote uitdaging hierin is wel dat we de mensen blijven bereiken. Er is sprake van natuurlijk verloop, anderen moeten we vasthouden, kort iets zeggen over hoe we dat doen. Bonding: people start calling for second interview.
  14. First 100 interviews. Question: what is the most important goal for you for the next 6 months? Some mentioned 2… Preliminary results!!!!
  15. Most mentioned: housing. 3 examples. Differ in many ways. Volgend jaar meer! Ook op website.