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Bread and Shoulders: Reversing the Downward Spiral, a Qualitative Analyses of the Effects of a Housing First-Type Program in France

Author

Listed:
  • Pauline Rhenter

    (Aix-Marseille University, Public Health Research Unit EA 3279, 13005 Marseille, France)

  • Delphine Moreau

    (Research Laboratory, Maison Blanche Hospital, 75018 Paris, France)

  • Christian Laval

    (Aix-Marseille University, Public Health Research Unit EA 3279, 13005 Marseille, France)

  • Jean Mantovani

    (Observatory Regional of Health, Midi Pyrenees, 31000 Toulouse, France)

  • Amandine Albisson

    (Observatory Regional of Health, Midi Pyrenees, 31000 Toulouse, France)

  • Guillaume Suderie

    (Observatory Regional of Health, Midi Pyrenees, 31000 Toulouse, France)

  • French Housing First Study Group

    (French Housing First Study Group, 13000 Marseille, France
    French Housing First Study Group: T. Apostolidis, E. Beetlestone, P. Birmes, T. Bossetti, R. Bouloudnine, B. Combes, J. Debieve, B. Falissard, C. Lancon, P. Le Cardinal, J. Naudin and B. Videau.)

  • Mohamed Boucekine

    (Aix-Marseille University, Public Health Research Unit EA 3279, 13005 Marseille, France
    Department of Research and Innovation, Support Unit for Clinical Research and Economic Evaluation, Public Hospital of Marseille (AP-HM), 13005 Marseille, France)

  • Aurelie Tinland

    (Aix-Marseille University, Public Health Research Unit EA 3279, 13005 Marseille, France
    Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), 13005 Marseille, France)

  • Sandrine Loubière

    (Aix-Marseille University, Public Health Research Unit EA 3279, 13005 Marseille, France
    Department of Research and Innovation, Support Unit for Clinical Research and Economic Evaluation, Public Hospital of Marseille (AP-HM), 13005 Marseille, France)

  • Tim Greacen

    (Research Laboratory, Maison Blanche Hospital, 75018 Paris, France)

  • Pascal Auquier

    (Aix-Marseille University, Public Health Research Unit EA 3279, 13005 Marseille, France
    French Housing First Study Group, 13000 Marseille, France)

  • Vincent Girard

    (Aix-Marseille University, Public Health Research Unit EA 3279, 13005 Marseille, France
    Regional Health Agency PACA (ARS), 13002 Marseille, France)

Abstract

This paper is a qualitative analysis of the effects of accompagnement , a support framework, on recovery trajectories of people with long-term homelessness and severe psychiatric disorders during 24 months in a Housing First-type program in France. A comprehensive methodology based on grounded theory was used to construct an interview guide, conduct multiple interviews with 35 Housing First participants sampled for heterogeneity, and produce memos on their trajectories before and after entering the program based on interview information. Thematic analysis of a representative subsample ( n = 13) of memos identified 12 objective factors and 6 subjective factors key to the recovery process. An in-depth re-analysis of the memos generated four recovery themes: (1) the need for secure space favorable to self-reflexivity; (2) a “honeymoon” effect; (3) the importance of even weak social ties; (4) support from and hope among peers. Three challenges to recovery were identified: (1) finding a balance between protection and risk; (2) breaking downward spirals; (3) bifurcating the trajectory. This study provides new insight into the recovery process, understood as a non-linear transformation of an experience—the relationship between objective life conditions and subjective perception of those conditions—which reinforces protective support over risk elements.

Suggested Citation

  • Pauline Rhenter & Delphine Moreau & Christian Laval & Jean Mantovani & Amandine Albisson & Guillaume Suderie & French Housing First Study Group & Mohamed Boucekine & Aurelie Tinland & Sandrine Loubièr, 2018. "Bread and Shoulders: Reversing the Downward Spiral, a Qualitative Analyses of the Effects of a Housing First-Type Program in France," IJERPH, MDPI, vol. 15(3), pages 1-22, March.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:3:p:520-:d:136319
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    References listed on IDEAS

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    1. Henwood, B.F. & Cabassa, L.J. & Craig, C.M. & Padgett, D.K., 2013. "Permanent supportive housing: Addressing homelessness and health disparities?," American Journal of Public Health, American Public Health Association, vol. 103(S2), pages 188-192.
    2. Tsemberis, S. & Gulcur, L. & Nakae, M., 2004. "Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals with a Dual Diagnosis," American Journal of Public Health, American Public Health Association, vol. 94(4), pages 651-656.
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    1. Suvi Raitakari & Suvi Holmberg & Kirsi Juhila & Jenni-Mari Räsänen, 2018. "Constructing the Elements of the “Recovery in” Model through Positive Assessments during Mental Health Home Visits," IJERPH, MDPI, vol. 15(7), pages 1-14, July.

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