Professionals working alongside the homeless require holistic approaches to ensure positive outcomes. However, some professionals demonstrate negative attitudes towards homelessness. So, what about psychology graduates? My experience working in the context of homelessness caused me to reflect upon the role of psychologists in assisting clients as part of multidisciplinary teams to manage mental health symptoms, and improve their access to community support such as housing and employment. The research suggests that the relationship between mental health and housing is a reciprocal one – housing is necessary for mental health and for addressing mental health issues in a stable environment, and a person’s mental health can create obstacles to maintaining housing.

As a youth support worker in the homelessness sector, I have witnessed the challenges for young people with mental illness, particularly aggression related to accessing and staying in accommodation. Mental illness and homelessness are intertwined and can create a complex, mutually reinforcing social stigma (Jensen, 2018). One in four Australians that experience homelessness are diagnosed with a mental illness (Australian Institute of Health and Welfare, 2016). Mental health reduces the safety net of support thus contributing to homelessness. Likewise homelessness deepens this social isolation (Chambers et al., 2014) and the acute stress related to homelessness reduces psychological wellbeing and exacerbates mental illness (Narendorf, 2017). Those experiencing homelessness with mental illness and ongoing trauma have reduced capacity to engage with services to receive critical support in order to exit the cycle of homelessness (Gabrelian et. al., 2015).

However, seeing mental health as the sole pathway for homelessness ignores the structural factors that contribute to individuals becoming homeless including family violence, relationship breakdown, housing affordability, employment issues, race and inequality (Heath, 2017). Understanding the complexities related to homelessness is critical for those working with these marginalised communities. When service providers and other professionals do not see homelessness holistically, it can lead to poor service delivery, poor quality care, and lack of client satisfaction within services. Furthermore, individuals experiencing homelessness report that when professionals lack understanding, display negative attitudes and implement ineffective interventions, it increases their sense of alienation, stigmatisation and despair (Parkinson, 2009).

Misconceptions among professionals

My personal experience is one insight into the challenge of working with homelessness and mental health holistically, due to the misconceptions of staff decreasing confidence to work with clients presenting with difficult behaviours. If the young man in the case presented here had been working with a psychologist could this have been different? Possibly. Community housing and outreach services employ a number of graduate students, including psychology graduates. These services and the graduate students working within them may be more confident to manage the risks associated with such behaviour (which is commonplace in these settings) if there was involvement and support from mental health professionals with expertise in homelessness. Mental health professionals with expertise in homelessness may provide strategies to deal with difficult situations that graduates feel tertiary education does not prepare them for.

Graduate students can also be hampered by stigma resulting in less understanding of issues surrounding homelessness due to limited exposure to information and experience with homelessness and those with mental health conditions within their undergraduate education. Through the lens of my personal experience as a youth worker, and my research as a psychology honours student, I explored this in a study of both psychology and social work students to investigate if misconceptions about homelessness exist.

The two samples were chosen due the high number of students that enter the community sector (potentially working with homeless populations) after graduating. Yet both groups receive different training. We asked undergraduate students (38 enrolled in a Bachelor of Psychology and 19 enrolled in a Bachelor of Social Work) to complete an online survey containing demographic questions, and the Attitudes Towards Homelessness Inventory (ATHI; Kingree & Daves, 1997). The ATHI measures attitudes towards homelessness, as well people’s beliefs about the causes of homelessness (personal deficiencies versus societal causes), willingness to affiliate with people experiencing homelessness, and beliefs about solutions. It asks people to indicate their agreement with statements such as “Homeless people had parents who took little interest in them as children” and “Recent government cutbacks in welfare have contributed substantially to the homeless problem in this country”. We compared the overall attitudes, as well as beliefs about causes and solutions of homelessness by psychology and social work students to better understand which students may benefit from greater educational input on homelessness in the undergraduate curriculum. Higher scores on the Attitudes towards Homelessness Inventory indicate more positive attitudes.

Results

Overall, students from both courses hold relatively positive attitudes towards homelessness. This being said, psychology students are thought to hold some negative views towards the homeless, indicated in their lower scores. Psychology students scored lower overall (average score of 45) than their social work peers (average score of 55). Specifically psychology students (average score of 3) were less likely compared to the social work students (average score of 4) to believe that structural factors such as government policies were responsible for homelessness. That is, they were less likely to see that homelessness is caused by a lack of government funding, discrimination and lack of financial stability.

Education is key to understanding

The differences in understanding of the causes of homelessness likely reflect that psychology and psychology courses take an individual approach to social issues like homelessness. It may also reflect that, as in other health degrees, few students receive information directly about homelessness through their coursework.

Exposing psychology students to structural factors of homelessness may provide opportunity to increase overall attitudes towards homelessness, reflected in an increase in scores on the ATHI. Other studies have demonstrated that learning about structural factors in a classroom setting that includes reflective journaling and exposure to life stories of homelessness, as well as professional placements in homeless services, can increase scores on the ATHI, leading to more accepting attitudes (Wisehart, Whatley, & Briihl, 2013).

Increasing education and promoting more accepting attitudes is important as psychology graduates can provide useful interventions as part of multidisciplinary teams to help break cycles of trauma, mental health symptoms and coping mechanisms that make tenancies harder to maintain. These include cognitive assessments (e.g., to establish learning disabilities), therapeutic interventions for trauma, depression and anxiety, and providing support staff with psychological education to assist clients and other key workers (Jarrett, 2011).

For those studying at university to enter health professions like psychology, education that includes structural explanations of homelessness could enhance the role of psychologists and further break down barriers for homeless people to enable access to services and support.

The first author can be contacted at [email protected]