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

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

[email protected]

Mary-Louise Corr, School of Life, Sport and Social Sciences,

Edinburgh Napier University

[email protected]

mailto:[email protected]

mailto:[email protected]




Acknowledgements

Young people who have participated in the research. Services and service providers who 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.




Drug Use and Homelessness

The link has been documented in Ireland and elsewhere throughout Europe

(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 homelessness and

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 “double jeopardy” (Neale, 2001), making young people

more susceptible 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 consequence of homelessness.




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-dimensional perspectives on the link between drug use and

homelessness have been replaced by “an awareness of more subtle and

complex relationships” (Doherty & Stuttaford, 2007:247).

While the causal link between drug use and homelessness has attracted

considerable research interest, much less attention has focused on the

intersection of homeless and drug careers, particularly over time.




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




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 (September 2005 – 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)




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




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.




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’s life stories.

Only 7 of the 40 young people had 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 problematic to the degree that it had become a dependency.




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 trouble and taking drugs. I used to live with my Grandad when

I was a kid. He died in 1996. After that, I don’t really know, you just start

getting into trouble … I wouldn’t blame it on anyone but, I would blame it, like

the people I 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).

“There was too much fighting going on in my house with my Ma and me Da. They

were too strict, fighting every single day, I couldn’t handle it, you know”

(Declan, 19, P.1).

Challenging family dynamics more influential than his personal drug use in

propelling him into homelessness.




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]




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. = 3 Ind. Exit = 12

EXIT: N=17 HOMELESS:

n=13

EXIT: N=15 HOMELESS:

N=13




Young People’s Drug ‘Journeys’

Young people had 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) engagement with treatment

services, (failed) attempts to ‘get clean’.

Drug use escalated for practically all of the young people as 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 homeless at Phases II and III continued to use drugs.




Drug and Homeless Pathways:

The Case of Exiting Homelessness

Young people’s narratives of exiting homelessness and/or sustaining

housing invariably referenced transition and change across a number of

domains of experience: education & training/daily routines/peer and family

relationships.

All who reported ‘problem’ drug use had 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

house now, 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).




Drug and Homeless Pathways:

The Case of Exiting Homelessness

Critically, exiting homelessness was an incremental process with risks attached.

Housing can be hard to maintain in cases were young people are struggling

financially and/or recovering from a substance use problem.

Sarah: Had exited homelessness by P. 2 (living in family home), subsequently

returned to homelessness, and was living in private rented accommodation by

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 drugs you know, just spiralled

out of control really … We ended up getting thrown out of that place ….”

“I eventually then got locked up … I wanted to get locked up … I just couldn’t cope”

“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 genuinely feel I

won’t go back on drugs [pause] because of [baby]. Because I just want to be in

his life” (Sarah, 26, P.3)




Drug Use and Continued Homelessness

All who remained homeless by 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 through systems (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 criminal activity.

By Phase III, 12 of the 13 who remained homeless had been incarcerated at

some stage (often on multiple occasions) and 5 were currently in prison.

“I’ve just, I’ve be locked up an awful lot since then (referring to Phase 2

interview). About 16 times since I last seen you” (Fergal, 23, P.3).




Drug Use and Continued Homelessness

The ‘double jeopardy’ of homelessness and drug use (Neale, 2001) is starkly

apparent in their narratives over the course of the study.

Many had attempted to address the matter of their drug consumption but these

efforts were constantly hampered by the absence of a stable place to live.

“They put people that were strung out to bits, using needles, and then they put like

clean people in that’s trying to get clean and then … people that are on drugs or

whatever, they start selling drugs and you’re only after coming off them and the

temptation is too much ‘cos it’s right there where you’re living like. It’s in your

sitting room literally, where you’re getting 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 accommodation types.

“It’s [heroin] a fuckin’ horrible drug. I need it now to survive every day. I wouldn’t be

able to do other things. I need gear to actually do what I have t do during the

day” (Fergal, 19, P.2)




Conclusion: A Question of Housing?

Access to stable housing: a ‘turning point’ experience for young people and a

strong enabler to reducing, or abstaining from, drug use. Housing enabled young

people to engage with drug treatment and maintain a regime of abstinence

(Mayock & Corr, 2012).

Housing conferred meanings that 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 importance of speedy exits from homelessness: young men in particular had

spent years navigating a system of emergency provision (Mayock et al., 2013).

Stable housing is increasingly recognised as an essential prerequisite to effective

drug treatment outcomes (FEANTSA, 2010; Somers et al., 2008; Zeger, 2012).

Housing alone not sufficient, particularly for young people with complex histories

and needs: the importance of ‘housing support’ (Jones and Pleace, 2010; Quilgars

et al., 2008) following the move to stable accommodation.




Relevant Publications Mayock, P., Corr, M.L. & O’Sullivan, E. (2013) Moving on, not out: When young people remain

homeless. Journal of Youth Studies, 16, (4), 2013, p441 – 459

Mayock, P. & Corr, M.L., Young People's Homeless and Housing Pathways: Key Findings from a

Six-year Qualitaitve Longitudinal Study, 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 Support in, editor(s)Lynch, D. and Burns, K. , Children’s Rights and Child Protection:

Critical Times, Critical Issues in 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 support as a facilitator to exiting homelessness, Child and Family Social Work, 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's Homeless Pathways, Dublin, The Homeless Agency.

Mayock, P. O'Sullivan, E. (2007) Lives in Crisis: Homeless Young People in Dublin. Dublin: The

Liffey Press. , Dublin, The Liffey Press.

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