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substance abuse issues. Although this model has been criticized as a "housing only" model, meaning that in some cases individuals are not provided with enough support or resources once they are housed, it is generally regarded as an effective solution to homelessness. Going hand in hand with street outreach is the
Housing First Model. It is often the state provision towards homeless street outreach because it gives tangible results, gets people off the streets, and is overall beneficial for a city's economy. Government officials that perform street outreach with the Housing First Model in mind can sometimes be faced with backlash because these outreach services can be seen as a way for the government to expand control over a previously hard to govern group, or a method by which unhoused community members are pushed out of sight for the benefit of their housed counterparts.
25:
this work because of the understanding that unhoused people tend to have increased barriers to access traditional services. Street outreach comes in different forms, from people walking around carrying supplies or offering resources, to mobile health clinics with teams of medical volunteers driving around and offering services. Regardless of its form, the essence of street outreach is the desire to meet people where they are at, build deep trust and connections, offer support, and reinforce the human dignity and respect that is deserving of all people. The core elements of effective street outreach include being systematic, coordinated, comprehensive, housing-focused, person-centered, trauma-informed, culturally responsive, as well as emphasizing safety and reducing harm.
73:
managers, and social work specialists. This kind of outreach involves an element of physical and moral danger for the outreach worker, as the traditional boundaries between clinician and patient do not exist in this domain. There is potential for outreach workers in this domain put their own wellbeing at risk in order to help those who in some cases may not adhere to the help they are given. The role of the outreach worker can become uncertain in this practiceâalthough outreach workers are supposed to be advocates, in this situation there is an inherent power dynamic that positions the outreach worker as the role of the gatekeeper, which allows them to wield the power over the unhoused individual to provide them with certain services.
81:
of those that are unsheltered by acts of respect for privacy (including asking for permission to enter a person's space, knocking on the frame of the tent to notify residents about potentially entering the homes of the unsheltered). The right approach in terms of the location and timing of street outreach, the people included on the team, and verbal and nonverbal first impressions can make the difference for individuals hesitant to access social services. Instead of coming from a place of governance and regulation that often results of
Housing First centered street outreach, community outreach by volunteers are often focused on giving dignity and respect to the unhoused.
34:
establish a personal connection that provides the spark for the journey back to a vital and dignified life) or to emphasize goals (meeting individuals on the street to increase their access to services). Outreach is not intended to be a one size fits all answer to homelessness, as the population of people who are unhoused is very multifaceted in their needs and backgrounds and the majority of outreach programs face significant limitations. A lingering concern in the field of street outreach to unhoused is whether âdownstreamâ service work outweighs the need for âupstreamâ advocacy work.
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sentiments. Another potential barrier is created by a sense of mistrust between unhoused individuals and governmental agencies and partners like outreach workers. Some unhoused individuals reject services and resources provided by outreach workers and are labeled as care avoidant or shelter resistant
105:
Consistent contact between outreach workers and the homeless population is challenging. Many homeless people find themselves having to move around constantly, presenting an obstacle to long-term programs and solutions. Due to this, street outreach is often referred to as dynamic, and not routine. In
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Issues surrounding territory, respect, and understanding regarding the homes of the unsheltered when engaging in homeless service outreach is often a factor that is considered by outreach workers, especially for those concerned with providing social services. Volunteers aim to affirm the territories
55:
model only works when outreach workers are able to redirect homeless individuals to adequate housing resources. When shelters are at capacity and supportive housing units are full, outreach workers cannot move individuals experiencing homelessness into housing. When creating new housing developments
84:
When conducting service-based outreach, it is important to be aware of individuals who do not wish to seek services or may be distrustful of offers of help. For example, in harm reduction outreach, the opioid epidemic and alarming increase in accidental overdoses from substances laced with fentanyl
46:
Model, which became prominent in the United States after 2010. This model prioritizes getting individuals their basic needs before all else, alleviating their critical needs for things like food and shelter first before attending to secondary needs such as finding a source of income or attending to
33:
The purpose of street outreach is heavily debated. Most agree that outreach serves a vital function, filling in a gap in access to services and helping those who face heightened barriers to care. However, proponents of outreach argue whether it is better to emphasize process (outreach as seeking to
24:
is a classic example of a form of outreach. Those who experience homelessness have a variety of complex issues that incite the need for specific forms of care. As such, street outreach is challenging work. There are multiple governmental and non-governmental agencies that have sought to engage in
101:
A survey of unhoused individuals who engaged with services revealed that there is âimprovement in general health, mental health, vitality after street outreach contacts, but only for those who later attended fixed site clinics (<50% of people)." Outreach programs that remain knowledgeable of
72:
are an essential part of outreach work in any city. Outreach workers in this sector are responsible for connecting individuals to physical and mental health resources as well as drug and alcohol counseling. Typically, these services are provided by trained professionals such as clinicians, case
109:
Additionally, due to the tendency for outreach organizations to be nonprofit and grassroots based, a significant limitation for outreach services is their reliance on volunteers' time and capacity and donor funding to continue to work with unhoused people. A barrier to widespread expansion of
76:
Several homeless street outreach programs focus on providing specialized mental health services, harm reduction, or health services in response to the lack of public services that effectively address these needs. Due to the intersectionality of issues that contribute to homelessness, some
98:. As such, it is difficult to refer to outreach as a concrete solution to homelessness. In some regards, homeless street outreach merely acts as a bridge or stepping stone to fixed site services that can provide greater support and continuity of care.
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an interview with a street outreach worker in Brazil, it was said that "This wandering life of the homeless makes us look for people and never find them." Follow up with sick becomes nearly impossible, making continued care out of reach.
50:
Barriers to effective outreach in regards to providing housing for unhoused individuals come from limited housing options, local pushback from housed individuals, or mistrust between unhoused individuals and outreach workers. The
819:""It's Just a Band-Aid on Something No One Really Wants to See or Acknowledge": A Photovoice Study with Transitional Aged Youth Experiencing Homelessness to Examine the Roots of San Diego's 2016â2018 Hepatitis A Outbreak"
778:
Tsai, Alexander C.; Kiang, Mathew V.; Barnett, Michael L.; Beletsky, Leo; Keyes, Katherine M.; McGinty, Emma E.; Smith, Laramie R.; Strathdee, Steffanie A.; Wakeman, Sarah E.; Venkataramani, Atheendar S. (2019-11-26).
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There are many limitations of street outreach to the homeless. Outreach fails to address the impacts of education, income, and other social determinants of health that would allow long term improvements in health and
113:
The abundance of limitations and fluid nature of street outreach makes addressing long term solutions a challenge. As such, street outreach is often referred to as a "band aid" solution for homelessness.
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outreach services is the lack of awareness of the needs fulfilled by outreach and the difficulty in quantitatively representing the impact of outreach on the lives of unhoused individuals.
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Fonseca Viegas, Selma Maria da; Nitschke, Rosane Gonçalves; Tholl, Adriana Dutra; Bernardo, Lucas
Andreolli; Potrich, Tassiana; Arcaya Moncada, Maria Josefa; Nabarro, Marta (June 2021).
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as a result. Typically this demographic of people reject help because they either view these services as ineffective or no longer trust a system that has failed them in the past.
524:"Care avoidance among homeless people and access to care: an interview study among spiritual caregivers, street pastors, homeless outreach workers and formerly homeless people"
217:
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that cater towards the unhoused community, these developments are oftentimes met with pushback from local authorities or housed neighborhoods that harbor
261:"State Interagency Council to End Homelessness and Interagency Council on Hunger and Homelessness: Executive Order No. 06-05: (544532010-001)"
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organizations have developed outreach that allows services to be offered concurrently for individuals who belong to more than one category.
353:
123:
415:
Tsemberis, Sam (2011). "Housing first: The pathways model to end homelessness for people with mental illness and addiction manual".
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Felner, Jennifer K.; Kieu, Talia; Stieber, Andrew; Call, Hunter; Kirkland, Daniel; Farr, Amanda; Calzo, Jerel P. (January 2020).
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existing fixed site spaces or are integrated in networks of service organizations are better able to coordinate access to care.
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has led to a strong negative outlook on the "fentanyl problem" and may stigmatize individuals who use fentanyl recreationally.
239:
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Klop, Hanna T.; Evenblij, Kirsten; Gootjes, Jaap R. G.; de Veer, Anke J. E.; Onwuteaka-Philipsen, Bregje D. (2018-09-05).
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Volunteers and government workers who work to provide housing through street outreach oftentimes operate under the
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697:"Healthârelated street outreach: Exploring the perceptions of homeless people with experience of sleeping rough"
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Rowe, Michael (1999). "Crossing the border: Encounters 16, 1â22. between homeless people and outreach workers".
218:"Outreach and Engagement in Homeless Services: A Review of the Literature~!2009-08-18~!2009-09-28~!2010-03-22~!"
435:"The Ambiguities of Homelessness Governance: Disentangling Care and Revanchism in the Neoliberalising City"
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Silva, Felicialle
Pereira da; FrazĂŁo, Iracema da Silva; Linhares, Francisca MĂĄrcia Pereira (April 2014).
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308:"Street Outreach Workers' Understanding and Experience of Working with Chronically Homeless Populations"
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Changing Terrains of Homeless Governance".
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Stigma as a fundamental hindrance to the United States opioid overdose crisis response
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379:"From the Grey Nuns to the Streets: A Critical History of Outreach Nursing in Canada"
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Rowe, Michael; Fisk, Deborah; Frey, Jennifer; Davidson, Larry (2002).
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630:"[Health practices by teams from Street Outreach Offices]"
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International
Journal of Environmental Research and Public Health
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Everyday territories: homelessness, outreach work and city space
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Gerrard, Michael B. (1993). ""The victims of Nimby."".
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Lee, Wonhyung; Donaldson, Linda Plitt (2018-09-03).
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433:Clarke, Andrew; Parsell, Cameron (November 2020).
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222:The Open Health Services and Policy Journal
587:Administration and Policy in Mental Health
124:Homelessness in the San Francisco Bay Area
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354:"State of Homelessness: 2021 Edition"
20:to individuals that are experiencing
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129:Homelessness in the United States
417:European Journal of Homelessness
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795::10.1371/journal.pmed.1002969.
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377:Hardill, Kathy (January 2007).
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423:(2): 6 â via Researchgate.net.
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284:Cite journal requires
269:10.1037/e544532010-001
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491::10.1111/gec3.12257.
383:Public Health Nursing
167:Global Public Health
451:10.1111/anti.12671
312:Journal of Poverty
96:housing insecurity
713:10.1111/jan.14225
528:BMC Public Health
481:Geography Compass
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