Date Presented 04/05/19
Women in social housing are situated in environments that may impose negative impacts on their psychosocial health. We used an exploratory, sequential, mixed-methods design to identify the met and unmet psychosocial needs and disabilities experienced by this population. Several psychosocial needs of the women went unmet, and disability was significant. Participants identified several areas for how their needs could be addressed. Research and practice implications will be explored.
Primary Author and Speaker: Carrie Anne Marshall
Contributing Authors: Carina Tjornstrand, Fiona Drake, Emily Downs, Rebecca Eerkes
INTRODUCTION: Although poverty and the environments of social housing place women at increased risk for poorer psychosocial health, little is known about the level of disability experienced by these women and their specific psychosocial needs.
PURPOSE: To describe the met and unmet psychosocial needs of women living in social housing and the level of disability associated with their health challenges.
DESIGN AND METHOD: We used a sequential, mixed-methods, exploratory design. Twenty women were recruited from a social housing complex in a mid-sized Canadian city. Initial, quantitative interviews were composed of a demographic measure, and seven standardized scales including the: Camberwell Assessment of Need Short Appraisal Schedule; World Health Organization Disability Assessment Schedule; Short Warwick-Edinburgh Mental Well-Being Scale; USDA Food Security Survey Module; Alcohol Use Disorders Identification Test-10; Drug Abuse Screening Test-10; and Community Integration Scale. Data from these interviews was analyzed, and these findings provided a foundation for a qualitative interview protocol that was delivered to the women in a second interview. Qualitative data provided rich context to our quantitative findings and allowed us to develop several recommendations for future research and practice with this population.
RESULTS: Participants identified a significant degree of psychiatric and physical comorbidity, and associated disability. A variety of the psychosocial needs of the women went unmet: 53.3% indicated that their ability to manage psychological distress was going unmet; 60% of participants reported difficulty in caring for their home; 66.7% reporting unmet physical health needs; and 60% reported feeling dissatisfied with daily activities. 71.4% of participants reported some degree of food insecurity. In our qualitative interviews, participants spoke at length about their lack of safety in congregate social housing and emphasized a strong need for improving their safety. Several of the women reported that leaving social housing was desired due to a lack of safety, yet this was impossible because of the high cost of market rent. The poverty related issues and health status of these women resulted in a significant degree of disability. Few services were available to women to reduce this disability, thereby perpetuating it further. Participants identified the importance of services and supports to help with engagement in meaningful activity, improve mental health, and improve daily functioning.
CONCLUSIONS: Occupational therapists supporting women living in social housing may benefit from awareness of the met and unmet needs of these women, and how environmental factors may influence their ability to function on a daily basis. The findings of this study are a call to action for practitioners, researchers, and policy-makers. Implications for future research in occupational therapy will be explored.
References
Mithen, J., Aitken, Z., Ziersch, A., & Kavanagh, A. M. (2015). Inequalities in social capital and health between people with and without disabilities. Social Science & Medicine, 126, 26-35.
Alvi, S., Schwartz, M. D., DeKeseredy, W. S., & Maume, M. O. (2001). Women's fear of crime in Canadian public housing. Violence against women, 7(6), 638-661.
