ABSTRACT
Background: Children < 5 years living in temporary accommodation (U5TA) are vulnerable to poor health outcomes. Few qualitative studies have examined service provider perspectives in family homelessness; none have focused on U5TA with a cross-sector approach. This study explored professionals' perspectives of the barriers and facilitators, including pandemic-related challenges, experienced by U5TA in accessing healthcare and optimising health outcomes, and their experiences in delivering services. Methods: Sixteen semi-structured online interviews were conducted. Professionals working in Newham (London) with U5TA families were recruited from non-profit organisations, the health sector, and Local Authority. A thematic analysis was conducted. Findings: Professionals described barriers including poor parental mental health; unsuitable housing; no social support; mistrust of services; immigration administration; and financial insecurity. Digital poverty, language discordance, and the inability to register and track U5TA made them even less visible to services. Professionals tried to mitigate barriers with improved communication, and through community facilitators. Adverse pandemic effects on U5TA health included delay and regression in developmental milestones and behaviours. In-person services were reduced, exacerbating pre-existing barriers. Interpretation: COVID-19 further reduced the ability of professionals to deliver care to U5TA and significantly impacted the lives of U5TA with potential life-long risks. Innovative and tailored cross-sector strategies are needed, including co-production of public health services and policies focusing on early development, mental health support, employment training, and opportunities for parents/carers.
Subject(s)
COVID-19 , Pandemics , Child , Humans , COVID-19/epidemiology , London/epidemiology , Health Services Accessibility , Outcome Assessment, Health Care , Qualitative ResearchABSTRACT
Background and objectives: Family homelessness has been characterised as a hidden crisis with 121,340 children living in temporary accommodation in England in March 2021. There is limited literature and, therefore, understanding of emotional wellbeing in school-aged children and young people who are experiencing family homelessness. This study adopts an original approach to explore the perspectives of: children and others in their ecological system, also highlighting a social justice focus for counselling psychology. Methodology and methods: Fourteen qualitative semistructured interviews were conducted with: school-aged children, parents, and educators with experience of, or supporting, family homelessness. The data were analysed in two reflexive thematic analyses. Ecological, intersectional and social justice lenses were used in synthesis. Analysis: The analysis of the parent and child data generated three themes: 1) Unsafe, unfit, and unsuitable accommodation, no place for a child;2) Four school moves in two years, the implications for the child in school;and 3) Living a life on hold, family homelessness perceived as a trauma. The analysis of the educator data also generated three themes: 1) A kaleidoscope, homelessness as a shock to the child and their family system;2) Learning in limbo, emotional wellbeing in education;and 3) The school as an anchor, a point of stability for the child and family. Discussion: The findings conceptualise family homelessness as a shock to the childa s ecological system, which affects their emotional wellbeing and education. They identify welfare austerity and COVID-19 as chronosystem stressors, which amplify precarity. The findings highlight pivotal roles for the family system and the school as points of stability in the childa s ecological system, and the school in connecting the childa s mesosystem. Potential implications for counselling psychology, education, policy, limitations and suggestions for further research are considered. (PsycInfo Database Record (c) 2022 APA, all rights reserved)