Occupational Performance Challenges Facing Homeless Adults in a Transitional Housing Facility: Perspectives From Staff & Management

Over 460,000 people in the United States experienced homelessness in 2023, and this number has been increasing since 2007. 51% of homeless adults were unsheltered while 49% were in shelters, but shelters have struggled to keep up with housing demands given limited resources and the complex occupational and health needs of these individuals. Effective solutions to transition individuals from sheltered to independent housing could reduce the prevalence of homelessness and decrease the number of unsheltered persons. Addressing specific occupational performance challenges could be key to successful independent housing, but more studies are needed to develop solutions to these challenges. This case study takes an in-depth qualitative approach to explore occupational performance challenges facing adults living in one transitional housing facility. Data was collected through focused group discussions involving staff at the facility and analyzed using iterative thematic analysis procedures. Preliminary findings show that these adults have difficulty with health management [skills to regulate negative emotions, making appointments or seeking necessary health care, and staying physically active], life skills [cooking, cleaning living spaces], community navigation [managing available transportation options to engage the community], limited social interaction [lack of trust and stigma], working, and unhealthy choices or limited engagement in healthy recreation. These challenges have interfered with success in enabling homeless individuals to establish permanent housing. The congruence between occupational challenges and the occupational therapy domain suggests that practitioners could significantly impact the health and wellbeing of homeless adults by collaborating with community stakeholders to provide interventions to support participation in the outlined occupations, which have potential to considerably support homeless adults seeking independent housing.

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