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Crazy, Dirty, and Lazy?: Stigmatization of Homeless Mentally Ill People by Providers of Homeless Services

Frye, Lara Elizabeth Aycock (2011)
Master's Thesis (77 pages)
Committee Chair / Thesis Adviser: Rochat, Roger
Committee Members: Andes, Karen
Research Fields: Health Sciences, Mental Health
Partnering Agencies: Does not apply (no collaborating organization)
Keywords: stigma; mental illness; addiction; homeless
Program: Rollins School of Public Health, Hubert Department of Global Health
Permanent url: http://pid.emory.edu/ark:/25593/946vn

Abstract


Crazy, Dirty, and Lazy?: Stigmatization of Homeless Mentally Ill People by Providers of Homeless Services
By Elizabeth A. Frye

Background
Stigmatized populations, such as the homeless and mentally ill, maintain
significantly poorer health outcomes, dying over 25 years younger than the general
population. Workers who provide homeless services control which individuals receive
temporary shelter, transitional and permanent housing, food, resources to assist in
employment, and access to free medical care. Stigma towards homeless people with
mental illness among workers may negatively affect health outcomes in this vulnerable
population.


Objective
In this study, I examine stigma towards people experiencing homelessness and
mental illness by volunteers and workers who provide homeless services, both from the
perspective of the service providers and the homeless clients.


Methods
I utilized data collected during a Community Needs Assessment of Homeless
Health Initiative to quantify positive and negative observations of service providers and
experiences of homeless individuals. Surveys of service providers and homeless clients
provide quantitative data on provider behavior towards their homeless clients. Individual
interviews with homeless individuals with mental and addictive disorders provide
qualitative data to better understand the experience of stigma among this population.

Results
According to service providers and homeless clients, stigma towards homeless
people with mental and addictive disorders is prevalent among workers providing
homeless services. Half of service providers reported stigma among service providers and
ranked the level of stigma as moderate to severe. Though homeless clients were reticent
to criticize workers who provide for their physical needs, half of homeless participants
reported rudeness and 40% felt disrespected in interactions with service providers.

Discussion
This study demonstrates stigma and maltreatment of homeless individual with
mental illness by workers paid to provide services for this population. Organizations
providing homeless services should implement stigma reduction campaigns and
education on mental and addictive disorders among workers to reduce stigma and
improve health outcomes. Further research is necessary to examine specific health
consequences resulting from shame and emotional damage as well as poor access to
services.

Table of Contents


Table of Contents


Chapter 1:

Introduction…………………………………………………................…………………1

Chapter 2:

Literature Review………………………………………................……………....…3

Chapter 3:
Methods…………………………...…………………………........….............……..15
Results……………………………………..…..……………........…………..............22

Chapter 4:

Discussion, Conclusion, and Recommendations …...............…………42

References……………………………………..……………………………….....…………50

Appendix A: Service Provider Survey Instrument……………………………55

Appendix B: Homeless Client Survey Instrument……………………….……64

Appendix C: Homeless Client Interview Guide…………………………………68









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