Exploring the occupational lives of people experiencing homelessness

Background: Between 2023 and 2024, the U.S. Department of Housing and Urban Development (2024) reported over an 18 percent increase of individuals experiencing homelessness on a given night. Homeless individuals experience some duration of time without a fixed residence, either in sheltered (e.g., emergency shelter) or unsheltered (e.g., under bridges) spaces. With the client-centered, holistic lens of occupational therapy, there is potential for supportive services during this period of instability. However, there is a dearth of literature describing the exact needs of this population and the distinct role of OT in this space. Objective: This capstone project aims to understand the lived experiences of people experiencing homelessness (PEH) in Atlanta, assess the needs of this population, and explore the potential scope of OT through a thorough literature review and series of semi-structured interviews. ACOTE Areas: Research, Education Methods: This project utilized a qualitative, cross-sectional design. Included subjects were those who self-identified as having previously experienced in the last year or were currently experiencing homelessness. These participants were recruited through interviewer convenience sampling. The primary data collection tool included semi-structured interview questions. Data analysis of the qualitative assessments results included inductive coding and thematic analysis. Results: Results of the semi-structured interviews revealed the lived experiences of four PEH and needs that OT may be equipped to address. Several key themes emerged, including the public library as a prominent center of occupation for PEH, needed support to bridge the gap between current situations and desired occupations, feelings of apprehension or stigma, and abundant access to basic resources such as food, shelter, and clothing. Conclusions and Relevance: The daily lives of PEH host a variety of challenges; however, occupational therapists can play a role in supporting these individuals. Given the described abundance of food, shelter, and clothing in Atlanta, therapists should focus on engaging higher-order occupations addressing psychological and self-fulfillment needs. Therapists can assist with meeting these occupational goals, which may ease the shame and stigma that they experience.