Evaluating the Client Base and Housing Outcomes of a Community Based Organization Serving Unhoused Adults

There is a well-documented, bidirectional relationship between mental health and housing instability. When coupled with the complex historical, societal, and political factors contributing to houselessness, the result is a unique set of mental health needs within this community. Despite this, there is a low rate of mental health service utilization and a dearth of research on how to tailor services to meet the needs of unhoused individuals. Additionally, first-hand perspectives are often omitted, as this population is seen as “hard to reach”. The goal of this two-phase mixed-methods program evaluation was to better understand the demographic and mental health profiles of unhoused clients seeking mental health treatment through a community-based organization in the South Bay Area, to identify areas in which services could be adapted to meet the needs of the client base. Additionally, clients receiving mental health services were interviewed, to ensure recommendations provided were based in consumer experience. The first phase of the study was a secondary data analysis of electronic health record data that revealed that female identifying and those living with others endorsed significantly more adverse childhood experiences. The second phase included 6 semi-structured interviews analyzed through thematic analysis, from which 6 themes emerged: (1) “journey” to LifeMoves, (2) seamless connections, (3) importance of trust, (4) dynamic needs of the unhoused, (5) benefits of therapy at LifeMoves, and (6) areas of growth. These findings highlight the need for a reconceptualization of trauma and mental health symptoms within the unhoused community and the importance of including first-hand perspectives in research.