Outreach

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Outreach Program for Women

Outreach is the activity of providing services to any population that might not otherwise have access to those services.[1][2] A key component of outreach is that the group providing it is not stationary, but mobile; in other words, it involves meeting someone in need of an outreach service at the location where they are.[1][2][3] Compared with traditional service providers, outreach services are provided closer to where people may reside, efforts are very often voluntary, and have fewer, if any, enforceable obligations. In addition to delivering services, outreach has an educational role, raising the awareness of existing services.[3] It includes identification of under-served populations and service referral and the use of outreach tools like leaflets, newsletters, advertising stalls and displays, and dedicated events. Outreach is often meant to fill in the gap in the services provided by mainstream (often governmental) services, and is often carried out by non-profit, nongovernmental organizations.[1]

Categories[edit]

There are many different types of outreach, but they can be categorized into these four groupings: domiciliary (undertaken at individual homes), detached (undertaken in public environments and targeting individuals), peripatetic (undertaken at public or private environments and targeting organizations rather than individuals).[4] and satellite outreach (where services are provided at a dedicated site).[3]

Homeless street outreach[edit]

The concept of street outreach to individuals that are experiencing homelessness is a classic example of a form of outreach. There are multiple governmental and non-governmental agencies that have sought to engage in this work because of the understanding that unhoused people tend to have increased barriers to access traditional services. Street outreach comes in different forms, from people walking around carrying supplies or offering resources, to mobile health clinics with teams of medical volunteers driving around and offering services. Regardless of its form, the essence of street outreach is the desire to meet people where they are at, build deep trust and connections, offer support, and reinforce the human dignity and respect that is deserving of all people.[5] The core elements of effective street outreach include being systematic, coordinated, comprehensive, housing-focused, person-centered, trauma-informed, culturally responsive, as well as emphasizing safety and reducing harm.[6]

Goals of outreach[edit]

The purpose of street outreach is heavily debated. Most agree that outreach serves a vital function, filling in a gap in access to services and helping those who face heightened barriers to care. However, proponents of outreach argue whether it is better to emphasize process (outreach as seeking to establish a personal connection that provides the spark for the journey back to a vital and dignified life) or to emphasize goals (meeting individuals on the street to increase their access to services).[7] Outreach is not intended to be a one size fits all answer to homelessness, as the population of people who are unhoused is very multifaceted in their needs and backgrounds and the majority of outreach programs face significant limitations.[8] A lingering concern in the field of street outreach to unhoused is whether “downstream” service work outweighs the need for “upstream” advocacy work.[9]

Housing[edit]

Volunteers and government workers who work to provide housing through street outreach oftentimes operate under the Housing First Model, which became prominent in the United States after 2010. This model prioritizes getting individuals their basic needs before all else, alleviating their critical needs for things like food and shelter first before attending to secondary needs such as finding a source of income or attending to substance abuse issues.[10] Although this model has been criticized as a "housing only" model, meaning that in some cases individuals are not provided with enough support or resources once they are housed, it is generally regarded as an effective solution to homelessness. Going hand in hand with street outreach is the Housing First Model. It is often the state provision towards homeless street outreach because it gives tangible results, gets people off the streets, and is overall beneficial for a cities economy. Government officials that perform street outreach with the Housing First Model in mind can sometimes be faced with backlash because these outreach services can be seen as a way for the government to expand control over a previously hard to govern group, or a method by which unhoused community members are pushed out of sight for the benefit of their housed counterparts.[11][12]

Barriers to effective outreach in regards to providing housing for unhoused individuals come from limited housing options, local pushback from housed individuals, or mistrust between unhoused individuals and outreach workers. The Housing First model only works when outreach workers are able to redirect homeless individuals to adequate housing resources. When shelters are at capacity and supportive housing units are full, outreach workers cannot move individuals experiencing homelessness into housing. When creating new housing developments that cater towards the unhoused community, these developments are oftentimes met with pushback from local authorities or housed neighborhoods that harbor NIMBY sentiments.[13] Another potential barrier is created by a sense of mistrust between unhoused individuals and governmental agencies and partners like outreach workers. Some unhoused individuals reject services and resources provided by outreach workers and are labeled as care avoidant or shelter resistant as a result. Typically this demographic of people reject help because they either view these services as ineffective or no longer trust a system that has failed them in the past.[14]

Fulfilling Basic Needs[edit]

In addition to redirecting unhoused individuals to housing resources, some outreach programs are also concerned with delivering and fulfilling other basic needs such as food, water, and hygiene. The kinds of services and resources provided vary based on the outreach organization and the resources available to them at the time. A number of non-profit organizations such as Dorothy Day House in Berkeley, California do mobile outreach services to areas of concentrated homelessness around the city to distribute essential items such as hot meals, groceries, water, rain gear, clothing, and hygiene products. Non-profit organizations concerned with providing basic needs tend to partner with local government as well as other non-profit organizations such as food banks in order to distribute these goods to the unhoused population for free.[15] By providing these services through mobile street outreach, outreach volunteers act as the link between state-provided services and homeless individuals by increasing accessibility to these essential items.

Providing Social Services[edit]

Social services are an essential part of outreach work in any city. Outreach workers in this sector are responsible for connecting individuals to physical and mental health resources as well as drug and alcohol counseling. Typically, these services are provided by trained professionals such as clinicians, case managers, and social work specialists. This kind of outreach involves an element of physical and moral danger for the outreach worker, as the traditional boundaries between clinician and patient do not exist in this domain. There is potential for outreach workers in this domain put their own wellbeing at risk in order to help those who in some cases may not adhere to the help they are given.[16] The role of the outreach worker can become uncertain in this practice—although outreach workers are supposed to be advocates, in this situation there is an inherent power dynamic that positions the outreach worker as the role of the gatekeeper, which allows them to wield the power over the unhoused individual to provide them with certain services.

Several homeless street outreach programs focus on providing specialized mental health services, harm reduction, or health services in response to the lack of public services that effectively address these needs. Due to the intersectionality of issues that contribute to homelessness, some organizations have developed outreach that allows services to be offered concurrently for individuals who belong to more than one category.[17]

Issues surrounding territory, respect, and understanding regarding the homes of the unsheltered when engaging in homeless service outreach is often a factor that is considered by outreach workers, especially for those concerned with providing social services. Volunteers aim to affirm the territories of those that are unsheltered by acts of respect for privacy (including asking for permission to enter a person's space, knocking on the frame of the tent to notify residents about potentially entering the homes of the unsheltered).[18] The right approach in terms of the location and timing of street outreach, the people included on the team, and verbal and nonverbal first impressions can make the difference for individuals hesitant to access social services.[19] Instead of coming from a place of governance and regulation that often results of Housing First centered street outreach, community outreach by volunteers are often focused on giving dignity and respect to the unhoused.[20]

When conducting service-based outreach, it is important to be aware of individuals who do not wish to seek services or may be distrustful of offers of help. For example, in harm reduction outreach, the opioid epidemic and alarming increase in accidental overdoses from substances laced with fentanyl has led to a strong negative outlook on the "fentanyl problem" and may stigmatize individuals who use fentanyl recreationally.[21]

Limitations[edit]

There are many limitations of street outreach to the homeless. Street outreach is often referred to as a "band aid" solution for homelessness.[22] Outreach as a solution to homelessness cannot address the impacts of education, income, and other social determinants of health that would allow long term improvements in health and housing security. In some regards, homeless street outreach merely acts as a bridge or stepping stone to fixed site services that can provide greater support and continuity of care.[19]

A survey of unhoused individuals who engaged with services revealed that there is “improvement in general health, mental health, vitality after street outreach contacts, but only for those who later attended fixed site clinics (<50% of people)."[19] Outreach programs that remain knowledgeable of existing fixed site spaces or are integrated in networks of service organizations are better able to coordinate access to care.

Additionally, due to the tendency for outreach organizations to be nonprofit and grassroots based, a significant limitation for outreach services is their reliance on volunteers' time and capacity and donor funding to continue to work with unhoused people. A barrier to widespread expansion of outreach services is the lack of awareness of the needs fulfilled by outreach and the difficulty in quantitatively representing the impact of outreach on the lives of unhoused individuals.[7]

See also[edit]

References[edit]

  1. ^ a b c Kate Hardy; Sarah Kingston; Teela Sanders (16 December 2010). New Sociologies of Sex Work. Ashgate Publishing, Ltd. p. 77. ISBN 978-0-7546-7986-8. Retrieved 16 September 2012.
  2. ^ a b Legal Services Research Centre (30 March 2009). Reaching Further: Innovation, Access and Quality in Legal Services. The Stationery Office. pp. 73–74. ISBN 978-0-11-706724-0. Retrieved 17 September 2012.
  3. ^ a b c "Maximising the Role of Outreach in Client Engagement", Dewson S, Davis S, Casebourne J. Research Report DWPRR 326, Department for Work and Pensions, 2006.
  4. ^ Tim Rhodes (1996). Outreach Work with Drug Users: Principles and Practice. Council of Europe. pp. 25–26. ISBN 978-92-871-3110-2. Retrieved 17 September 2012.
  5. ^ Olivet, Jeffrey; Bassuk, Ellen; Elstad, Emily; Kenney, Rachael; Jassil, Lauren (2010-04-07). "Outreach and Engagement in Homeless Services: A Review of the Literature~!2009-08-18~!2009-09-28~!2010-03-22~!". The Open Health Services and Policy Journal. 3 (2): 53–70. doi:10.2174/1874924001003020053. ISSN 1874-9240.
  6. ^ "State Interagency Council to End Homelessness and Interagency Council on Hunger and Homelessness: Executive Order No. 06-05". PsycEXTRA Dataset. 2006. doi:10.1037/e544532010-001. Retrieved 2021-01-08.
  7. ^ a b Lee, Wonhyung; Donaldson, Linda Plitt (2018-09-03). "Street Outreach Workers' Understanding and Experience of Working with Chronically Homeless Populations". Journal of Poverty. 22 (5): 421–436. doi:10.1080/10875549.2018.1460737. ISSN 1087-5549. S2CID 158094617.
  8. ^ "State of Homelessness: 2021 Edition". National Alliance to End Homelessness. Retrieved December 17, 2021.{{cite web}}: CS1 maint: url-status (link)
  9. ^ Hardill, Kathy (January 2007). "From the Grey Nuns to the Streets: A Critical History of Outreach Nursing in Canada". Public Health Nursing. 24 (1): 91–97. doi:10.1111/j.1525-1446.2006.00612.x. PMID 17214658.
  10. ^ Tsemberis, Sam (2011). "Housing first: The pathways model to end homelessness for people with mental illness and addiction manual". European Journal of Homelessness. 5 (2): 6 – via Researchgate.net.
  11. ^ Clarke, Andrew; Parsell, Cameron (2020-08-18). "The Ambiguities of Homelessness Governance: Disentangling Care and Revanchism in the Neoliberalising City". Antipode. 52 (6): 1624–1646. doi:10.1111/anti.12671. ISSN 0066-4812. S2CID 225379785.
  12. ^ Baker, Tom; Evans, Joshua (2016). "'Housing First' and the Changing Terrains of Homeless Governance". Geography Compass. 10 (1): 25–41. doi:10.1111/gec3.12257. ISSN 1749-8198.
  13. ^ Gerrard, Michael B. (1993). ""The victims of Nimby."". Fordham Urb. LJ. 21: 490–495.
  14. ^ Klop, H.T., Evenblij, K., Gootjes, J.R.G. (2018). "Care avoidance among homeless people and access to care". BMC Public Health. 18 (1): 1095. doi:10.1186/s12889-018-5989-1. PMC 6126023. PMID 30185163.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  15. ^ "History". Dorothy Day House Berkeley. Retrieved May 1, 2021.{{cite web}}: CS1 maint: url-status (link)
  16. ^ Rowe, Michael, Deborah Fisk, Jennifer Frey, and Larry Davidson. (2002). "Engaging persons with substance use disorders: Lessons from homeless outreach". Administration and Policy in Mental Health and Mental Health Services Research. 29 (3): 263–273. doi:10.1023/A:1015147710813. PMID 12033671. S2CID 21833394.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  17. ^ Silva, Felicialle Pereira da; Frazão, Iracema da Silva; Linhares, Francisca Márcia Pereira (April 2014). "[Health practices by teams from Street Outreach Offices]". Cadernos de Saude Publica. 30 (4): 805–814. doi:10.1590/0102-311x00100513. ISSN 1678-4464. PMID 24896055.
  18. ^ Rowe, Michael (1999). "Crossing the border: Encounters 16, 1–22. between homeless people and outreach workers". Lam, J., & Rosenheck, R.A.
  19. ^ a b c Ungpakorn, Rosa; Rae, Bernadette (2020). "Health-related street outreach: Exploring the perceptions of homeless people with experience of sleeping rough". Journal of Advanced Nursing. 76 (1): 253–263. doi:10.1111/jan.14225. ISSN 1365-2648. PMID 31588583. S2CID 203849311.
  20. ^ Smith, Robin James (2018). "Everyday territories: homelessness, outreach work and city space" (PDF). British Journal of Sociology. 69 (2): 372–390. doi:10.1111/1468-4446.12280. PMID 28718874.
  21. ^ Tsai, Alexander C.; Kiang, Mathew V.; Barnett, Michael L.; Beletsky, Leo; Keyes, Katherine M.; McGinty, Emma E.; Smith, Laramie R.; Strathdee, Steffanie A.; Wakeman, Sarah E.; Venkataramani, Atheendar S. (2019-11-26). "Stigma as a fundamental hindrance to the United States opioid overdose crisis response". PLOS Medicine. 16 (11): e1002969. doi:10.1371/journal.pmed.1002969. ISSN 1549-1277. PMC 6957118. PMID 31770387.
  22. ^ Felner, Jennifer K.; Kieu, Talia; Stieber, Andrew; Call, Hunter; Kirkland, Daniel; Farr, Amanda; Calzo, Jerel P. (January 2020). ""It's Just a Band-Aid on Something No One Really Wants to See or Acknowledge": A Photovoice Study with Transitional Aged Youth Experiencing Homelessness to Examine the Roots of San Diego's 2016–2018 Hepatitis A Outbreak". International Journal of Environmental Research and Public Health. 17 (13): 4721. doi:10.3390/ijerph17134721. PMC 7369867.

External links[edit]

Media related to Outreach at Wikimedia Commons