Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review
Abstract
:1. Introduction
2. Methods
2.1. General Approach
2.1.1. Identify the Research Question
2.1.2. Identify Relevant Studies
2.1.3. Select Studies
2.1.4. Chart the Data
2.1.5. Collate and Summarize the Data
2.1.6. Consultation
3. Results
3.1. Study Characteristics
3.2. Intervention Types and Outcomes
3.3. Reporting of Cultural and Linguistic Diversity
3.4. Themes and Sub-Themes
3.5. Housing Provision
3.5.1. Housing First—Efficacy and Considerations
3.5.2. Other Housing Provision Models
3.5.3. Costs of Housing Models
3.5.4. Mental Health—Intersections and Interventions
3.5.5. Housing, Homelessness, and Mental Health
3.5.6. Mental Health Interventions for People Experiencing Homelessness (Non-Housing)
3.5.7. Complexity and Needs beyond Housing
3.5.8. Social Connection and Community
3.5.9. Health and Support Requirements of People Who Are Homeless
3.5.10. Shame, Stigma, and Discrimination
3.5.11. Employment, Financial Assistance, and Income Support
3.5.12. Substance Use
3.5.13. Housing Provision and Substance Use
3.5.14. Substance Use Interventions (Non-Housing)
3.5.15. Service Provider and Policy Issues
3.5.16. System Change
3.5.17. Service Needs and Gaps
3.5.18. The Role of Cultural and Linguistic Diversity
3.5.19. The Intersection of Ethnicity
3.5.20. The Value of Tailored Approaches for People from CaLD Backgrounds
3.5.21. Consumer Experience
3.5.22. Working with People with Lived Experience
3.5.23. Consumer Choice
3.5.24. Novel Ways of Engaging People Vulnerable to or Experiencing Homelessness
4. Discussion
4.1. Housing Is Key but Services to Complement Housing Are Required
4.2. Greater Attention Is Needed toward Indicators of Cultural and Linguistic Identity and Diversity
4.3. Systemic Change Is Vital
5. Strengths and Limitations
5.1. Study Design and Reporting Limitations
5.2. Strengths and Limitations of the Review
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Inclusion Criteria |
---|
Full text. |
Quantitative and qualitative primary studies. |
Peer-reviewed literature. |
Published between 2000 and 2020. |
English language. |
Study intervention: (1) Public health focus and/or address social factors that influence housing (determinants of housing); and (2) Include mental health outcomes such as changes in self-reported mental health, signs, and symptoms of mental health problems. |
Study population: (1) People from CaLD backgrounds; (2) Over the age of 18 years; (3) Living in high-income countries; (4) Access to a form of basic universal health care; and (5) Vulnerable to homelessness. |
Migrant | “Immigrant*” OR ethnic OR “Culturally and Linguistically Diverse” OR “Ethnic minority*” OR “migra*” OR “Asylum seeker” OR refugee* |
Living condition | Homeless* |
Interventions | intervention* OR strateg* OR “health education” OR “community services” OR “social services” OR housing OR shelter OR “primary health*” OR policy OR evaluat* OR outcome OR impact OR efficacy OR effectiveness |
Study Type | No. of Studies (%) | Citation |
---|---|---|
Randomized control trial | 28 (57.1) | [55,56,60,61,63,68,72,73,76,80,81,82,83,84,85,86,87,88,89,91,92,93,94,95,96,97,98,99] |
Longitudinal study | 6 (12.2) | [59,69,75,77,78,100] |
Qualitative | 5 (10.2) | [54,58,70,74,90] |
Mixed methods | 3 (6.1) | [52,64,71] |
Quasi-experimental study | 3 (6.1) | [53,66,67] |
Retrospective chart review | 1 (2.0) | [57] |
Comparative study | 1 (2.0) | [62] |
Cross-sectional evaluation | 1 (2.0) | [79] |
Non-randomized control trial | 1 (2.0) | [65] |
TOTAL | 49 (100) |
Intervention Type | Program | No. of Studies (%) | Citation |
---|---|---|---|
Housing and shelter provision | Housing first | 26 (53.0) | [56,59,61,62,63,70,77,80,81,82,83,84,85,86,87,88,89,91,92,93,94,95,96,97,98,99] |
Full-service partnership | 2 (4.1) | [66,67] | |
Ecologically based treatment | 2 (4.1) | [68,72] | |
Permanent supportive housing | 2 (4.1) | [69,78] | |
Supportive housing | 1 (2.0) | [55] | |
Rehousing in the community | 1 (2.0) | [100] | |
Housing—various | 1 (2.0) | [60] | |
Collaborative initiative to help end homelessness | 1 (2.0) | [75] | |
Total | 36 (73.5) | ||
Physical health including substance use | Thresholds mothers project | 1 (2.0) | [57] |
Substance use interventions | 1 (2.0) | [73] | |
AWARE: AOD and health program | 1 (2.0) | [76] | |
The Power of YOU-AOD and health program | 1 (2.0) | [64] | |
Casa-care health service | 1 (2.0) | [77] | |
Total | 5 (10.2) | ||
Refugee and migration status | Sponsored refugee status | 1 (2.0) | [58] |
Forced migration status | 1 (2.0) | [54] | |
Total | 2 (4.1) | ||
Mental health | Mobile phone-based mental health intervention | 1 (2.0) | [71] |
Shelter-based mental health clinic | 1 (2.0) | [79] | |
Total | 2 (4.1) | ||
Creative arts intervention | Arts-based program | 1 (2.0) | [90] |
Hip Hop Self-Expression group intervention | 1 (2.0) | [74] | |
Total | 2 (4.1) | ||
Income support | Earned income tax credit | 1 (2.0) | [53] |
Total | 1 (2.0) | ||
Group intervention | Men’s group | 1 (2.0) | [52] |
Total | 1 (2.0) | ||
TOTAL STUDIES | 49 (100.0) |
A Note on Housing First |
---|
Housing First was developed in the 1990s and is a critical policy response in the USA, the UK, Canada, and Europe [101]. It has been suggested that Housing First should be adopted across a community’s entire homelessness response system [102]. Tsembis [103] described Housing First as being two services, housing and support, underpinned by a program philosophy and values [103]. Generally, the model incorporates five broad principles [104], described below by Rhatigan and Blay [104]:
Housing First approaches comprise initiatives that provide housing, either scattered-site or communal/single site implementation [103], with additional “wrap-around” support, for example, to those with mental health and other health conditions as immediate priorities, “without requiring participation in treatment or sobriety as preconditions” [82]. |
Classification | No. of Studies (%) | Citation |
---|---|---|
Ethnicity | 10 (20.4) | [60,62,64,72,80,88,89,92,100] |
Race/Ethnicity | 9 (18.4) | [53,63,65,66,67,68,70,76,78] |
Race | 5 (10.2) | [56,59,61,69,75] |
Ethno-racial status | 4 (8.2) | [82,84,86,99] |
Ethnicity or Cultural identity; Country of birth | 3 (6.1) | [87,93,97] |
Migration status; Country of birth/origin. | 3 (6.1) | [52,54,58] |
No formal classification used | 3 (6.1) | [55,57,74] |
Race and Ethnicity | 2 (4.1) | [71,79] |
Ethnicity; Country of birth. | 2 (4.1) | [91,95] |
Ethno-cultural identity | 1 (2.0) | [83] |
Racial-ethnic minority status | 1 (2.0) | [81] |
Ethnic/Cultural background | 1 (2.0) | [90] |
Ethno-racial minority status | 1 (2.0) | [98] |
Visible minority; Country of birth | 1 (2.0) | [85] |
Race/Ethnicity; Country of birth | 1 (2.0) | [94] |
Ethno-racial status; Country of birth | 1 (2.0) | [96] |
Race; Latinx status; Ethnic group | 1 (2.0) | [77] |
TOTAL | 49 (100) |
Theme | Sub-Themes |
---|---|
Housing provision | Housing First: efficacy and considerations |
Other service provision models | |
Costs of housing models | |
Mental health: intersections and interventions | Housing, homelessness, and mental health |
Mental health interventions for people experiencing homelessness (non-housing) | |
Complexity and needs beyond housing | Social connection and community |
Shame/stigma/discrimination | |
Health and support requirements of homeless populations | |
Employment, financial assistance, and income support | |
Substance use | Housing provision and substance use |
Substance use interventions (non-housing) | |
Service provider and policy issues | System change |
Service needs and gaps | |
The role of cultural and linguistic diversity | The value of tailored approaches for people from CaLD backgrounds |
The intersection of ethnicity | |
Consumer experience | Working with people with lived experience |
Consumer choice | |
Novel ways of engaging |
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Share and Cite
Crawford, G.; Connor, E.; McCausland, K.; Reeves, K.; Blackford, K. Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review. Int. J. Environ. Res. Public Health 2022, 19, 16946. https://doi.org/10.3390/ijerph192416946
Crawford G, Connor E, McCausland K, Reeves K, Blackford K. Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review. International Journal of Environmental Research and Public Health. 2022; 19(24):16946. https://doi.org/10.3390/ijerph192416946
Chicago/Turabian StyleCrawford, Gemma, Elizabeth Connor, Kahlia McCausland, Karina Reeves, and Krysten Blackford. 2022. "Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review" International Journal of Environmental Research and Public Health 19, no. 24: 16946. https://doi.org/10.3390/ijerph192416946