Service use and recovery among currently and formerly homeless adults with mental illness

Background: A range of health and social services exist to address the many life adversities experienced by people with mental illness. However, the effects of services on their recovery in the context of ongoing homelessness and poverty have been minimally examined. Aims: This qualitative study sought to better understand the role of health and social services in the recovery processes of people with mental illness and histories of homelessness. Similarities and differences in the perceived impacts of services on recovery between currently and formerly homeless participants were also explored. Method: In-depth interviews were conducted with 52 currently and formerly homeless people with mental illness. Informed by a recovery framework, qualitative data were analyzed using two cycles of coding. Results: Services were perceived to affect recovery by (1) finding ways to cope and get by, (2) feeling less alone, (3) giving back, (4) being dehumanized or seen as someone and (5) encountering restrictions when getting help. Experiences of discrimination, fewer opportunities to give back and limited service options were heightened among participants experiencing homelessness compared to the housed group. Conclusion: Health and social services can promote and hinder recovery among currently and formerly homeless people with mental illness. Despite several differences between the two groups, the relationship between recovery and service use was similar for currently and formerly homeless participants, suggesting that both groups access services to address needs related to social connection, health and functioning and meaningful activities.