Date of Award
Doctor of Philosophy (PhD)
Families with children comprise one-third of the entire homeless population (Henry, Watt, Rosenthal, & Shivji, 2017). Homelessness exposes children to chaotic, unsafe living environments that pose threats to healthy development; unsurprisingly, children in homeless services display high rates of mental health disorders compared to stably housed children (Bassuk et al., 2015; Buckner, 2008). Despite concerted efforts at the state and local levels to end family homelessness by 2020, rates have remained largely unchanged over the past decade (Henry et al., 2017; U.S. Interagency Council on Homelessness, 2015). Additional indicators such as increasing wait times, average length of stay, and reentry rates reflect substantial unmet need among families in the homeless services system that exposes children to ongoing risk for mental disorder. A developmentally informed homeless services system must aim to minimize children’s time in homeless services, reduce exposure to chaos and instability in homeless services, and promote sustainable return to stable housing. This mixed methods study applies a community-based system dynamics approach to 1) Develop a dynamic hypothesis to explain observed rates of reentry, length of stay, unmet family need, and child risk among homeless families, 2) Apply participatory system dynamics methods to build and test a theoretical model of feedback processes driving these outcomes, and 3) Elicit and test potential interventions to improve homeless system performance for families on key outcomes using participatory and simulation system dynamic modeling. Key informant interviews and qualitative group model building sessions with a range of stakeholders including homeless service providers and homeless shelter clients with children generate insights into the processes underlying patterns of service use that reinforce vulnerability to mental disorder. Simulation models incorporating these insights and calibrated using administrative data test interventions to improve homeless system performance. Results indicate elements of the current service system have counterintuitive impacts on system performance. Crowding in shelters erodes client empowerment, leading to longer stays in services which contributes to further crowding. Capacity constraints act as natural limits on the number of families in services and average length of stay, but compound unmet need as families are unable to access necessary assistance. Interventions that promote prevention and socioemotional supports in services offer promise for alleviating bottlenecks at service entrances as well as exits, and point to opportunities for future research implementing and testing systems-level change in homeless services. Improving the efficiency of the homeless service system can reduce children’s exposure to conditions that threaten healthy development.
Chair and Committee
Patrick J. Fowler
Peter S. Hovmand, Melissa Jonson-Reid, Leopoldo J. Cabassa, Sanmay Das,
Marcal, Katherine, "Promoting Child Behavioral Health in Homeless Services: A Community-Based System Dynamics Approach" (2019). Arts & Sciences Electronic Theses and Dissertations. 1835.