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Dpath-3): Changes in the Composition and Service Needs of the Homeless Adult Population Wayne State University Wayne State University Dissertations January 2019 Detroit People And Transitions In Housing-3 (dpath-3): Changes In The Composition And Service Needs Of The Homeless Adult Population Kiel Opperman Wayne State University, [email protected] Follow this and additional works at: https://digitalcommons.wayne.edu/oa_dissertations Part of the Clinical Psychology Commons Recommended Citation Opperman, Kiel, "Detroit People And Transitions In Housing-3 (dpath-3): Changes In The Composition And Service Needs Of The Homeless Adult Population" (2019). Wayne State University Dissertations. 2242. https://digitalcommons.wayne.edu/oa_dissertations/2242 This Open Access Dissertation is brought to you for free and open access by DigitalCommons@WayneState. It has been accepted for inclusion in Wayne State University Dissertations by an authorized administrator of DigitalCommons@WayneState. DETROIT PEOPLE AND TRANSITIONS IN HOUSING-3 (DPATH-3): CHANGES IN THE COMPOSITION AND SERVICE NEEDS OF THE HOMELESS ADULT POPULATION by KIEL JAY OPPERMAN DISSERTATION Submitted to the Graduate School of Wayne State University, Detroit, Michigan in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY 2019 MAJOR: PSYCHOLOGY (Clinical) Approved By: ____________________________________ Advisor Date ____________________________________ ____________________________________ ____________________________________ ____________________________________ DEDICATION This is dedicated to all our fellow citizens of Wayne County who find themselves homeless. Let us never cease in bolstering the voice of those who need it the most. ii ACKNOWLEDGEMENTS I would like to acknowledge all of those who dedicate their lives to supporting the most vulnerable in Wayne County. At times, this type of work can be defeating, seeing so much suffering and not having access to the resources our consumers need. Even though service providers and advocates of the homeless community are overworked and underpaid, they were extremely supportive of our research project and went out of their way to ensure this study’s success. I want to thank all of those who assisted us and believe this project was important for the homeless community. I would also like to thank my family, friends, and partner. It is hard to believe that I have almost earned a Ph.D. in clinical psychology, a dream that began when I was a junior in high school. My mom (Laurie), dad (John), and sister (Amy) have supported me throughout this 16- year journey, during the highs and the lows. It is because of their unfailing encouragement that I am here today; I could not have done this without each of you. Thank you so much. To my friends who helped me temporarily escape from the stress of graduate school, I want to thank each of you. It meant a lot to me that we could share so many good times, which allowed for me to relax and get away from the chaos that is a Ph.D. program in clinical psychology. I want to thank my wonderful partner, Erica. You have always been patient and understanding of the responsibilities and inconveniences associated with being a graduate student in a Ph.D. program. I cannot begin to list all of the instances where you went above and beyond to make my life easier. We shared lots of laughter, happy hours, delicious meals, and new experiences over the past few years. I am so excited to start a life with you, one where I am no longer a student… iii The data collection associated with this dissertation was complex and very time consuming. Without the help of my dedicated research team, I never would have finished this project.. First, I want to thank Cara Cannoy and Kelly Toal, both of who took the reins of this project when I went on internship at the Detroit VA. I also want to thank all of the research assistants who assisted in this project: Brittnee Avritt, Shelby Darichuk, Katrail Davis, Emily Eicher, Shaylin Excell, Shoshana Krohner, Rebecca Rea, Cara Struble, Lindsey Tregenza, and Colin Wilson. Finally, I would like to thank my advisor, Dr. Toro and dissertation committee: Dr. Mark Lumley, Dr. Emily Grekin, and Dr. Michael Kral. It is through your guidance and support that I am about to graduate and fulfill my dream of becoming a clinical psychologist. iv TABLE OF CONTENTS INTRODUCTION......................................................................................................................... 1 Health Disparities Among Homeless People........................................................................... 2 Changes in the Composition of the Homeless Population ..................................................... 4 Preliminary Studies .................................................................................................................. 6 DPATH-3 Assessment of Homeless Adults in Wayne County, MI ...................................... 6 Specific aim 1. ........................................................................................................................ 7 Specific aim 2. ........................................................................................................................ 8 Exploratory aim. ................................................................................................................... 8 Implications ............................................................................................................................... 8 METHOD .................................................................................................................................... 10 Design ....................................................................................................................................... 10 Probability Sampling Methodology....................................................................................... 10 Key informant interviews. .................................................................................................. 11 Sampling surveys. ............................................................................................................... 12 Collecting full-length interviews. ....................................................................................... 13 Potential risk........................................................................................................................ 13 Community Involvement and Benefit ................................................................................... 14 Measures .................................................................................................................................. 15 Key informant interview. ................................................................................................... 16 Sampling survey measures. ................................................................................................ 16 Full length-interview measures. ......................................................................................... 16 Data Analysis ........................................................................................................................... 19 v Specific aim 1. ...................................................................................................................... 20 Specific aim 2. ...................................................................................................................... 21 Exploratory aim. ................................................................................................................. 21 RESULTS .................................................................................................................................... 22 Key Informant Interviews: DPATH-3 .................................................................................. 22 Sampling Surveys: DPATH-3 ................................................................................................ 22 Full-Length Interviews: DPATH-3 ....................................................................................... 24 Full-length interviews: DPATH comparisons – specific aim 1. ...................................... 25 Full-length interviews: Unmet service needs- specific aim 2. ......................................... 29 Full-length interviews: barriers to care- exploratory aim. ............................................. 31 DISCUSSION .............................................................................................................................. 34 Specific Aim 1 .......................................................................................................................... 34 Specific Aim 2 .......................................................................................................................... 41 Exploratory Aims .................................................................................................................... 46 Overarching Implications for Homeless People and the Service Community .................. 49 Localized Recommendations.................................................................................................. 54 Limitations ............................................................................................................................... 56 Future Directions .................................................................................................................... 58 REFERENCES ...........................................................................................................................
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