As individuals with lived experiences of homelessness, trauma, and psychological well being points, we had been excited on the alternative to critically evaluation the analysis article ‘A Co-produced Worldwide Qualitative Systematic Evaluate on Lived Experiences of Trauma Throughout Homelessness in Maturity and Impacts on Psychological Well being’ (Adams et al, 2025).
We’re keenly conscious of the consequences that trauma has had on us earlier than, throughout, and after experiences of homelessness. This enduring influence of traumatic experiences, and the hyperlink between experiences of homelessness and trauma, is properly established. Research point out that 80-100% of people that expertise homelessness even have expertise of traumatic occasions (Piercy, 2023; O’Donnell et al, 2014). Adams et al’s (2025) systematic evaluation about how trauma is a results of grownup experiences of homelessness is talking to a difficulty that’s pricey to our hearts.
Nonetheless, we had been disillusioned by the scope and conclusion of this evaluation. We agree with the authors’ conclusion that ‘understanding traumatic experiences throughout maturity homelessness [is] essential for informing intervention growth and insurance policies to mitigate and eradicate homelessness’ (Adams et al, 2025, p. 1). We’re not sure, nonetheless, if that is new information.
The hyperlink between homelessness and trauma is well-known; some research estimate that 100% of people that expertise homelessness even have expertise of traumatic occasions. This co-produced evaluation aimed to discover experiences of each homelessness and trauma.
Strategies
The researchers concerned on this systematic evaluation display a rigorous use of a number of established protocols, together with for his or her co-production with individuals with lived expertise of homelessness. The co-production facet was formed by the Authors and Shoppers Collectively Impacting on eVidencE (ACTIVE) framework (Pollock et al, 2019). ACTIVE directs clear co-production processes that clearly define who was concerned, how they had been recruited, and the diploma to which they influenced the analysis.
The worldwide qualitative systematic evaluation included tutorial and gray literature sourced from ASSIA, CINAHL, Cochrane, EMBASE, MEDLINE, Proquest theses and dissertations, PsycINFO, Scopus, and Internet of Science, in addition to Google and related charity/well being/social care web sites. The search key phrases included phrases associated to qualitative analysis, homelessness, trauma, psychological well being, and substance use.
The processes of this evaluation had been additional guided by the Important Appraisal Abilities Programme Qualitative Research Guidelines, a longtime score scale that was tailored by the researchers, and a ‘“best-fit” framework synthesis’ (Adams et al, 2025, p. 513).
In addition to the great use of a number of frameworks, the literature search was notably thorough. The researchers included all related worldwide literature revealed up till February 2024, searching for translations and direct entry to papers the place wanted.
For this evaluation, the researchers selected to make use of a broad understanding of psychological well being: they included dialogue of resilience and wellbeing, substance use, and psychological well being issues. In addition they selected to make use of SAMHSA’s ‘holistic illustration’ of trauma to incorporate ‘the vary of occasions and experiences of trauma that will be mirrored in qualitative literature’ (Adams et al, 2025, p. 513). Nonetheless, they refined the inhabitants of individuals experiencing homelessness, excluding those that had been homeless on account of group displacement.
Outcomes
In complete, 8,915 information had been screened for inclusion by the group with 180 totally assessed for eligibility and 27 included within the evaluation. These research representing the experiences of 909 individuals had been included and direct quotes from individuals with experiences of homelessness, trauma, and psychological well being had been used for the evaluation.
The researchers recognized ten themes from the literature utilizing their SAMSHA-based conceptual mannequin of trauma associated to homelessness.
Expertise of homelessness
The researchers recognized that folks experiencing homelessness recurrently used destructive emotional descriptors of their experiences. This included experiences of disgrace, rejection, isolation, shock, disbelief, helplessness, and failure. Homelessness was described as a extremely traumatic expertise.
Chaos surrounding homelessness
Homelessness was recurrently skilled alongside different traumatic and sophisticated occasions. This included inappropriate, insufficient, and unsafe lodging; felony justice involvements; caregiving obligations; and well being difficulties.
Coping with the psychological well being impacts of trauma
All included research described trauma as impacting the psychological well being of individuals with experiences of homelessness. The authors describe these impacts as ‘very outstanding within the proof’ (Adams et al, 2025, p. 519), however word that impacts diverse.
A relentless state of worry
The authors describe fears associated to private security as a ‘widespread influence of trauma whereas homeless’ (Adams et al, 2025, p. 519). These fears arose from private experiences of violence in addition to from witnessing the experiences of others.
Anxiousness and melancholy
Individuals experiencing homelessness described being overwhelmed by their experiences, resulting in panic assaults and suicidality.
Substance use as a administration technique
Use of medication and alcohol had been described as a coping mechanism whereas experiencing homelessness.
Methods to really feel secure
The authors described methods that had been put in place to extend emotions of security. These included the usage of shelters and withdrawal from different individuals experiencing homelessness.
Responses to repeated publicity to trauma
Individuals experiencing homelessness additionally described direct and oblique traumas along with being homeless. These experiences had been recognized as creating an acceptance of the inevitability of trauma or as forming a motivation to alter.
Acceptance and resignation as a response
The recurrent experiences of trauma contributed to traumatic experiences being seen because the norm. This included the outline of traumatic experiences with out the anticipated destructive feelings and/or with the idea of traumatic experiences as inevitable.
Hope for a greater tomorrow as a response
A minority of individuals experiencing homelessness expressed hope and resilience in response to their experiences of homelessness. This included the expression of a want to make a distinction within the lives of others.
This qualitative evaluation discovered that folks experiencing homelessness had been so accustomed to trauma that it was seen as a standard a part of being.
Conclusions
The authors concluded that experiences of homelessness contain experiences of trauma. They spotlight the additional results of this on psychological well being, substance use, and a desensitisation to traumatic experiences.
The authors advocate early intervention to mitigate the impacts of trauma and ‘enhance the psychological well being and wellbeing of people who find themselves experiencing homelessness and assist their transition out of homelessness’ (Adams et al, 2025, p. 523).
The authors additionally counsel that extra analysis is required to higher perceive methods to forestall the trauma of homelessness.
This evaluation highlights the influence of trauma on psychological well being and substance use amongst those that expertise homelessness.
Strengths and limitations
As we now have already famous, we’re not satisfied that the findings of this systematic evaluation are noteworthy or enough. Whereas this systematic evaluation is clearly complete inside its scope, we really feel that this scope is unhelpfully restricted.
The authors argue that interventions to construct extra optimistic responses to homelessness would cut back the impacts of trauma and improve the probability that folks experiencing homelessness will interact with companies that may assist them exit homelessness. Nonetheless, this doesn’t account for the truth that homelessness companies have restricted assets and that these influence on the helps that they can present, notably within the context of inadequate entry to inexpensive housing (Bullen & Baldry, 2019; Clarke et al, 2020; Spinney et al, 2020).
We recognise that the authors’ evaluation would possibly properly be influenced by the lived experiences of the analysis group. Because the authors state, together with individuals with lived expertise of the subject material in analysis groups can enhance the standard, influence and relevance of the findings. The experiences of this group is likely to be completely different to our personal, and this would possibly cause them to completely different priorities and understandings.
Nonetheless, we had been additionally unclear in regards to the diploma of affect exerted by the lived expertise analysis group members. Whereas virtually all points of the ACTIVE framework indicated that the lived expertise researchers exercised affect or management, the authors don’t make it specific which member/s of the analysis group made this evaluation.
Additionally, the authors don’t describe how energy and conflicts had been managed between lived expertise group members and the remainder of the analysis group. That is regardless of the authors stepping by way of their course of for managing conflicts between the institutional researchers together with when, and the way, selections are escalated to the senior researcher.
Whereas we commend the authors for acknowledging the significance of lived expertise, and together with co-production processes on this challenge, we discovered ourselves with extra questions than solutions in regards to the results on this evaluation. For instance, how had been the lived experiences associated to the particulars of this evaluation? Did the lived expertise researchers have any alternatives to resolve on the scope of this evaluation or how they had been to be concerned in its processes? Contemplating this evaluation relied on established protocols, which the lived expertise contributors had been skilled in, how did their lived expertise experience work together with the educational understandings of information?
Total, the strategies used on this examine display a conscientious and thorough analysis design, however we fear that the nuances and gray areas of lived expertise and co-produced analysis may need been misplaced the place there wasn’t specific, and academically created pointers.
The strategies used on this examine display a conscientious and thorough analysis design, however we fear that the nuances and gray areas of lived expertise and co-produced analysis may need been misplaced.
Implications for observe
The clearest implications of this evaluation for observe are that addressing homelessness inevitably entails addressing trauma.
Christine has lengthy advocated for trauma-informed practices to be embedded in all homeless companies to cut back trauma triggers and de-escalate psychological well being crises. Past this, trauma-informed practices present clear companies that assist unbiased and knowledgeable decision-making for individuals experiencing homelessness (Wiewel & Hernandez, 2022). Christine has private expertise, and we each have skilled expertise, which has proven us how companies can both scale back or improve the impacts of trauma.
Nonetheless, the important thing cause that homelessness continues is due to inadequacies in housing coverage and provide (see, for instance, Clarke et al, 2020; Colburn & Aldern, 2022; Spinney et al, 2020). Whereas it is likely to be essential to deal with the impacts of trauma that outcomes from homelessness, we can not see how any interventions to deal with trauma could possibly be efficient whereas persons are in any other case saved in experiences of homelessness.
Trauma-informed companies, and higher particular person trauma coping methods, won’t finish homelessness on their very own, however they will contribute to higher outcomes.
Trauma-informed companies won’t alone finish homelessness, however they will contribute to higher outcomes.
Assertion of pursuits
Christine Thirkell and Skye Constantine are founding members of the Lived Expertise Led Homelessness Collective, an unbiased peer community of individuals with lived/residing expertise of homelessness in Australia. They’re each actively concerned in varied collaborations with lived/residing expertise of homelessness together with analysis, advocacy, and capability constructing in each volunteer and paid capacities. All views expressed are their very own and are unbiased of any affiliations.
Edited by
Laura Hemming.
Hyperlinks
Main paper
Emma Adams, Kerry Brennan-Tovey, Joanne McGrath, Steven Thirkle, Neha Jain, Maria Aquino, Victoria Bartle, Joanne Kennedy, Margaret Ogden, Jeff Parker, Sophie Koehne, Eileen Kaner, Sheena Ramsay (2025) A co-produced worldwide qualitative systematic evaluation on lived experiences of trauma throughout homelessness in maturity and impacts on psychological well being. Trauma, Violence, & Abuse 2025 26(3) 510-527.
Different references
Piercy, PB. Homelessness and trauma: a vicious cycle. The Psychological Elf, 31 Mar 2023.
