As folks with lived experiences of homelessness, trauma, and psychological well being points, we have been excited on the alternative to critically evaluate 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 results that trauma has had on us earlier than, throughout, and after experiences of homelessness. This enduring affect of traumatic experiences, and the hyperlink between experiences of homelessness and trauma, is nicely 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 evaluate about how trauma is a results of grownup experiences of homelessness is chatting with a problem that’s expensive to our hearts.
Nonetheless, we have been dissatisfied by the scope and conclusion of this evaluate. We agree with the authors’ conclusion that ‘understanding traumatic experiences throughout maturity homelessness [is] vital 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 data.
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 evaluate aimed to discover experiences of each homelessness and trauma.
Strategies
The researchers concerned on this systematic evaluate exhibit a rigorous use of a number of established protocols, together with for his or her co-production with folks with lived expertise of homelessness. The co-production side 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 have been recruited, and the diploma to which they influenced the analysis.
The worldwide qualitative systematic evaluate 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 evaluate have been additional guided by the Crucial Appraisal Expertise 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 excellent 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 evaluate, 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 have been homeless as a consequence of neighborhood displacement.
Outcomes
In complete, 8,915 data have been screened for inclusion by the group with 180 absolutely assessed for eligibility and 27 included within the evaluate. These research representing the experiences of 909 folks have been included and direct quotes from folks with experiences of homelessness, trauma, and psychological well being have been used for the evaluation.
The researchers recognized ten themes from the literature utilizing their SAMSHA-based conceptual mannequin of trauma associated to homelessness.
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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.
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Chaos surrounding homelessness
Homelessness was recurrently skilled alongside different traumatic and sophisticated occasions. This included inappropriate, insufficient, and unsafe lodging; felony justice involvements; caregiving duties; and well being difficulties.
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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 distinguished within the proof’ (Adams et al, 2025, p. 519), however notice that impacts various.
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A continuing state of worry
The authors describe fears associated to private security as a ‘frequent affect 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.
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Nervousness and despair
Individuals experiencing homelessness described being overwhelmed by their experiences, resulting in panic assaults and suicidality.
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Substance use as a administration technique
Use of medicine and alcohol have been described as a coping mechanism whereas experiencing homelessness.
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Methods to really feel secure
The authors described methods that have been put in place to extend emotions of security. These included using shelters and withdrawal from different folks experiencing homelessness.
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Responses to repeated publicity to trauma
Individuals experiencing homelessness additionally described direct and oblique traumas along with being homeless. These experiences have been recognized as creating an acceptance of the inevitability of trauma or as forming a motivation to alter.
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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.
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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 need to make a distinction within the lives of others.
This qualitative evaluate discovered that folks experiencing homelessness have been so accustomed to trauma that it was seen as a traditional 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 stop the trauma of homelessness.
This evaluate highlights the affect of trauma on psychological well being and substance use amongst those that expertise homelessness.
Strengths and limitations
As we’ve already famous, we aren’t satisfied that the findings of this systematic evaluate are noteworthy or adequate. Whereas this systematic evaluate is clearly complete inside its scope, we really feel that this scope is unhelpfully restricted.
The authors argue that interventions to construct extra constructive responses to homelessness would cut back the impacts of trauma and improve the chance that folks experiencing homelessness will interact with providers that may assist them exit homelessness. Nonetheless, this doesn’t account for the fact that homelessness providers have restricted assets and that these affect on the helps that they’re able to present, notably within the context of inadequate entry to reasonably priced housing (Bullen & Baldry, 2019; Clarke et al, 2020; Spinney et al, 2020).
We recognise that the authors’ evaluation may nicely be influenced by the lived experiences of the analysis group. Because the authors state, together with folks with lived expertise of the subject material in analysis groups can enhance the standard, affect and relevance of the findings. The experiences of this group is perhaps totally different to our personal, and this may cause them to totally different priorities and understandings.
Nonetheless, we have been additionally unclear in regards to the diploma of affect exerted by the lived expertise analysis group members. Whereas nearly all facets of the ACTIVE framework indicated that the lived expertise researchers exercised affect or management, the authors don’t make it express which member/s of the analysis group made this evaluation.
Additionally, the authors don’t describe how energy and conflicts have been managed between lived expertise group members and the remainder of the analysis group. That is regardless of the authors stepping by their course of for managing conflicts between the institutional researchers together with when, and the way, choices 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 venture, we discovered ourselves with extra questions than solutions in regards to the results on this evaluate. For instance, how have been the lived experiences associated to the particulars of this evaluate? Did the lived expertise researchers have any alternatives to resolve on the scope of this evaluate or how they have been to be concerned in its processes? Contemplating this evaluate relied on established protocols, which the lived expertise contributors have been educated in, how did their lived expertise experience work together with the tutorial understandings of information?
Total, the strategies used on this research exhibit a conscientious and thorough analysis design, however we fear that the nuances and gray areas of lived expertise and co-produced analysis might need been misplaced the place there wasn’t express, and academically created tips.
The strategies used on this research exhibit a conscientious and thorough analysis design, however we fear that the nuances and gray areas of lived expertise and co-produced analysis might need been misplaced.
Implications for follow
The clearest implications of this evaluate for follow are that addressing homelessness inevitably entails addressing trauma.
Christine has lengthy advocated for trauma-informed practices to be embedded in all homeless providers to scale back trauma triggers and de-escalate psychological well being crises. Past this, trauma-informed practices present clear providers that assist impartial and knowledgeable decision-making for folks experiencing homelessness (Wiewel & Hernandez, 2022). Christine has private expertise, and we each have skilled expertise, which has proven us how providers can both cut back or improve the impacts of trauma.
Nonetheless, the important thing purpose 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 perhaps vital to handle the impacts of trauma that outcomes from homelessness, we can’t see how any interventions to handle trauma might be efficient whereas persons are in any other case stored in experiences of homelessness.
Trauma-informed providers, and higher particular person trauma coping methods, won’t finish homelessness on their very own, however they will contribute to higher outcomes.
Trauma-informed providers 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 impartial peer community of individuals with lived/dwelling expertise of homelessness in Australia. They’re each actively concerned in numerous collaborations with lived/dwelling 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 impartial 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 evaluate 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.
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