An exploration of the role of alcohol in relation to living situation and significant life events for the homeless population in Merseyside, UK
Executive Summary
Approximately 10% of the population in the UK are estimated to have been homeless at some point in their lifetime (Crisis 2014) and there were 2,744 rough sleepers identified in England in 2014 (Department for Communities and Local Government 2015). Alcohol misuse is both a cause and effect of homelessness (Shelter 2007) and is considered to be a major health risks amongst the homeless (Crisis 2002).
This research used life history interviews and calendars to explore changes in the research participants’ alcohol consumption in relation to their living situation and significant life events. Additionally, PhotoVoice activities were used to further explore their everyday lived experiences.
Recovery capital, which is derived from the concept of ‘social capital’ (Bourdieu and Wacquant 1992; Teachman et al 1997), refers to the quality and quantity of resources that a person can access in order to initiate and sustain recovery from addiction (Granfield and Cloud 2001). In the context of this research, recovery capital has also been applied to the resources needed in order to overcome homelessness as well as addiction to alcohol.
The findings from this research highlight the importance of social capital during significant life events. It was often a lack of social capital that led to homelessness and increased alcohol consumption. Subsequently, in order to overcome alcohol addiction and homelessness, participants need to develop recovery capital. The sample that was recruited for this project was small, and is therefore not representative of the experiences of the homeless population in general. However, the findings from this research do demonstrate how further research is needed in order to further explore the relationships between alcohol consumption, living situation and significant life events.
Key findings
- Becoming homeless is often the result of several adverse life events occurring in a similar time-frame combined with a lack of available support. Having support networks is important in avoiding and overcoming homelessness.
- Alcohol is often used as a coping mechanism following mental health problems or adverse events. This can lead to alcohol use disorders and dependence.
- Death of loved ones and relationship breakdowns are often a factor leading to homelessness and/or high levels of alcohol. This is partly because they cause a further loss of support networks. Improving relationships is a key motivation in reducing alcohol consumption.
- Developing resilience is important in both overcoming homelessness and alcohol dependence, and in preventing future relapse.
- The involvement of research participants, through co-production methods such as PhotoVoice, provides key insights into lived experiences and perceptions.
Background
Homelessness is increasing in England and across the UK. It is estimated that 10% of the population in the UK have been homeless at some point in their lifetime (Crisis 2014) and there were 2,744 rough sleepers identified in England in 2014 (Department for Communities and Local Government 2015).
Alcohol use disorder is both a cause and effect of homelessness (Shelter 2007). High levels of alcohol consumption present a major health risk among the homeless population (Crisis 2002). Previous research shows people who are both homeless and have addictions face further difficulties in both finding housing and overcoming their substance use (McQuistion et al 2014; Padgett et al 2008). This is due to both stigma associated with homelessness and substance use disorders (Phillips 2015) and low levels of social support (Velasquez 2000; McQuistion et al 2014).
Life history approach
This project investigated the relationship between alcohol consumption, living situations, significant life events and recovery capital. It was based on ‘life history calendar’ interviews (Porcellato et al 2014; Fikowski et al 2014), in which participants mapped changes in living conditions and alcohol use against a calendar grid containing significant life events such as births, relationships, deaths.
Participants also took photographs that reflected their everyday experiences.
Recovery capital
The term ‘social capital’ can refer to the social resources an individual has access to, such as peer group and family support (Bourdieu and Wacquant 1992; Teachman et al 1997). ‘Recovery capital’ is originally founded on the concept of social capital, and refers to the quantity and quality of resources available to an individual to initiate and sustain recovery from addiction. (Granfield and Cloud 2001). In this report, the concept of recovery capital has been applied to the resources needed in order to overcome homelessness as well as alcohol addiction.
Implications
This research highlights the significance of social capital with regards to homelessness, alcohol use disorders and dependence. Strong social capital and support during adverse life events increases the chance that damaging consequences will be avoided. Our findings demonstrate the importance of identifying individuals with low social capital during crisis periods to help ensure they receive appropriate support.
The concept of recovery capital was important for participants experiencing alcohol addiction. Some had attended detox and rehabilitation programmes previously and described how lack of resources and social support hindered their recovery.
This research also shows that, alongside promoting recovery capital, developing resilience can also help prevent relapse. Many of the adverse events that happened in the participants’ life course are common within the general population (for example divorce, relationship breakdowns, illness and unemployment). However, among our participants a lack of resilience and social capital meant such events often escalated. It is therefore important that services working with this population help in developing resilience skills.
Conclusion
This research demonstrates that life history calendars improve understanding of the perspectives of homeless alcohol users, and therefore improve the development of both prevention approaches and support strategies.
Our findings also highlight the importance of social capital in coping with significant, and adverse, life events. Poor social capital can contribute to homelessness and increased alcohol consumption. Recovery capital is important in tackling both alcohol dependence and homelessness.
Understanding the relationship between alcohol consumption, living situation and significant life events is clearly important in helping to reduce both homelessness and alcohol use disorders.
Developing tools by which these relationships can be identified and understood is critical. Life history calendars represent a potentially powerful approach, which these findings show can be applied effectively in the context of homeless alcohol use.