'An inkling of hope' : understanding personal recovery in individuals transitioning out of chronic homelessness : a transatlantic qualitative study

  • Dimitar Karadzhov

Student thesis: Doctoral Thesis


Individuals with serious mental illness (SMI) who are homeless are a client group withcomplex but often misunderstood and unmet health and social care needs. Althoughadopted by mental health policies and programmes in many developed countries,personal (mental health) recovery has remained markedly underresearched andundertheorised in relation to socio-structural disadvantage such as homelessness. Thistransatlantic qualitative participatory study aimed to address those knowledge andexplanatory deficits by exploring how individuals with a history of SMI and chronichomelessness made sense of their personal recovery, as well as what the barriers to,and facilitators of, their recovery were. This study also endeavoured to unravel thesocio-structural and contextual influences shaping recovery, as well as how individualsnavigated and negotiated those to enable better well-being and recovery. The lifestories and present-day narratives of 18 clients of temporary accommodation servicesin the U.S. and Scotland were elicited using in-depth interviews and a mobile phonediary between February and September 2018. Data from 45 interviews and more than200 diary entries were analysed using interpretative phenomenological analysis (IPA)and abductive-retroductive, critical realist analysis. The IPA revealed the significance of‘owning’ one’s recovery, as well as that of safety and constancy, insight, coping andsymptom management, nurturing a strong and positive sense of self, meaning in life,and feeling ‘wanted, accepted and needed’. Those super-ordinate themes captured theprocesses of envisioning and enacting recovery amidst homelessness. The criticalrealist analysis produced an explanatory model of personal recovery, whereby recoverywas the emergent outcome of the interplay between the conditioning effects of certainsocial structures and cultures and participants’ own agential capacities manifested inautonomous or fractured reflexive deliberations. Mental health and homelessnessservices should be designed and delivered in ways that enable clients’ intrinsiccapacities for self-reflection, self-directedness and emotional connectedness.
Date of Award15 Jul 2020
Original languageEnglish
Awarding Institution
  • University Of Strathclyde
SponsorsUniversity of Strathclyde
SupervisorBeth Weaver (Supervisor) & Neil Quinn (Supervisor)

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