| dc.description.abstract | Background: In recent years, the Netherlands has faced a significant increase in the number of people experiencing homelessness (PEH) and housing exclusion. The issue appears to be most present in urban areas. Among the homeless population, people living rough (i.e. in public spaces) face the most extreme types of living situations. Many of them are excluded or
disengaged from social services.
Aim: This study aims to get insights into the factors that shape social service utilization among the population living rough in Amsterdam, highlighting the role of personal, social and structural conditions.
Methods: Semi-structured interviews were conducted with local practitioners (n=7 outreach
workers, n=1 local advocate), experts by experience (n=3), and academic professionals (n=4).
Participants were selected through purposive sampling based on expertise and relevance. Data was systematically analyzed using framework analysis, guided by the socio-ecological model (SEM).
Results: Service utilization among rough sleepers is shaped by numerous factors on the personal, social, and structural level. On the individual level, socio-demographic characteristics (e.g. gender, nationality), personal attitudes (e.g. distrust) and past experiences can shape how people experience or access care services. On the social level, interpersonal dynamics between care providers and rough sleepers can either support or hinder service engagement. On the structural level, it was found that organizational constraints (e.g. limited service capacity or poor conditions), inter-organizational conditions (e.g. fragmented referral systems) and restrictive policies (e.g. lacking legal entitlement or regional connection) can either exclude or prevent individuals from using local services. More often, it is the interplay between these multi-level factors that ultimately results in service (dis)engagement.
Conclusions: Social service utilization among rough sleepers is often shaped by the interaction between personal, social, and structural conditions. While structural constraints may directly exclude people from access, it is the interplay between personal and social barriers that can further constrain service use. This study offers practical insights for effective local policy and interventions, while also identifying directions for future research aimed at improving social care for homeless people living rough. | |
