Reflexive mapping exercise of services to support people experiencing or at risk of homelessness: a framework to promote health and social care integration

ABSTRACT

This article describes the process to create a framework to map services for people experiencing and/or at risk of becoming homeless. Using a participative and multi-agency approach the Reflexive Mapping Exercise (RME) was proposed to increase knowledge on what is available to address the health and social care needs of those experiencing homelessness and to encourage synergies between sectors addressing prevention and management of homelessness. Applied in the Scottish context of design and implementation of national and local policies, this framework identify gaps in service provision and can be a tool to improve integration and communication between services to support vulnerable groups. The RME results provided information of the current status of services in eight areas of care, combined with their spatial distribution. The analysis revealed an unequal distribution of services, with major focus on services addressing crisis periods of homelessness and less on prevention and sustainability out of homelessness. The REM has been informing the redesign of services of a local five years homelessness strategic plan (2016–2021) in a Scottish city, with high levels of deprivation, and can be used to create more integrated pathways to health and social care for people experiencing extreme social exclusion.

KEYWORDS:

• Reflexive mapping exercise
• integrated care
• homelessness
• inequalities‌
• multi-agency working

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Scottish Government [grant number 121.80.4497].

Notes on contributors

Andrea Rodriguez

Andrea Rodriguez has Masters in Psycho-sociology of Communities, and a PhD in SocialPsychology from Federal University of Rio de Janeiro, Brazil. Her academic and professional experience has a strong connection with Third Sector organisations working with human rights, social inequalities, health promotion and community development. She has 25 years of experience working in social and educational programmes, and doing community-based participatory research. She leads the Scottish oral Health Improvement Research Programme for people experiencing homelessness.

Garima Arora

Garima Arora has Masters in Public Health fromUniversity of Glasgow, Scotland. She worked as a general dentist in New Delhi, India, before taking the post of at the Department of Medicine College Jagdalpur, India. Currently, she works on the Scottish Oral Health Improvement Prison Programme at University of Dundee, UK.

Laura Beaton

Laura Beaton has Masters in Health Psychology from University of Edinburgh, and a PhD in Dental Public Health from University of Dundee, UK. Currently she works as a research fellow at the Dental Clinical Effectiveness team at NHS Education for Scotland, examining the implementation of dental guidance in general dental practice.

Fernando Fernandes

Fernando Fernandes has a PhD in Geography from Federal University of Rio de Janeiro, Brazil. Fernando have been working with urban marginality in Brazil and Scotland for almost two decades. Since 2010 Fernando works at University of Dundee, currently at the Community, Learning and Development Programme, exploring theoretical and conceptual dialogue to address criminalization of the poor. He is also an associate for the centre fro Youth and Criminal Justice and the Scottish Centre for Crime and Justice Research.

Ruth Freeman

Ruth Freeman completed her PhD at the Queen’s University of Belfast. She is a member of the British Psychoanalytic Council and a fellow of the Faculty of public health, Royal College of Physicians (UK). She is Professor of Dental Public Health Research and Honorary Consultant in Dental Public Health. She is Director of the Oral Health and Health Research programme and Co-director of the Dental Health Services Research Unit at the University of Dundee.