Weighing the options: Service user perspectives on homeless outreach services

On a single night in 2018, over 194,000 individuals experienced unsheltered homelessness across the United States. Homeless outreach programs are often a first point of contact for these individuals, providing essential services, including connecting them to emergency shelter. Guided by the socio-rational choice model, this qualitative study aimed to address two questions: 1) How do experiences with outreach workers affect the way individuals experiencing unsheltered homelessness determine the utility of services offered by outreach programs? 2) What specific factors related to outreach interactions are involved in street homeless individuals’ decision to utilize or reject services from homeless outreach programs? Thirty-eight semi-structured interviews were conducted with street homeless individuals who had experience with homeless outreach in New York City. Interviews were first coded using a template approach followed by the use of a theory-guided approach for further analysis. Five main themes were identified that provided an understanding of individuals’ decision to engage with outreach services: credibility, transparency, offering choices, bureaucracy, and opportunity cost. This study provides insight into unsheltered individuals’ perspectives on homeless outreach workers and programs and offers suggestions for implementing micro- and macro-level changes to better meet the needs of our homeless neighbors.