Doctorate in Clinical Psychology: Main Research Portfolio

: 1) Delayed discharge in inpatient psychiatric care: A Systematic Review; 2) The representation of Black, Asian and Minority Ethnic Groups in Child and Adolescent Mental Health Services: A comparison of service access and provisions across ethnicities; 3) Homelessness and ideas of persecution: A mixed-methods questionnaire study examining persecutory beliefs and the role of safety behaviours in unstable housing.

Abstract

Mental health difficulties are highly prevalent in homeless populations. Fears of harm from others (persecutory beliefs) may contribute to, perpetuate, and result from people’s difficulties with unstable housing. Our aim was to examine whether persecutory beliefs contained housing concerns, assess the use of safety behaviours, and begin to explore the impact of such experiences on homelessness. We further aimed to investigate whether this group wanted to be asked about persecutory worries and supported with them.

Twenty-three people with experience of both homelessness and at least moderate-severe persecutory beliefs participated in a mixed-methods questionnaire. We found that persecutory worries explicitly related to previous (stable) living situations in eleven participants, with seven citing fearing harm from landlords or neighbours. An additional six participants reported persecutory beliefs that specifically related to homelessness. All participants reported using avoidance strategies to try to stay safe, with everyone reporting at least six different safety behaviours such as avoiding being at home or avoiding neighbours. There was also evidence of links between unstable housing, persecutory beliefs, and safety behaviours, with fifteen participants stating a clear association between these factors. Most participants reported that they would have wanted support with their persecutory beliefs.

The results of this study provide evidence that for some individuals the content of persecutory beliefs specifically relates to their living situation. Such beliefs, understandably, prompt avoidance and safety behaviours. This provides some suggestion that these experiences both can contribute to and maintain difficulties with housing. Participants described a desire to be supported with persecutory worries, though noted various barriers to accessing service input.

These findings have clinical implications for improving services for people experiencing persecutory fears relating to their housing, regardless of whether people are receiving formal mental health care or not.

Date of Award	22 Sept 2023
Original language	English
Awarding Institution	University of Bath
Supervisor	Pamela Jacobsen (Supervisor)