‘Don’t Leave Me Hanging’: Homeless Mothers ’ Perceptions of Service Providers

Few interventions have been developed for substance-abusing homeless mothers. Among those interventions, high dropout rates (up to 85%) are consistently reported. Understanding homeless mothers ’ experiences with service providers may be an important first step to understanding ways to increase treatment engagement. Therefore, the current study used qualitative methods to gain a better understanding of homeless mothers ’ perceptions of service providers. A total of 28 mothers who were currently residing at a homeless shelter in a Midwestern city participated in three focus groups. Overall, mothers held negative perceptions of service providers related to understanding, support, and fear. Based upon this study’s findings, recommendations are offered to improve service delivery and guide future research. Keywords Homeless mothers; substance abuse; treatment engagement; service providers In recent years, the number of homeless families has increased in the United States with an estimated 535,447 individuals identified as a member of a homeless family (U.S. Department of Housing and Urban Development, 2010). Previous literature has examined risk factors for becoming homeless, as well as the challenges associated with homelessness. One challenge experienced by a high percentage (38 % to 56%) of homeless mothers is substance use (Center for Substance Abuse Treatment [CSAT], 2009). Unfortunately, attempts at developing interventions for homeless mothers with substance use disorders have limited success, and programs report high treatment dropout rates (Sacks et al., 2004; Smith, North, & Fox, 1995). To engage and maintain homeless mothers in treatment, exploring those factors that impact their decisions to seek out and remain in treatment may be important. Experiences with service providers likely impact treatment engagement and retention; therefore, this study uses qualitative methods to better understand those experiences. Homeless mothers face several challenges, including unmet medical needs (Lewis, Andersen, & Gelberg, 2003) and high rates of sexual and physical abuse (Bassuk et al.