Table 3 Quotes on characteristics of homeless people that hamper accessible or appropriate care
Theme | No. | Quote |
|---|---|---|
1. No stereotype | Q1 | “Care avoidance isn’t a single big group you can tackle in one go. The pattern varies hugely from one person to the next.” (P16, spiritual caregiver) |
2. Complexity of problems | Q2 | “I’d associate care avoidance with significant medical problems. They’ve also often been through a lot of psychotherapy and mental care already. They’ve seen it all before.” (P24, street pastor) |
3. Other priorities | Q3 | “If you’re homeless, you have to be ready to do things for your health that you don’t actually like. If they’d had normal lives, it maybe wouldn’t have been do difficult, but they don’t think it’s worth it. Scoring is often more important.” (P22, formerly homeless person) |
4. Maintaining self-control | Q4 | “I don’t think that they’re afraid to go to a doctor. They’re afraid that it’ll end up restricting their lives, you know? Suppose the doctor says you’ve got to be admitted to hospital... well, there’s no boozing or smoking in hospital. That lifestyle will be changed drastically – the doctor’s restricting what you can do, because you’ve got to go to hospital. They don’t want that. They don’t want to be tied down; they want to be able to respond when they think they need to. Maybe they’ll do nothing all day, but you never know – maybe the one time that they do have an appointment is just the moment when they could nick something or score or whatever. Yup, then they’re stuck with the appointment and they don’t think it’s right” (P22, formerly homeless person) |
5. Fear of stigmatization and treatment related to psychological or psychiatric problems | Q5 | “For mental things in particular, I think that people do avoid care. So it’s sometimes not so much care avoidance as denial and lack of an understanding of their illness as well. That’s often the case with psychiatric conditions. People who hallucinate but have a lot of difficulty admitting they’re hallucinations and who feel they’re being pigeon-holed. But if it’s a perception that you’ve got but they haven’t, then they feel they’re being accused of inventing things that they think are absolutely true. But, well, they don’t think there’s much point talking to a doctor anymore because they won’t be taken seriously.” (P6, street pastor) |