2. S. BENBOW RN MSc n, C. FORCHUK RN PhD & S. L. RAY RN PhD

3. Individuals with mental illness are considered as most stigmatized group of people and highly devalued among those with disabilities. Homeless Mothers with mental illness have to face lots of challenges in their life time. This is considered as the most vulnerable population than other homeless women as they not only have to face stigma of mental illness but they are also younger and poorer. They usually suffer from poor physical and mental health which increases their emotional distress and leads to social withdrawal.

4. HEALTH OF MOTHERS WITH MENTAL ILLNESS EXPERIENCING HOMELESSNESS AS WELL AS THEIR INDIVIDUAL ACTS TO OVERCOME EXISTING BARRIERS

6. To examine existing oppression and ongoing resistance in the lives of homeless mother with mental illness To learn from these mothers what is conducive to their health

8. Lack of development and utilization of social support Domestic violence Neighbours harassment Relationship breakdown Natural disasters Low income Lack of affordability

10. Oppression- oppression is socially unjust situation whereby a group is unfairly denied access to the resources of society (Hill Collin 2000). It includes  Discrimination and Stigma faced by both mothers and children  Exploitation  Marginalization  Health inequalities  Difficult to utilize available resources

12. Acute and chronic illness Communicable diseases Substance abuse Sexual, physical, financial and psychological abuse Sexual transmitted infections Increased suicidal attempts Mortality Pre-existing health problems can exacerbate

13. High rates of victimization among homeless women High incidence of sexual and physical abuse High exposure and experience of trauma with history of childhood abuse. Ongoing male partner violence Harassment Threats and property damage within neighbourhoods

15. Study was examined from the perspective of feminist intersectionality. Feminist theory acknowledges the lived experiences of women as a valued source of knowledge for social change and intersectionality examines the complex dimensions of oppression based on race, ethnicity, gender, religion, ability, sexual orientation and class as interactive forces.

16. The design of the study is a qualitative secondary analysis. A pre-existing data from critical ethnography focus transcripts were analysed. These transcripts were generated from two primary studies:  Diversity and Homelessness: Minorities and Psychiatric Survivors study  A study on mental health and housing (Community- University Research Alliance). o Supplementary secondary analysis was used to examine existing data from the primary studies.

17. PARTICIPANTS There were total 67 participants. The sample was taken from seven focus group transcripts. Six focus groups were generated from the diversity and homelessness study and one focus group was from the CURA study.

19. Three themes emerged from the focus groups:  Discrimination based on intersecting social identities.  Being stuck: The cycle of oppression.  We’re not giving up: Resistance through perseverance.

20. These women expressed their experiences of discrimination based on a number of intersecting social identities, such as their homelessness, poverty status, mental illness, single motherhood as well as their race, language barriers and nationality. They shared that the discrimination they experienced was mostly from landlords and employers. Some participants expressed that landlords had expected them to identify their race, sexuality and disability as part of the housing application process. Others said that they were turned down from housing based on single motherhood and their poverty status/homelessness.

21. : I notice that I get a lot of racism against me because I look Native. I’m not Native but I look Native... ‘Well, we don’t want no Indian drunken in here.’ You get turned down... There’s a lot of racism on that and that’s a barrier for me in a lot of places as far as jobs, housing. Um, it took me probably about six months to fight to get into housing when I was living there because they didn’t want any Natives on the one street and I had to prove that I wasn’t Native. My children are half Native but they didn’t have to know that.

22. Embedded in each focus group was the concept of a never ending cycle. The mothers and service providers referred to the complex cyclic nature of becoming homeless, living in a dangerous environment, obtaining housing and often returning to homelessness. During this process, issues related to abuse and insufficient financial supports were reported. Many women explained that ending their homelessness came at the cost of returning to an abusive or dangerous situation. The cycle of oppression kept women suffering, struggling and unable to move forward.

23. Instead of sitting in here and if you are sitting here long enough and you don’t get a place. That is what is pushing you back to your abuser. Because I’m at the point where I am ready to just go back because I can’t get the place that I need... I’m getting pretty close to going back to that situation just to go back to him because I know that I’ll be taken care of, to a certain extent, because I can’t find the home that I need. And it’s like, what is the sense in even frigging trying if no one is willing to give that opportunity

24. CIRCLE REVOLVING DOOR CYCLE OF HOUSING CYCLE OF ABUSE CYCLE OF ABUSE OF SYSTEM ITSELF

25. Study reports that mothers were not passive participants but they actively tried to break away from the cycle. Escaping from abusive situations and subsequently becoming homeless to ensure their safety showed great courage and strength. Women reported that they sought safety for themselves and their children by fleeing domestic violence and becoming homeless.

26. Women emphasized the power of voice in creating change with their work in committees, political activism and publicity. Women also resisted hopelessness and embraced the possibility of a better future.

27. I left an unsafe situation um in my own home really, from my own home, so I find this [shelter], this is a safe place for me...I needed to find a safe situation outside of my home which right now this is it, so that’s why I’m here.

28. The study explored the oppression faced by mothers with mental illness and their attempts to escape from violence Mental illness and abuse were found as influencing each other and main contributing to the cycle of homelessness. mothers felt stuck in never ending cycle but they also demonstrated great resilience, strength and perseverance despite facing incredible hardships.

29. Restriction to an English-speaking population. Lack of demographics collected. Lack of information related to specific mental illness diagnoses. First, there was a limitation related to use of interpreters. Newcomers who did not speak English refrained from participation despite availability of interpreters. Also, information related to specific participant mental health diagnoses and participant demographics may have provided further context and understanding of participants’ unique experiences.

30. This research help the nurses to know the reason of oppression and also the ways to overcome this. While working with clients nurses can explore their health experiences to know their self identified health needs. By knowing this, nurses can learn from homeless mothers with mental illness how to offer them best support. Being first line nurses, mental health nurse can increase awareness regarding discrimination and injustices that homeless mothers face. Through this she can promote acknowledgement of vulnerable population.

31. Nurses can support clients in their resistance efforts by lobbying governments for increased individual and organizational support and allocation of tailored, appropriate resources Nurses can raise awareness of the need for temporary housing shelters for these women, as well as support for transitional programmes supporting homeless mothers with mental illness from homelessness to housing. Nurse should be aware of human rights and act as an advocate for the proper enforcement of clients’ rights in order to help break the cycle of oppression.