1. FRAGMENTED FAMILIES: UNDERSTANDING THE HEALTH AND SOCIAL SERVICE SYSTEM NEEDS FACING HOMELESS MOTHERS Denise Zabkiewicz, PhD, Michelle Patterson, PhD, and Kelsi Cox, BA Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia SUMMARY & CONCLUSIONS  Children are an important part of mothers’ lives and ensuring their safety and security, including housing and child custody, was found to be a high priority for all mothers.  While some mothers received services that met their needs, others felt stigmatized as a result of their poverty and single motherhood.  A service system committed to maintaining family integrity while simultaneously meeting the needs of homeless families should consider the use of independent advocates in order to facilitate the broad range of social and health services that families living in poverty are in need of. The investigators would like to acknowledge the clients and staff at St. Elizabeth’s Home for their participation and support of this project. This study was funded by the President’s Research Start-Up Grant, Simon Fraser University. BACKGROUND  Families, headed primarily by single mothers, are now the fastest growing segment of the homeless population in North America.  While the majority of homeless women are parents of minor-aged children, few children are living with their homeless mothers.  Health and social services are conceptually divided and most services are not well designed to meet the fragile nature and complex needs of mothers living in poverty who rely on them.  For homeless mothers, the requirements they must fulfill to access and obtain services are often at odds with each other and in conflict with their parental roles and priorities.  It is within this context of a myriad of complex support needs that homeless families are forced to fragment and mothers are commonly separated from or lose custody of their children.  Mother-child separations often contribute to mental health problems in both mothers and their children. Other consequences include significant risks to children’s emotional and cognitive development as well as to emotional and behavioural problems.  Securing safe housing was critical. Safety centered on location, security, neighbors and fellow tenants.  Permanent housing was a top priority that impacted mothers’ abilities to parent and create stability in their lives.  Extended periods of homelessness made it a challenge for mothers to establish relationships with children who were not living with them.  Feelings of hopelessness and disappointment surrounding the lack of housing resources and the extended period of time it took to obtain subsidized BC Housing were common.  Mothers utilized a variety of services including income assistance, legal aid, community programs, shelters and food banks.  Experiences with service providers ranged from very positive… “I really thank everyone working here…they give me some encouragement or some strength and motivation to go ahead….I start to have positive thinking. I can study, I can have a better job now, I have hope to change.” …to experiences of stigma and discrimination. “I always have a feeling like no matter how hard you try, you feel like, get back to your corner, you belong there.” Themes surrounding services Hopes for the future METHODS  Semi-structured, in-depth interviews were conducted with 13 homeless mothers residing at St. Elizabeth’s Home emergency and transitional housing shelters in Vancouver, BC.  Participants were recruited through study flyers posted at the shelter.  Interviews, lasting approximately 1 hour, were conducted in a private location either in the participant’s own living area or in a common area within the shelter.  Participants received a $50 honorarium for their participation.  The study protocol was approved by the SFU Research Ethics Board and the management at the St. Elizabeth’s Home.  Thematic content analyses were conducted. Themes surrounding family fragmentation RESULTS faculty of health sciences STUDY AIMS  To describe the conflicts and trade-offs that homeless mothers face as they struggle to perform their mothering roles under the public scrutiny of homeless service providers and the threat of family f fragmentation. Themes surrounding housing  All mothers fought to ensure that they would be able to maintain custody of their children. One mother contacted Family Services proactively before her child was born so she could take parenting courses and prevent him from being apprehended. “I was doing all of those things because I wanted to make sure that they didn’t take John from me.”  Three mothers had permanently left their children in the care of family members. “I had no place to go….no house, no nothing, no apartment. So I had to leave her right?” Themes surrounding family reunification  Mothers learned to “jump through hoops” placed before them in their efforts to reunite with their children.  Once children were apprehended from mothers, establishing a home with stable housing was a requirement for regaining custody.  Regaining custody was often a long, arduous battle. “From then it was well 3 months, 3 months, another 3 months, another 6 months and it took me 7 years (of) fighting.” “…then came the long battle, it was about 8, 10 months to get them back. It was like I’d done something wrong, and the foster mother wouldn’t even look at me…”  Certain services seemed to meet the needs of specific women, while others felt that they were not receiving the support they needed.  Mothers involved with Family Services spoke of feeling continually watched and under constant supervision. “It’s very difficult being under a microscope with the Ministry…nobody looks good under a microscope.”  Some mothers felt that having the support of an advocate was crucial to navigating the system.  Mothers spoke of their hopes to return to school and move on with their lives in a way that was productive and healthy.  A common theme was a desire to use personal experiences to help others in similar situations.  There was also hope that the system would change in the future to better meet the needs of families and to focus more on prevention. “That’s where things need to be changed. Instead of pointing the finger, they should be saying, you know what, ‘we can’t understand what you went through, but we can try to help.’ “