Résumés
Abstract
Homelessness is an escalating global issue, often rooted in significant trauma, which increases the risk for frontline workers of vicarious trauma that adversely impacts their well-being and work environment. This scoping review aimed to map existing interventions designed to support the well-being of frontline workers in the homelessness sector, highlighting their characteristics, objectives, and outcomes. Following the six-step framework by Arksey and O’Malley, refined by Levac et al. and the Joanna Briggs Institute, we conducted a narrative thematic analysis of 17 studies encompassing 1,679 frontline workers. The identified interventions addressing learning and development opportunities, therapy and consultation, supervision and mentorship, team building and networking, financial support, peer group support, administrative assistance, and self-care strategies. Reported outcomes of interventions included improved knowledge, skills, and self-efficacy; increased job satisfaction; stronger collaboration and sense of belonging; reduced burnout and staff turnover; advocacy for policy changes; and overall improvement in worker well-being. From the narrative analysis of intervention’s components and outcomes, four key themes emerged: (i) tailored training equips frontline workers to prevent and manage vicarious trauma; (ii) multidisciplinary teams benefit both clients and frontline workers; (iii) timely consultation and supervision reduce burnout and turnover; and (iv) administrative and leadership support enhances frontline worker well-being. These findings highlighted that strengthening the homelessness workforce requires a coordinated, cross-sectoral approach involving capacity-building through tailored training, leadership support via supervision and consultation, and appropriate financial incentives. Implementing comprehensive, systemic support fosters a healthier workforce and enables frontline providers to deliver more effective, trauma-informed care. This review provides a comprehensive overview of strategies to support frontline workers serving people experiencing homelessness.
Keywords:
- homeless persons,
- health personnel,
- community health workers,
- social determinants of health
Parties annexes
Bibliography
- Abdel-Samad, M., Calzo, J. P., Felner, J. K., Urada, L., Verbyla, M. E., Madanat, H., Adams, B. E., Alves, T., Appleyard, B., Chanin, J., Flanigan, S., Foad, H., Ginsberg, M., Higgins, M., Ko, E., Maher, K., Mladenov, N., Peattie, P., Welsh, M., & Sleet, D. (2021). Conceptualizing an interdisciplinary collective impact approach to examine and intervene in the chronic cycle of homelessness. International Journal of Environmental Research and Public Health, 18(4), 1-17. https://doi.org/10.3390/ijerph18042020
- Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
- Altungy, P., Torres, R., Liébana, S., Saiz, J., & Sánchez-Marqueses, J. M. (2022). An exploratory study on mental health and burnout in social care workers of an emergency shelter for the homeless population during the COVID-19 pandemic. Clinical and Health, 33(1), 29-34. https://scielo.isciii.es/pdf/clinsa/v33n1/1130-5274-clinsa-33-01-29.pdf
- Botan, V., Bowling, N. C., Banissy, M. J., Critchley, H., & Ward, J. (2018). Individual differences in vicarious pain perception linked to heightened socially elicited emotional states. Frontiers in Psychology, 9, 2355. https://doi.org/10.3389/fpsyg.2018.02355
- Bramley, G., & Wood, J. (2024). The economics of homelessness. In Gibb, K., Leishman, C., Marsh, A., Meen, G., Ong ViforJ, R., & Watkins, C. (Eds.). The Routledge Handbook of Housing Economics (pp. 1-15). Routledge. https://doi.org/10.4324/9780429327339
- Burge, R., Tickle, A., & Moghaddam, N. (2021). Evaluating trauma informed care training for services supporting individuals experiencing homelessness and multiple disadvantage. Housing, Care and Support, 24(1), 14-25. https://doi.org/10.1108/HCS-01-2021-0002
- Burke, C. W., Firmin, E. S., Lanni, S., Ducharme, P., DiSalvo, M., & Wilens, T. E. (2023). Substance use disorders and psychiatric illness among transitional age youth experiencing homelessness. JAACAP Open, 1(1), 3-11. https://doi.org/10.1016/j.jaacop.2023.01.001
- Chapleau, A., Seroczynski, A. D., Meyers, S., Lamb, K., & Haynes, S. (2011). Occupational therapy consultation for case managers in community mental health: exploring strategies to improve job satisfaction and self-efficacy. Professional Case Management, 16(2), 71–79. https://doi.org/10.1097/NCM.0b013e3181f0555b
- Compton, M. T., Reed, T., Broussard, B., Powell, I., Thomas, G. V., Moore, A., Cito, K., & Haynes, N. (2014). Development, implementation, and preliminary evaluation of a recovery-based curriculum for community navigation specialists working with individuals with serious mental illnesses and repeated hospitalizations. Community Mental Health Journal, 50(4), 383–387. https://doi.org/10.1007/s10597-013-9598-2
- Conejo, S. P., Lisboa, V. C., Caldeira, A. R., & Garcia, M. R. (2016). The construction of autonomy for professionals who work with drug users: An analysis of two intervention projects in the largest asylum centre in Brazil. Journal of Health Psychology, 21(3), 419–428. https://doi.org/10.1177/1359105316628755
- Crawford, K., & Campbell, A. (2025). Cross-sector homeless service collaboration: Perspectives from social service providers. International Journal on Homelessness, 5(2), 119–141. https://doi.org/10.5206/ijoh.2023.3.17513
- De Brier, N., Stroobants, S., Vandekerckhove, P., & De Buck, E. (2020). Factors affecting the mental health of healthcare workers during coronavirus disease outbreaks (SARS, MERS, & COVID-19): A rapid systematic review. PLOS ONE, 15(12), e0244052. https://doi.org/10.1371/journal.pone.0244052
- Figley, C. R. (Ed.). (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York, NY: Brunner/Maze
- Ferris, L. J., Jetten, J., Johnstone, M., Girdham, E., Parsell, C., & Walter, Z. C. (2016). The Florence Nightingale effect: Organizational identification explains the peculiar link between others' suffering and workplace functioning in the homelessness sector. Frontiers in Psychology, 7, 16. https://doi.org/10.3389/fpsyg.2016.00016
- Feriante, J., & Sharma, N. P. (2023). Acute and chronic mental health trauma. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK594231/
- Fogel, S. J., Groton, D., & Gurdak, K. (2025). Understanding what makes them stay: Retention in the frontline workforce for those unhoused. Journal of Social Service Research, 51(2), 529–542. https://doi.org/10.1080/01488376.2025.2460116
- Gaetz, S., Barr, C., Friesen, A., Harris, B., Hill, C., Kovacs-Burns, K., Pauly, B., Pearce, B., Turner, A., & Marsolais, A. (2012). Canadian definition of homelessness. Toronto: Canadian Observatory on Homelessness Press. www.homelesshub.ca/homelessdefinition
- Gifford, W.A., Squires, J.E., Angus, D.E., Ashley, L. A., Brosseau, L., Craik, J. M., Domecq, M., Egan, M., Holyoke, P., Juergensen, L., Wallin, L., Wazni, L., & Graham, I. D. (2018). Managerial leadership for research use in nursing and allied health care professions: A systematic review. Implementation Science, 13(1), 1-23. https://doi.org/10.1186/s13012-018-0817-7
- Gillard, S. (2019). Peer support in mental health services: Where is the research taking us, and do we want to go there? Journal of Mental Health, 28(4), 341–344. https://doi.org/10.1080/09638237.2019.1608935.
- Graham, K., & Meyer, M. (2025). Developing a system response to health and homelessness: The important role of health leaders. Healthcare Management Forum, 38(1), 30–34. https://doi.org/10.1177/08404704241266497
- Huo, Y., Couzner, L., Windsor, T., Laver, K., Dissanayaka, N. N., & Cations, M. (2023). Barriers and enablers for the implementation of trauma-informed care in healthcare settings: A systematic review. Implementation Science Communications, 4(1), 1-20. https://doi.org/10.1186/s43058-023-00428-0
- Iacobucci, G. (2022). Multi-agency approach is needed to improve services for homeless people, says NICE. BMJ, 376, o706. https://doi.org/10.1136/bmj.o706
- Iosim, I., Runcan, P., Dan, V., Nadolu, B., Runcan, R., & Petrescu, M. (2021). The role of supervision in preventing burnout among professionals working with people in difficulty. International Journal of Environmental Research and Public Health, 19(1), 160. https://doi.org/10.3390/ijerph19010160
- Jaskela, S., Guichon, J., Page, S. A., & Mitchell, I. (2018). Social workers’ experience of moral distress. Canadian Social Work Review, 35(1), 91–107. https://doi.org/10.7202/1051104ar
- Jego, M., Abcaya, J., Calvet-Montredon, C., & Gentile, S. (2019). Improving health care management in primary care for homeless people: A literature review. European Journal of Public Health, 29, (Suppl. 4), ckz186.005. https://doi.org/10.1093/eurpub/ckz186.005
- Joob, B., & Wiwanitkit, V. (2020). Traumatization in medical staff helping with COVID-19 control. Brain, Behavior, and Immunity, 87, 10. https://doi.org/10.1016/j.bbi.2020.03.020
- Kerman, N., Ecker, J., Tiderington, E., Gaetz, S., & Kidd, S. A. (2023). Workplace trauma and chronic stressor exposure among direct service providers working with people experiencing homelessness. Journal of Mental Health (Abingdon, England), 32(2), 424–433. https://doi.org/10.1080/09638237.2021.2022629
- Kerman, N., Ecker, J., Tiderington, E., Gaetz, S., & Kidd, S. A. (2021). Paid sick leave benefits among essential frontline workers serving people experiencing homelessness in Canada during the COVID-19 pandemic. Public Health, 195, 142–144. https://doi.org/10.1016/j.puhe.2021.04.022
- Klaic, M., Kapp, S., Hudson, P., Chapman, W., Denehy, L., Story, D., & Francis, J. J. (2022). Implementability of healthcare interventions: An overview of reviews and development of a conceptual framework. Implementation Science, 17, 10. https://doi.org/10.1186/s13012-021-01171-7
- Kurtessis, J. N., Eisenberger, R., Ford, M. T., Buffardi, L. C., Stewart, K. A., & Adis, C. S. (2017). Perceived organizational support: A meta-analytic evaluation of organizational support theory. Journal of Management, 43(6), 1854–1884. https://doi.org/10.1177/0149206315575554
- Lemieux-Cumberlege, A.H., Griffiths, H., Pathe, E., & Burley, A. (2023). Posttraumatic stress disorder, secondary traumatic stress, and burnout in frontline workers in homelessness services: Risk and protective factors. Journal of Social Distress and Homelessness, 33(2), 329-340. https://doi.org/10.1080/10530789.2023.2191405
- Lemieux‐Cumberlege, A., & Taylor, E. P. (2019). An exploratory study on the factors affecting the mental health and well‐being of frontline workers in homeless services. Health and Social Care in the Community, 27(4), e367–e378. https://doi.org/10.1111/hsc.12701
- Lenzi, M., Santinello, M., Gaboardi, M., Disperati, F., Vieno, A., Calcagnì, A., Greenwood, R. M., Rogowska, A. M., Wolf, J. R., Loubière, S., Beijer, U., Bernad, R., Vargas Moniz, M. J., Ornelas, J., Spinnewijn, F., Shinn, M., & HOME_EU Consortium Study Group. (2020). Factors associated with providers’ work engagement and burnout in homeless services: A cross-national study. American Journal of Community Psychology, 66(3-4), 385–397. https://doi.org/10.1002/ajcp.12470
- Leung T, Schmidt F, Mushquash C. A personal history of trauma and experience of secondary traumatic stress, vicarious trauma, and burnout in mental health workers: A systematic literature review. Psychol Trauma. 2023 Sep;15(Suppl 2), S213-S221. doi: 10.1037/tra0001277.
- Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(1), 69. https://doi.org/10.1186/1748-5908-5-69
- Levesque, J., Sehn, C., Babando, J., Ecker, J., & Embleton, L. (2021). Understanding the needs of workers in the homelessness support sector. Canadian Observatory on Homelessness Press. https://www.homelesshub.ca/sites/default/files/attachments/HubSolutions-Understanding-Needs-Oct2021.pdf
- MacTavish, E. and Dupuis, K. (2025). Interventions for addressing moral distress and moral injury in long-term care staff: A scoping review. Journal of Long-Term Care, 81–96. https:// doi.org/10.31389/jltc.278
- Mackie, P., Johnsen, S., & Wood, J. (2019). Ending street homelessness: What works and why we don't do it. European Journal of Homelessness, 13(1), 85-96. https://orca.cardiff.ac.uk/id/eprint/135333
- Malden, S., Doi, L., Ng, L., & Cuthill, F. (2023). Reducing hospital readmissions amongst people experiencing homelessness: A mixed-methods evaluation of a multi-disciplinary hospital in-reach programme. BMC Public Health, 23, 16048. https://doi.org/10.1186/s12889-023-16048-1
- McCarter, A. K. (2007). The impact of hopelessness and hope on the social work profession. Journal of Human Behavior in the Social Environment, 15(4), 107-123. https://doi.org/10.1300/J137v15n04_07
- McDonald, J., & Hale, K. (2021). Mental readiness for frontline workers in homelessness services in Ottawa, Canada. International Journal on Homelessness, 2(1), 80–104. https://doi.org/10.5206/ijoh.2022.1.13720
- McDonald, J. M., Hale, K. J., Kirkwood, T. J. (2024). Excellence in homelessness services: Evidence-based frontline practices. International Journal on Homelessness, 4(3),139-157. https://doi.org/10.5206/ijoh.2023.3.16655
- Mette, J., Wirth, T., Nienhaus, A., Harth, V., & Mache, S. (2020). “I need to take care of myself”: A qualitative study on coping strategies, support and health promotion for social workers serving refugees and homeless individuals. Journal of Occupational Medicine and Toxicology, 15(1), 1-15. https://doi.org/10.1186/s12995-020-00270-3
- Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 143. https://doi.org/10.1186/s12874-018-0611-x
- Nagy-Borsy, E., Kovács, V. A., Arva, D., Voko, Z., Szeitl, B., Kiss, I., & Rákosy, Z. (2025). Health status, health determinants, and use of preventive services among frontline workers in homeless services. Journal of Primary Care and Community Health, 16, 1-9. https://doi.org/10.1177/21501319241312579
- Nagy-Borsy E, Vági Z, Skerlecz P, Szeitl B, Kiss I, Rákosy Z. (2021). Health status and health behaviour of the Hungarian homeless people. Archives of Public Health, 79(1), 15. https://doi.org/10.1186/ s13690-021-00534-2
- Oser, C. B., Biebel, E. P., Pullen, E., & Harp, K. L. (2013). Causes, consequences, and prevention of burnout among substance abuse treatment counselors: A rural versus urban comparison. Journal of Psychoactive Drugs, 45(1), 17–27. https://doi.org/10.1080/02791072.2013.763558
- Olivet, J., McGraw, S., Grandin, M., & Bassuk, E. (2010). Staffing challenges and strategies for organizations serving individuals who have experienced chronic homelessness. The Journal of Behavioral Health Services and Research, 37(2), 226-238. https://doi.org/10.1007/s11414-009-9201-3
- Peters, M., Godfrey, C., McInerney, P., Soares, C., Khalil, H., & Parker, D. (2015). The Joanna Briggs Institute reviewers’ manual 2015: Methodology for JBI scoping reviews. The Joanna Briggs Institute. https://espace.library.uq.edu.au/view/UQ:371443
- Peters, L., Hobson, C. W., & Samuel, V. (2021). A systematic review and meta-synthesis of qualitative studies that investigate the emotional experiences of staff working in homeless settings. Health and Social Care in the Community, 30(1), 58–72. https://doi.org/10.1111/hsc.13502
- Pixley, C. L., Henry, F. A., DeYoung, S. E., & Settembrino, M. R. (2022). The role of homelessness community based organizations during COVID-19. Journal of Community Psychology, 50(4), 1816–1830. https://doi.org/10.1002/jcop.22609
- Pollock, A., Campbell, P., Cheyne, J., Cowie, J., Davis, B., McCallum, J., McGill, K., Elders, A., Hagen, S., McClurg, D., Torrens, C., & Maxwell, M. (2020). Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: A mixed methods systematic review. The Cochrane Database of Systematic Reviews, 11(11), CD013779. https://doi.org/10.1002/14651858.CD013779
- Ramalho, J. (2014). Mentoring in the workplace. Industrial and Commercial Training, 46(4), 177-181.https://doi.org/10.1108/ICT-11-2013-0078
- Ramsay, N., Hossain, R., Moore, M., Milo, M., & Brown, A. (2019). Healthcare while homeless: Barriers, facilitators, and the lived experiences of homeless individuals accessing healthcare in a Canadian regional municipality. Qualitative Health Research, 29(13), 1839–1849. https://doi.org/10.1177/1049732319829434
- Ravitz, P., Cooke, R. G., Mitchell, S., Reeves, S., Teshima, J., Lokuge, B., Lawson, A., McNaughton, N., Skinner, W., Cooper, C., Fefergrad, M., & Zaretsky, A. (2013). Continuing education to go: Capacity building in psychotherapies for front-line mental health workers in underserviced communities. Canadian Journal of Psychiatry, 58(6), 335–343. https://doi.org/10.1177/070674371305800605
- Reeve, A., Moghaddam, N., Tickle, A., & Young, D. (2021). A brief acceptance and commitment intervention for work-related stress and burnout amongst frontline homelessness staff: A single case experimental design series. Clinical Psychology and Psychotherapy, 28(5), 1001–1019. https://doi.org/10.1002/cpp.2555
- Saldua, M. (2024). Addressing social determinants of health among individuals experiencing homelessness. Behavioral Health News. SAMHSA Center for Behavioral Health Statistics and Quality. https://behavioralhealthnews.org/addressing-social-determinants-of-health-among-individuals-experiencing-homelessness/
- Schiff, J. W., & Lane, A. M. (2019). PTSD symptoms, vicarious traumatization, and burnout in front-line workers in the homeless sector. Community Mental Health Journal, 55(4), 454–462. https://doi.org/10.1007/s10597-018-00364-7
- Schneider, C. W., Hobson, C., & Shelton, K. H. (2022). ‘Grounding a PIE in the sky’: Laying empirical foundations for a psychologically informed environment (PIE) to enhance well-being and practice in a homeless organisation. Health and Social Care Community, 30, e657–e667. https://doi.org/10.1111/hsc.13435
- Stergiopoulos, V., Saab, D., Pridham, K. F., Aery, A., & Nakhost, A. (2018). Building flexibility and managing complexity in community mental health: Lessons learned in a large urban centre. BMC Psychiatry, 18, 20. https://doi.org/10.1186/s12888-018-1597-y
- Teixeira-Santos, L., Bobrowicz-Campos, E. & Abreu, W. (2024). How can we help? A training needs assessment for non-health professionals and volunteers working with asylum seekers and refugees. Journal of Public Health, 33(11), 2467-2476. https://doi.org/10.1007/s10389-024-02216-z
- Watson, J., Crawley, J., & Kane, D. (2016). Social exclusion, health and hidden homelessness. Public Health, 139, 96–102. https://doi.org/10.1016/j.puhe.2016.05.017
- Wirth, T., Mette, J., Prill, J., Harth, V., & Nienhaus, A. (2019). Working conditions, mental health, and coping of staff in social work with refugees and homeless individuals: A scoping review. Health and Social Care in the Community, 27(4), e257–e269. https://doi.org/10.1111/hsc.12743
10.7202/1051104ar