Trauma can be both a cause and a consequence of homelessness and has lasting impacts on mental health and wellbeing. Often research focusses on trauma and adversity in childhood leading to homelessness, but understanding traumatic experiences during adulthood homelessness can be just as important for informing intervention development and policies to mitigate and eradicate homelessness. Working with people with lived experience of homelessness, this review aimed to synthesis the qualitative evidence exploring the impact of trauma during homelessness on mental health (including substance use) from the perspective of adults (18 years of age and older) experiencing homelessness. Alongside gray literature, ASSIA, CINAHL, Cochrane, EMBASE, MEDLINE, Proquest theses and dissertations, PsychInfo, Scopus and Web of Science were searched from inception until February 2024. No language, date, or geographical limits were applied. A ‘best-fit’ framework synthesis of 26 papers, covering the experience of over 900 people, identified three overarching themes linked with the SAMHSA three E’s of trauma: 1) making sense of homelessness as a trauma, 2) dealing with the impacts of trauma and 3) responses to repeated exposure to trauma. Trauma rarely takes place in isolation and often prior experiences shape how people experiencing homelessness make sense and cope with trauma. Policy and prevention should prioritise early intervention to reduce the mental health burden of trauma and homelessness. Additionally, creating support that empowers and builds resilience will encourage more positive management strategies.

中文翻译：

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联合制作的关于成年无家可归期间创伤生活经历和对心理健康影响的国际定性系统评价


创伤既可以是无家可归的原因，也可以是无家可归的结果，并对心理健康和福祉产生持久影响。研究通常集中在童年时期导致无家可归的创伤和逆境上，但了解成年后无家可归的创伤经历对于为缓解和根除无家可归的干预制定和政策提供信息同样重要。与有无家可归生活经历的人合作，本综述旨在综合定性证据，从无家可归的成年人（18 岁及以上）的角度探索无家可归期间创伤对心理健康（包括药物使用）的影响。除灰色文献外，还检索了从建库到 2024 年 2 月的 ASSIA、CINAHL、Cochrane、EMBASE、MEDLINE、Proquest 论文和学位论文、PsychInfo、Scopus 和 Web of Science。没有语言、日期或地理限制。一个由 26 篇论文组成的“最适合”框架综合，涵盖了 900 多人的经历，确定了与 SAMHSA 创伤的三个 E 相关的三个总体主题：1） 将无家可归理解为一种创伤，2） 处理创伤的影响和 3） 对反复暴露于创伤的反应。创伤很少孤立地发生，而且以前的经历往往会塑造无家可归者如何理解和应对创伤。政策和预防应优先考虑早期干预，以减轻创伤和无家可归的心理健康负担。此外，创造支持以增强能力和建立复原力将鼓励更积极的管理策略。