Exploring occupational therapy interventions in homeless settings in Tshwane

In South Africa, the national lockdown was both a challenge and an opportunity to address health-related issues of homelessness. While initial emergency responses in Tshwane focused on basic needs and medical intervention, the need for more holistic intervention became evident.

To understand the experiences and perceptions, benefits and facilitators, and barriers and challenges of university-driven occupational therapy interventions with people experiencing homelessness in Tshwane during the various coronavirus disease 2019 lockdown levels and beyond to March 2023.

Research was conducted in various homeless settings, such as temporary shelters, transitional- or permanent housing facilities or drop-in centres, where occupational therapy intervention was implemented.

An explorative, descriptive qualitative design was used, with focus group discussions and semi-structured interviews conducted with people experiencing homelessness and homeless practitioners. These were audio recorded, transcribed and thematically analysed. Student-written occupational therapy planning and feedback documents were analysed through reflexive thematic analysis and interpreted using the Capability Approach.

Inputs and conversion factors positively influencing intervention outcomes included a supportive environment, client-centred care, therapeutic activities in small groups, ensuring positive volition, and understanding the real-life experiences of participants. Challenges included unsupportive environments, language barriers, poor attitudes and motivation, and lack of continuity of occupational therapy intervention.

Occupational therapy intervention in homeless settings is valuable, as it considers personal, social and environmental aspects affecting a person's functioning.

Applying the unique contribution of occupational therapy intervention in homeless settings will improve overall health- and social service delivery.