Instrument for measuring the severity of homelessness

(This instrument was developed under a research project that defined homelessness, and also explained the methodology for measurement of the severity of homelessness)

Homelessness is an on-going situation with different phases and levels of individual risk. The threshold or level of risk denotes the degree of negative elements or impact by the direct environment on the individual. The challenges which affect homeless people have different indicators. The arithmetical mean of all syndromes provides the specific classification of the homeless person: borderline threshold  over 3.5. The worrying threshold/ 2.5 – 3.5 and critical threshold / less than 2.5 / of endangerment to their quality of life.

Areas of Challenge  SCALED INDICATORS
Employment status 5 – permanently employed
4 – seasonal work*
3 –  social support, in-kind support from   NGO, religious organizations and /or the business sector
2 – one-off employment
1 – no employment * The sales of the Face to Face street magazine is classed as seasonal work
Housing 5 – sub-standard
4 –  under threat of eviction or housed with relatives or friends
3 – housed in a shelter/centre
2 – lives on the street and makes use of the Red Cross reception point services
1 – lives on the street and makes no use of the Red Cross reception point services    
Health 5 – with health insurance
4 – uses Red Cross health services
3 – uses health services only in urgent situations
2 – independent healthcare
1 – no healthcare   
Use of potentially dangerous substances 5 – does not abuse alcohol, drugs and other psychotropic substances
4 – heavy smoker
3 – occasional abuse of alcohol/drugs
2 – frequent abuse of alcohol/drugs
1 – regular long term abuse of alcohol/drugs 
Physical appearance 5 –clean, regular clothes  
4 – modest clothing, dirty       3 – clean, inappropriate clothing
2 – dirty, inappropriate clothing, neglected
1 – extremely unhygienic, shabby appearance
Contacts 5 – regularly visits and is visited by relatives and friends and support workers
4 – relatives and friends visit the person, but the person  doesn’t regularly visit the supporting institutions
3 – occasional contact with relatives, friends and institutions
2 – contact with others only in exceptional cases
1 – no contacts  


Borderline threshold – The preventive forms of actions towards the homeless persons refer to the labour market and to the housing. People with symptoms for becoming homeless, need to be immediately offered some type of work. Particular attention is to be placed to the families who live in substandard conditions, in illegal place of residence, or to families with a risk of losing their rented home.
Worrying threshold – identification of risky groups of people and undertaking of all possible measures in cases where symptoms for entry into homelessness are observed. Particular role here have the Social Welfare Centres, the visiting service, the visiting social workers of the city of Skopje and the religious communities. (The main activities refer to detailed review of the income, housing, property situation, work, family, and health insurance).
Critical threshold – securing housing (Centre for homeless people with a new concept or training – supported housing – therapeutic community)
Securing food, clothing and health care It is mandatory that the institutions for homeless organize education – with professional and psychological dimension. For the residents in the centres and in the training-residences there needs to be provided work engagement (courses, workshops, trainings), trainings that will improve their work habits which will enable them to become more competitive on the labor market. According to the practice in the other countries, a personal assistant may be provided for the homeless, who from a position of a friend and assistant reimerses the homeless into the societal life