Mistrust of outreach workers and lack of confidence in available services among individuals who are chronically street homeless.

This qualitative study explored how individuals who are homeless perceive outreach practices and available services. Interviews were conducted with 24 people who had been homeless for >/=1 year and who consistently resided on the streets of west midtown, Manhattan, New York. Reasons why these individuals refuse services include a pervasive mistrust of outreach workers and the agencies that employ them, as well as a prominent lack of confidence in available services. The findings suggest a need for an approach to outreach that incorporates giving individualized attention from outreach workers, using an empathetic listening approach, minimizing stereotyping, providing greater choices, and employing formerly homeless people as outreach workers.