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Jan 9, 2024

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Literature Review Solomon Enow Walden University Social work P Res 1 SOCW-6301-26 September 28, 2023

Many researchers and studies have proven that homelessness is a public health concern and a major problem in most western nations. I have examined different research articles on homelessness amongst individual with severe mental illness and what are the risk factors if they remain unsheltered. Most of the research articles I reviewed reported that minority populations are the once mostly affected by homelessness. All the research studies I looked at, indicated that homelessness and severe mental illness was a barrier to employment, high risk for premature death, complicated treatment, and that there was gap in service involvement. Subedi et al (2022) in their study to compare hospital readmission rate amongst the homeless and non-homeless noted that “In the U.S., more than half a million people experienced homelessness in a single night in January 2020, with male, Black, and Hispanic Americans being disproportionately affected. He added that this population suffers from severe mental illness, substance use disorder and other infectious diseases like tuberculosis, Hep C and heart problem. Subedi et al., suggested that this group’s limited access to preventive and ambulatory care contributes to their worsening condition. And that due to their poor living condition will lead to high acute care utilization such as emergency room, inpatient admission and hospital readmission. While another quantitative research study by (Loubiere et al., (2020) done in the greater Paris in four large French cities aim to look at health care use among homeless individuals with severe mental illness. This study had recruited homeless individual with severe mental illness who were living on the street, shelters, prisons and hospital to understand the use of healthcare system. Loubiere et al., (2020) noted that one in four people who are homeless suffers from severe mental illness such as schizophrenia and bipolar disorder. This research study by Loubiere et al., reported that diagnosis of schizophrenia and being homeless were important determinants

for emergency visits. Subedi et al., 2022 and Loubiere et al., 2020 reported similar finding on patterns of hospital utilization, such as emergency room, inpatient hospital and readmission for severe mentally ill and homeless population. The opioid crisis continues to be a serious problem in our communities today. According to Hong et al., “opioid overdoses killed almost 47,000 people in 2018, and 32% of those deaths were caused by prescription opioids (Mattson et al., 2021).” This study by Hong et al. looked at the association between violence victimization, homelessness and severe mental illness amongst people who use opioids in three US cities. Hong et al., suggested the need to address multilevel needs to promote the overall well-being among people with intersecting vulnerabilities because of the relationship between substance use, mental health, and housing status. The authors noted that the increase level of violence victimization associated with homeless individuals with severe mental illness. Hong et al., (2023) reported that necessary care and mental health treatment is not readily available to individual with opioid use disorder and co-occurring mental illness. A study by Morse et al., (2020) study looked at implementing and evaluating intensive community- based program for homeless individuals with alcohol disorder without severe mental illness received community reinforcement approach (CRA) and case management services, while those with alcohol and severe mental illness were assigned to assertive community treatment and integrated dual disorders (ACT/IDDT) services. Homeless individual and severe mentally ill are a vulnerable population. And many studies have proven that homelessness is a serious problem in the western world. Morse et al., (2020) study found that when given the right treatment and support homeless and severe mental ill individuals will have positive outcomes such as significant decrease in substance use, decrease in homelessness, increase in employment, stable housing and decrease in criminal behavior.

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