Henwood, B., Padgett, D., and Tiderington, E. 2014. Provider Views of Harm Reduction Versus Abstinence Policies Within Homeless Services For Dually Diagnosed Adults. The Journal of Behavioral Health Services & Research, Vol. 41(1), 80-89.
The article, “Provider Views of Harm Reduction Versus Abstinence Policies Within Homeless Services For Dually Diagnosed Adults”, by Dr. Benjamin Henwood, Dr. Deborah Padgett, and Emmy Tiderington endeavors to address how front-line service providers (providers), who work with those with serious mental health issues, addiction, and chronic homelessness, view harm reduction policies as opposed to the abstinence approach to homeless services (Henwood, Padgett, & Tiderington, 2014, p. 80). The aim of researchers is to apply the findings to the behavioural health care of this segment of society (Henwood, Padgett, & Tiderington, 2014, p. 80).
Traditional methods of providing homeless services to the dually diagnosed homeless require individuals to abstain from substance abuse (Henwood, Padgett, & Tiderington, 2014, p. 80). This approach, referred to as treatment first (TF), fails to address issues associated with chronically homeless adults who had become habituated to this lifestyle (Henwood, Padgett, & Tiderington, 2014, p. 81). The rigidness of this approach, which includes abstinence and behaviour modification such as “curfews, daily supervision, mandatory attendance at day treatment, no visitors,
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Homelessness has been a social problem for a long time so by trying to enable the individuals to gain access to the same health care as others it may prevent the amount of deaths of homeless people. It was found that just over a third of homeless person’s deaths were due to alcohol and drug misuse; if homeless individuals had access to a GP or health services they may be able to be referred and continuously reviewed to enable them to stop the substance misuse.
Homelessness and substance abuse are often two problems that continue to be linked together. According to the Substance Abuse and Mental Health Administration (2011), research conducted in the past five years indicates that about 50% of those who are homeless have co-occurring substance abuse problems. Along with co-occurring substance abuse problems, there continues to be other problems such as treatment access to those who are homeless. In this paper we will explore research on the homeless population in relation to substance abuse, and effective interventions on an individual level.
Health ←and→ mental health troubles reflected an extensive range of concerns centered on chronic health problems, substance abuse, psychosocial, clinically diagnosed problems, self-esteem problems. Substance abuse was noticed as a major obstacle to conquering homelessness addictive behaviors in the same way as alcoholism, drug abuse were frequently identified in
According to the U.S. Conference of Mayors, only 16% of the single adult homeless population suffer from some form of mental illness and according to the National Coalition to the Homeless, The increasingness of homelessness over that past two decades can not be explained by addiction alone
In the United States the homeless population continues to grow rapidly. Homelessness has been a public health issue for many decades. Often times these individuals feel as though society has turned a blind eye to them. This at risk population is seen by society as lazy or chose to live a life on the streets, but if one would examine this population closely would see that there is more to this at risk population than what society has labeled them as. The forces, which affect homelessness, are multifaceted. Social forces such as family breakdown, addictions, and mental illnesses are in combined with structural forces such as lack of low-cost housing, insufficient health services, and poor economic conditions. Many would
The most recent survey of homeless individuals conducted January 29, 2014 revealed 958 homeless adults with no dependants, 70 of which were completely unsheltered, and an additional 130 homeless adults who also had dependent children with them. 208 of these homeless adults are chronically homeless (HUD’s 2014 Continuum of Care Homeless Assistance Programs, Populations, and Subpopulations, 2014).Wayside Christian Mission reaches approximately 7,000 homeless individuals annually (Wayside Christian Mission, 2007). In the Journal of General Internal Medicine, a majority of homeless individuals surveyed stated that they felt discriminated against or that they received lesser care because of their poverty or homelessness (Wen, Hudak, & Hwang, 2007). Homeless and impoverished individuals suffer from high rates of depression, psychiatric illness, alcohol and or substance abuse, HIV/AIDS, TB, Trauma, preterm birth, COPD, low birth weight, musculoskeletal problems, decreased access to care, foot problems, malnutrition, and high Emergency Room utilization (Stanhope & Lancaster, 2014). Not only do homeless persons have a high rate of illness, but they are also less able to appropriately treat health problems. Many homeless individuals have limited access to care, cannot afford medications or nutritious food, and may have difficulty with managing a strict
According to the American Journal of Public Health (AJPH), disease was prevalent in the newly homeless. This population accessed health care services at high rates in the year before becoming homeless. Significant improvements in health status were seen over the study period as well as a significant increase in the number who were insured (American Journal of Public Health, 2012). The homeless in Overtown face a variety of risks and barriers to their health. Firstly, a good number of the population suffers from mental illness, they suffer from a range of mental health problems from depression, personality disorders, schizophrenia and many more. Most are unable to treat their mental
Homelessness as a result of deinstitutionalization in the US increased dramatically, tripling in 182 cities over the court of the 1980s (Bagenstos, 2012). In addition, mental health and substance abuse is a major problem in across the country because of homelessness. According to the Substance Abuse and Mental Health Services Administration,20 to 25% of the homeless population in the United States suffers from some form of severe mental illness (DMHAS, 2014). Consequently, mental illnesses disrupt people’s ability to carry out key aspects of daily life, such as self-care and household responsibilities. As a result of these factors and the stresses of living with a mental disorder, people with mentally illnesses are much more likely to become homeless than the general population (Karger, & Stoesz, 2014). Even if homeless individuals with mental illnesses are provided with housing, they are unlikely to achieve residential stability and remain off the streets unless they have access to continued treatment and services. In Connecticut there are a number of housing options that are in place like supportive housing. Research has shown that supported housing is effective for people with mental illnesses (DMHAS, 2014). Unfortunately, in Connecticut, lack of funding is a significant barrier to the successful implementation of supported housing programs. Because of homelessness people cycle between street corner, jail cell and hospital beds, in addition the homeless who are
A review of the article: A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance
A substantial percentage of homeless population are individuals who are chronically unemployed or have difficulty managing their lives effectively due to prolonged and severe drug and/or alcohol abuse. Substance abuse can cause homelessness from behavioral patterns associated with addiction that alienate an
A misconception that we must address is the fact that there is no single reason for a person to become a homelessness person. The stereotype of a person with a substance abuse problem is, unfortunately, the common perception of the cause of homelessness, which is not the case. This misconception leads us to have a harsher view on these people, which then pushes us to inforce criminal sanctions.
The research article I chose to analyze, Housing First Services for People who Are Homeless with Co-Occurring Serious Mental Illness and Substance Abuse, studied the outcomes of alcohol and substance abuse as well as participation in substance abuse and mental health treatment between people in housing first programs and treatment first programs in New York City. The two research questions asked were, “Are there group differences in alcohol and drug use at 48 months?” and “Are there group differences in participation in substance abuse and mental health treatment at 48 months?” (Padgett, Gulcur, & Tsemberis, 2006, p. 76). The purpose of this study was to find out
The problems of homelessness and mental illness are inextricably intertwined. One way that mental illness impacts people's lives is that it oftentimes renders them unable to carry out the functions of daily life, such as keeping a job, paying their bills, and managing a household. In addition to disrupting the events of daily life, mental illness "may also prevent people from forming and maintaining stable relationships or cause people to misinterpret others' guidance and react irrationally" (National Coalition for the Homeless, 2009). What this means is that a population that is already vulnerable because of an inability to consistently manage self-care lacks the same safety net as much of the rest of society.
In our communication they made clear that they also looked at themes that did not match, such a voluntary leaving of the home. However, no member took into consideration metal health. All members also focused on the cause and problems of homelessness with no member viewing the possible solutions to it. An article by Bassuk, E., Rubin, L., & Lauriat, A. (1984). “Is homelessness a mental health problem?” Looked at Seventy-eight homeless men, women, and children staying at an emergency shelters and found The vast majority have severe psychological illnesses that remained untreated. The authors discuss the relationship of mental health policy to the homeless and suggest that shelters have become alternative institutions to meet the needs of mentally ill people who are no longer cared for by departments of mental health. The findings of the management of metal issues for those who are homeless is mirrored by the case studies of Stephanie’s and Teresa’s mental health playing a large role in their homelessness. Fischer, P. J., & Breakey, W. R. (1991) in their “The epidemiology of alcohol, drug, and mental disorders among homeless persons” look into the prevalence of alcohol, drug, and mental disorders and the characteristics of homeless substance abusers and persons with mental illnesses. They found that prevalence rates of disorders are much higher in homeless
Understanding how both individual and structural factors contribute to and sustain homelessness is a critical factor in successfully addressing homelessness. All to often service providers blame homeless individuals for the circumstances they are in, making assumptions that substance abuse or other irresponsible behaviors have caused the problems leading to the individual to become homeless. Hoffman and Coffey (2008) suggest, “the perpetuation of homelessness is not internal to the homeless individual as many claim, but rather may be embedded in the service industry itself, which subjects both clients and providers to bureaucratic forms of authority and experiences of disrespect.” While not all homeless people suffer from mental illness or substance abuse, all of