¶ … homeless population can be described as a social grouping that is susceptible for the reason that the homeless experience greater risk for poor health-related results. Considering the situation of homelessness and the connection involving availability of resources, health status and relative risks, it becomes critical for the nurses to come up with diagnosis and treatments for health-associated problems in this kind of vulnerable population. The description of this article touches on the homeless as a vulnerable population applying health-associated problems of model of vulnerable population as a theoretical framework. A repeated matter, in the Springfield Massachusetts shelters, is about the setting free of prisoners exclusive of discharge planning that gives opportunity for going ahead with care for mental illness. In 1970's deinstitutionalization decided to do away with mentally ill warehousing in facilities that do not recognizes the rights of human. Sufficient community supports fail to be present to this vulnerable population. Persons of Homeless mentally ill before long became greater. In 1955- 2002 prison populations rise from 559,000 to over 2 million. The approximation shows that amongst the prison population 16% experience symptoms of severe mental illness. The guideline for psychiatric services in jails and prisons is being provided by The American Psychiatric Association. The provided guidelines involve connecting them with right community agencies competent in offering continuing treatment." (American Psychiatric Association, 2000). Several inmates are set free with no Medicaid or MA Health in place, bureaucratic public policies offers barriers. If there is no insurance majority of the community providers fails to offer services costly psychotropic medications are not purchased. Within Springfield MA, Healthcare for the Homeless helps clients to find their way in the system and acquire mental health care. In terms of nursing, the ethic of caring is suppose to facilitate nurses to back up legislation that guarantee reachable mental health care for everyone, as well as persons set free from the prison system Lovell, D. & Jemelka, R... (1998).

The history as to why this problem of setting free prisoners without discharge planning that provides for continuity of care for mental illness has developed, and is perpetuated, entail various factors. The 1970's deinstitutionalization and the subsequent rise in number of the mentally ill prison have radically risen in homelessness and including the prison population. According to the statistics from the Bureau of Justice under the jurisdiction of State authorities there were 1,377,815 prisoners and 193,046 in Federal jurisdiction in 2006. Local Jails from local detained 766,010 individuals either having pending trial or serving a sentence. The overall figure of confined persons is over 2,300,000. The estimation shows that amongst prisoners 16% have major mental illness (Bureau of Justice Statistics, 2008). The clients sometimes did not get treatment on having psychiatric illness at the time when they were in custody. In any case they are set free they are regularly in mental distress. The bureaucracy of receiving Social Security for disability or acquiring Mass Health re-establish is always a great task. Acquiring treatment for community mental health in an appropriate way is very hard or not possible. Homeless Health Care offers an onsite, incorporated health care system that helps clients with right to use to medical and psychiatric care. "According to Aroskar the ethical imperative for the nurse should be the moral means to eradicate barriers to the ethical practice of nursing in their specialty. (Aroskar M., 1994, p.11). For the nurses who are in the correctional system, emergency rooms hospitals and community, should the activist for policies that support treatment for the mental health that vulnerable population's experiences, as well as set free prisoners.

Case History

As per the call for nursing support for continuity of care to the set free prisoners is verified according to the following; a definite release note for a guy that was serving in prison for over twenty years: The client is suppose to be set free in two weeks time while the agency operating on housing has not so far establish a place. One should provide client with information and medical records concerning emergency mental health. Provide client with listings of main medical centers where he can be offered with care despite of Mass Health status or where he lives. The client should have a copy of pertinent medical record.

When he was being set free from a medium security prison he was taken till a shelter where the hand untied and he was given $50.00. He did not have connection to the social supports...

When he was in prison his treatment was anti-psychotics and anti-depressants. He was released while not supplied with these medications. The client had bowel symptoms as well as bloody stools. Only on two instances when he was prepped for a colonoscopy, however the test was done away with. While he was at the shelter a nurse from Healthcare for the Homeless met that individual and decided to refer him to the psychiatric nurse clinician. When he was assessed he appeared pale and disheveled; he showed hopelessness, sadness and suicidal intent.
Historical Background of Issue

The present problem was presented during a Public Broadcasting Company special, in Frontline: the winner of the Robert Kennedy award in 2002 (The New Asylums), analytical reporters followed chosen prisoners into the Ohio Prison System. "This provided an intense investigation of the multifaceted and rising subject of mental health in prison together with moving representation of the persons at the center of this matter. Treatment was offered for the mentally ill clients in the prison system; however majority were discharged without giving them community support (Navasky, M...2005). In an online chat of the film, produced by Miri Navasky indicated that: she believed that in any case better care existed in the community several of the inmates they came across would have been capable of being paroled and remain on medication. A single client who went to a pilot program belonging to the mentally ill in transition was fairing on well. Recidivism of the mentally ill prisoners without support was graphically portrayed (Navasky M., 2005).

Selected Responses to Issues of Continuity of Mental Health Care for Released Prisoners

Massachusetts Correctional System response

The situation of Massachusetts has facilitated to be obligatory that each individual have insurance. In any case an individual is imprisoned they fail to get cover by the Massachusetts Health and Social Security Disability. Presently pilot programs that are existing give opportunity for discharge planners to submit an application for Mass Health earlier to the release of the inmates. On being set free, the inmate are given directives to call Mass Health and select a primary physician, after that his insurance is activated. In any case the inmate experiences mental health problems then the correctional discharge nurses attempts to organize a mental health appointment post release. The records of the client are obtainable, containing a signed release, to the community provider. Always the prisoners are set free with their outstanding bubble packs of medications and possibly a prescription. Various medications, like benzodiazepines may be extremely risky if stopped suddenly. The correctional system nurses do their work efficient to support and get appointment community mental health. Community agencies tend not to be in position to put up with every referral from the correctional system. The type of the criminal offense may contribute in making it difficult or not possible to free an inmate to someplace if not an existing shelter bed. In any case the discharge nurse is not aware of where an inmate is being discharged to, she is not capable of arranging continuity of care.

Healthcare for the Homeless

In any case a client is seen for a mental health visit, the client may get an appointment with the counselor of the mental health, psychiatrist or psychiatric nurse clinician. The City of Springfield Grant offers Clinical Works, a medical record system which is computerized that has the work of evaluations and documentation. Every member of staff has his or her individual laptop to smooth the progress of this process. It offers health histories, standardized mental health assessment tools and records of past visits of every client. The appointments may be scheduled for clients by fellow staff on the computer also. Clients always shift to supportive housing or shelter to shelter, making their histories is present at all sites with the computer system. The providers are existing at specific sites at the similar time every week and always clients self-refer at these moments. Clients can go ahead to be seen by the initial clinician or may be directed for an appointment in terms of medication to the psychiatrist or psychiatric nurse clinician. During first visit it is checked if they are having MA Health or other insurance. A case manager then work on getting benefits if they are in need. In any case medication is required for an uninsured client, then samples and free drug programs may be used. The procedure of getting a community provider can begin right…