Homeless Mental Health
Mental health is an issue that is deemed to be very under-treated and very under-diagnosed within the United States. Beyond that, there are populations that are much more at risk than others. A good example would be the prison population where drug use and mental health issues are both rampant. However, there is another group that is highly stricken and very vexing and difficult to treat and that would be the homeless. Indeed, many people that are homeless are in that position due to mental health issues. Mental health is often not the only issue involved as comorbidity can exist with substance abuse. However, mental health will be the focus of this report. Facets of the homeless with mental health that will be focused upon within this report will include issues like diversity, ethics, values, social justice, diagnosing of patients, initiation/termination of care, aftercare, and the broader topic of social work when it comes to treating and otherwise interacting with the homeless. While mental health can be very difficult to deal with and treat when it comes to the homeless, it is something that social workers and other related professionals should absolutely strive to address and deal with.
As partially indicated in the introduction, there is deemed to be a high concentration of mental illness within the homeless population. This is perceived to be even truer in certain situations. To clarify that, there are two main types of homeless people. There are those that come upon a short bit of bad luck and these people are often able to reobtain housing in fairly short order. By contrast, there are those that are persistently and constantly homeless over a period of time. The latter of those groups is deemed to be much more likely to be mentally ill and thus in need of intervention and treatment options from social work agencies. At the same time, alcohol and other drug abuse is actually fairly consistent across all types of homeless peoples. The length, depth and breadth of a person's homelessness obviously has a lot to do with how many stressors and other aggravating factors they have. This in turn will lead to more issues with being able to start treatment, continue treatment until it can reasonably be terminated and keeping those people on the straight and narrow after they are treated (Lippert & Lee, 2015).
While some may hold that a lot of the people that are homeless are in their situation due to actions or inactions of their own doing, this is simply not the case. Further, even if it were true, leaving it untreated and unabated would not be ethical, would not be consistent with proper social justice and there can be things done to address the mental health needs of people that are homeless. Further, these interventions can go far enough so as to prevent continued mental illness once treatment is rendered. Such was proven in a Housing First program that showed that there was a reduction in re-offending among formerly homeless adults with mental disorders. The stakes are made quite clearly in that study when they state that those that are mentally ill are at high risk of being arrested as are the homeless. When those two traits converge within the same person, the overall risk of arrest is obviously going to be even higher. Beyond the obvious ethical and social justice issues as it relates to treating and helping the homeless with their mental health issues, there are also significant public costs associated with not treating those people and otherwise addressing the problem in a way other than simply incarcerating and dismissing the homeless...
Rather than just make laws banning panhandling and sleeping in certain public areas, it is asserted by many that there needs to be a focus on the source of the problem and treating those that have said problem. Indeed, if the root cause of the problem, mental health in this case, is not addressed, the problem will not go away and will certainly get worse as more and more people are untreated for mental illness and thus become homeless as a result. Beyond the above, there is a clear over-representation of mentally ill people in prison systems and being in prison is not really where those people need to be unless they are truly violent even with the proper treatments and thus unfit for release into broader society. For those that are just violent or those that know they need treatment but refuse to engage in the same, prison may be the answer. However, for those that are not violent and that want to get treated, rehabilitation in the form of mental health treatment can and should be funded so as to reduce the suffering of those that are mentally ill and the negative social aftermath that is commonly left in their wake (Somers, Rezansoff, Moniruzzaman, Palepu & Patterson, 2013).
When it comes to ethics and social justice, it should also be pointed out that a lot of the people that are chronically or even occasionally homeless and mentally ill at the same time have children and they need to be protected as well in the form of their parent or parents getting the mental health that they deserve. The author of this report has seen more than one situation where a parent is greatly struggling even when they are trying extremely hard but the children suffer nonetheless because there is nothing simple or easy about being homeless. Further, homeless and/or mentally ill people with children can be unwilling and scared to come forward and ask for help out of fear that their children will be seized by the state due to the parent due to the mental illness and/or the homelessness. When it comes to referrals and getting people the help they need, this can create obvious issues. However, it is important to get an intervention in place for such people as there are signs from the scholarly literature that the presence of children can create new and unique factors relating to mental illness when speaking of homeless people that have dependent children. An interesting fact that some people may be unaware of is that while mental illness may lead to homelessness, the same can be true in reverse. Quite often, becoming homeless by itself can lead to the degradation of a person's mental state and this can happen when children are present. In many ways, this presents a multi-faceted problem that is comprised of homelessness, mental health and the presence of children that are themselves affected and see their parents affected as well. The latter item in that short list, on its own, can cause its own problems with the children involved. Even if removal of the child from the parent's custody until they get their metnal health and other affairs sorted is not the most attractive option, it can sometimes be the best way to proceed as it lifts a burden off the parent temporarily. So long as the parent acts in good faith and gets the treatment they need, they should be reunited with their child or children soon enough. The children need to be in a stable and structured environment and this can involve something other than the custody of a parent even if the parent is willing. The issue is whether the parent is able from a financial and mental health standpoint. If they are not, the social work agencies probably need to step in (Chambers et al., 2014).
As noted already, structure and stability is a huge part of getting someone treated and on the road to recovery. The author of this report personally knows and understands that it is important and pivotal for someone in the different stages of treatment and recovery to have their life in a certain formulation and structure even if they do not have a house to call their own. This applies when speaking about overall patient engagement in the process, when the patient is being diagnosed, during the core/middle phase and when there are plans to terminate or at least pause treatment. One major way to provide structure and stability for a homeless person is to remove the homeless aspect from their life. This can be accomplished through shelters or low-cost housing. Not all jurisdictions have these sort of facilities at the ready but many that do not have such accommodations will operate through Section 8 or something else similar so as to get a person housing at low to no cost while they recover financially and mentally. It has been found through experimental and quasi-experimental studies that people that are given at least temporary accommodations during their mental health treatment process do much better in terms of healing and progressing than those that remain in a state of perpetual or intermittent homelessness. After all, getting someone a semi-permanent place to stay is going to be better in many ways as compared to…
et al. (2005) Facts on Trauma and Homeless Children. National Child Traumatic Stress Network - Homelessness and Extreme Poverty Working Group. Online available at http://www.nctsnet.org/nctsn_assets/pdfs/promising_practices/Facts_on_Trauma_and_Homeless_Children.pdf Burt, Aron, Douglas, et al., (1999) Homelessness: Programs and the People They Serve: Summary Report - Findings of the National Survey of Homeless Assistance Providers and Clients Washington, DC: The Urban Institute, 1999 Burt, Martha, (2001) What Will it Take to End Homelessness? Washington, DC: The
But mentally disturbed individuals, being confined to a greater proclivity toward chronic homelessness, are a separate problem, addressed most directly by the Center for Mental Health Services, which is a federally chaired organization. The CMHS is a channel through which policy regarding disbursement of social resources is implemented. It garners all of its data from the National Resource Center of Homelessness and Mental Illness, which is the only agency
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