![]() To directly translate these figures into effects on health is hard, again because of the relative lack of data. However, according to Crisis, 120,000 households in England were officially recognized as being homeless under the legal definition in 2006, but there are in addition around 400,000 “hidden homeless” adults at any one time, who may or may not have applied to the appropriate authorities for homeless status, and who are thus not entitled to any accommodation and not counted. UK government figures suggest that 500 people sleep rough on any one night. The statistics in England alone are an illustration of the difficulties of counting this population. Many people would consider the homeless to include only those who sleep on the streets, but considering only these people vastly underestimates the size of the problem. Perhaps one reason why it is hard to provide appropriate care for the homeless is that they are of course not a homogenous population, nor are they easy to count. These cases neatly illustrate the complexity and interrelatedness of social and health support systems that are required to keep an individual a healthy member of society. Here they remain without attracting psychiatric attention, because hostel staff… have learnt to tolerate a level of disturbance which relatives, neighbours or landlords would not.”. Instead of being brought to psychiatric attention and receiving appropriate treatment at these times of crisis, they may drift into hostels for the homeless. As the authors of the case report say, these individuals “have tenuous social supports which collapse when they develop psychoses. A case report from 1993 of two homeless men whose condition improved substantially when they were diagnosed with schizophrenia and treated with antipsychotics illustrates that homeless individuals, simply by the fact of being homeless, may fail to get the treatment that someone in a housed environment would receive. ![]() Why are papers such as the one by Fazel and colleagues, which document these health needs, so important? If the health needs of groups are understudied and underrepresented in the medical literature, it is likely that their health needs are not being addressed equably by society as a whole. Helen Herrman, professor of psychiatry at the University of Melbourne, Australia, notes in her Perspective on Fazel and colleagues' paper that these needs are not well documented: “It is a stark finding that despite all that has been written about mental illness among homeless people, and all the speculation about the origin of the problem, the authors deemed only 29 studies relevant to their analysis.” And of course this paper only includes individuals in Western countries worldwide, the health needs of an even more vulnerable group of homeless people-refugees and persons displaced by conflict-are even more challenging. What the results do reinforce is that homeless individuals have substantial and complex health needs. What these figures don't show, of course, is whether mental illnesses are the cause or consequence of homelessness-or, as seems more likely, whether these conditions are mutually contributory and their causes interrelated. For psychotic illnesses, the prevalence ranged from 2.8%–42.3%, with similar findings for major depression. Among prior studies meeting criteria for consideration, the prevalence of alcohol dependency ranged from 8.1%–58.5%, and drug dependence ranged from 4.5%–54.2%. The analysis shows that there is a substantial prevalence of mental disorders among homeless people in Western countries. This Editorial's title comes from another charity, Shelter, which breaks down the causes of homelessness into individual factors such as drug and alcohol misuse lack of social support family background, including family breakdown and disputes and an institutional background, including being in prison, or increasingly and perhaps especially shamefully today, the armed services.Ī systematic review published in this month's PLoS Medicine looks at just one aspect of this complex issue-the prevalence of mental disorders in the homeless. A home is not just a physical space: it provides roots, identity, security, a sense of belonging and a place of emotional wellbeing.” So says the United Kingdom charity Crisis. Homelessness is about more than rooflessness.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |