British Journal of General Practice, 56(525), April 2006, pp.286-293.
Publisher:
Royal College of General Practitioners
This systematic review aims to critically evaluate the international literature relating to the health care of homeless people and discusses the effectiveness of treatment interventions. Medline, EMBASE, CINAHL, Web of Science and the Cochrane Library databases were reviewed using key terms relating to homelessness, intervention studies, drug misuse, alcohol misuse and mental health. The review was not limited to publications in English. It included searching the Internet using key terms, and grey literature was also accessed through discussion with experts.
This systematic review aims to critically evaluate the international literature relating to the health care of homeless people and discusses the effectiveness of treatment interventions. Medline, EMBASE, CINAHL, Web of Science and the Cochrane Library databases were reviewed using key terms relating to homelessness, intervention studies, drug misuse, alcohol misuse and mental health. The review was not limited to publications in English. It included searching the Internet using key terms, and grey literature was also accessed through discussion with experts.
Subject terms:
homeless people, intervention, mental health problems, prevention, primary care, alcohol misuse, drug misuse, health care;
Health and Social Care in the Community, 11(5), September 2003, pp.446-452.
Publisher:
Wiley
There is limited awareness of the link between differing health problems and migrancy of homeless people. This cross-sectional study sought to quantify the extent of migrancy of homeless people from their birthplace and evaluate whether a history of problematic drug or alcohol misuse or enduring mental health problems were associated with this. The work was conducted at an inner-city health centre for the homeless in the north of England. Birthplace was created as an entry on computerised registration records and collected and recorded for each homeless person registering with the service over the study period. Information was also extracted regarding diagnoses of problematic illicit drug or alcohol use and enduring mental health problems. The study identified statistically significant differences for the migration of homeless people from birthplace for age and problematic drug and alcohol use, the last independently associated with increased likelihood of migration from birthplace. Conversely, a history of illicit drug use is associated with a reduced possibility of migration from birthplace when accessing primary healthcare services. There was no significant difference for migration from birthplace for mental health. Not all homeless people migrate from their birthplace and health problems of drug use, mental health or alcohol use are independently associated with different patterns of migration. Understanding the migrancy of homeless people is important when planning and targeting appropriate health and social services to address their varying health, social and psychological needs.
There is limited awareness of the link between differing health problems and migrancy of homeless people. This cross-sectional study sought to quantify the extent of migrancy of homeless people from their birthplace and evaluate whether a history of problematic drug or alcohol misuse or enduring mental health problems were associated with this. The work was conducted at an inner-city health centre for the homeless in the north of England. Birthplace was created as an entry on computerised registration records and collected and recorded for each homeless person registering with the service over the study period. Information was also extracted regarding diagnoses of problematic illicit drug or alcohol use and enduring mental health problems. The study identified statistically significant differences for the migration of homeless people from birthplace for age and problematic drug and alcohol use, the last independently associated with increased likelihood of migration from birthplace. Conversely, a history of illicit drug use is associated with a reduced possibility of migration from birthplace when accessing primary healthcare services. There was no significant difference for migration from birthplace for mental health. Not all homeless people migrate from their birthplace and health problems of drug use, mental health or alcohol use are independently associated with different patterns of migration. Understanding the migrancy of homeless people is important when planning and targeting appropriate health and social services to address their varying health, social and psychological needs.
Subject terms:
homeless people, mental health, mental health problems, migrants, migration, primary care, alcohol misuse, drug misuse;
Psychiatric Bulletin, 27(6), June 2003, pp.217-220.
Publisher:
Royal College of Psychiatrists
Ward staff were asked to rate whether in-patients with a diagnosis of functional psychotic illness also met criteria for a diagnosis of alcohol or drug misuse or dependence during the preceding 6 months. Those who demonstrated such evidence were then asked to report the nature and extent of their substance use and whether they continued to use as in-patients. 264 in-patients with psychotic illness were screened for evidence of recent or current alcohol or drug misuse. According to staff reports, 127 (48.9%) met the criteria for substance misuse or dependence. The mean age of those with 'dual diagnosis' was 34.7 years and 72% were male. Eighty-three (83%) of those with a history of current or recent alcohol or drug misuse reported that they had continued to use alcohol and/or illicit drugs in the in-patient wards during their current admission. It appears difficult to prevent in-patients with drug or alcohol misuse problems from continuing to use substances in hospital. Further consideration and investigation of how best to manage this group is therefore required.
Ward staff were asked to rate whether in-patients with a diagnosis of functional psychotic illness also met criteria for a diagnosis of alcohol or drug misuse or dependence during the preceding 6 months. Those who demonstrated such evidence were then asked to report the nature and extent of their substance use and whether they continued to use as in-patients. 264 in-patients with psychotic illness were screened for evidence of recent or current alcohol or drug misuse. According to staff reports, 127 (48.9%) met the criteria for substance misuse or dependence. The mean age of those with 'dual diagnosis' was 34.7 years and 72% were male. Eighty-three (83%) of those with a history of current or recent alcohol or drug misuse reported that they had continued to use alcohol and/or illicit drugs in the in-patient wards during their current admission. It appears difficult to prevent in-patients with drug or alcohol misuse problems from continuing to use substances in hospital. Further consideration and investigation of how best to manage this group is therefore required.
Subject terms:
mental health problems, psychiatry, primary care, severe mental health problems, acute psychiatric care, alcohol misuse, drug misuse, dual diagnosis, evidence-based practice;
Looks at three innovative projects where health and social care professionals have been working together. Features a project providing therapy for drug and alcohol misusers, a project on continence at a day centre for older people; and working with black and ethnic minority volunteers to tackle mental health problems in their communities.
Looks at three innovative projects where health and social care professionals have been working together. Features a project providing therapy for drug and alcohol misusers, a project on continence at a day centre for older people; and working with black and ethnic minority volunteers to tackle mental health problems in their communities.
Subject terms:
incontinence, interagency cooperation, joint working, mental health problems, occupational therapists, older people, primary care, social care provision, social workers, alcohol misuse, black and minority ethnic people, drug misuse, health, general practitioners;
Journal of Mental Health, 9(3), June 2000, pp.329-343.
Publisher:
Taylor and Francis
Place of publication:
London
Relatives and those living close to people with alcohol and drug problems experience significant stress which often manifests itself in terms of physical and psychological symptoms. The present paper describes a brief 5- step intervention that has been used and tested with relatives of alcohol and drug users in the primary care setting. The intervention is based on the stress-coping -health model and has been developed from previous research. The steps of the intervention are described including strategies for exploring three key areas: the stress experienced by relatives, their coping responses and the social support available to them. Each step is described in some detail together with information as to how to apply it. Finally, case example are presented illustrating the intervention. It is argued that this approach offers a useful way of understanding and working with families and concerned others experiencing addiction related problems.
Relatives and those living close to people with alcohol and drug problems experience significant stress which often manifests itself in terms of physical and psychological symptoms. The present paper describes a brief 5- step intervention that has been used and tested with relatives of alcohol and drug users in the primary care setting. The intervention is based on the stress-coping -health model and has been developed from previous research. The steps of the intervention are described including strategies for exploring three key areas: the stress experienced by relatives, their coping responses and the social support available to them. Each step is described in some detail together with information as to how to apply it. Finally, case example are presented illustrating the intervention. It is argued that this approach offers a useful way of understanding and working with families and concerned others experiencing addiction related problems.
Subject terms:
intervention, mental health problems, needs, primary care, relatives, social care provision, stress, treatment, therapy and treatment, alcohol misuse, drug misuse, families, evidence-based practice, health care;
Presents a comprehensive assessment of the mental health needs of Londoners and shows that these are greater than in other parts of the country. Provides strong evidence that these needs are not being met adequately by current mental health services, and demonstrates that they are working beyond their capacity to cope. Includes sections on: the sociodemographic context; special areas of need for mental health services; mental health services for older people; child and adolescent services in London; substance misuse services; HIV/AIDS related mental health services; mentally disordered offenders; the homeless in London; services in primary care; black and minority ethnic people; levels of in-patient and residential provision; structure and functioning of services; and costs.
Presents a comprehensive assessment of the mental health needs of Londoners and shows that these are greater than in other parts of the country. Provides strong evidence that these needs are not being met adequately by current mental health services, and demonstrates that they are working beyond their capacity to cope. Includes sections on: the sociodemographic context; special areas of need for mental health services; mental health services for older people; child and adolescent services in London; substance misuse services; HIV/AIDS related mental health services; mentally disordered offenders; the homeless in London; services in primary care; black and minority ethnic people; levels of in-patient and residential provision; structure and functioning of services; and costs.
Subject terms:
HIV AIDS, homeless people, homelessness, mental health problems, mental health services, mentally disordered offenders, needs, older people, primary care, social policy, substance misuse, young people, alcohol misuse, black and minority ethnic people, children, demographics, drug misuse, financing;
Includes papers on: teamwork among professionals involved with disturbed families; integrating hospital and community services; policy and finance for community care; primary health care; day care and rehabilitation services; community care, community compulsion and the law; the role of the voluntary sector; managing the psychiatric emergency in the community; interventions with long-term clients; coping with drug and alcohol misuse; shifting into community focus; dealing with psychosis in families; liaison psychiatry and primary health care settings; long-term medication and the responsibilities of the team; daily living skills for clients in the community; support for community psychiatric nurses in multidisciplinary teams; principles of evaluation; evaluating community services; and multidisciplinary care in the community for users with mental health problems - guidelines for the future.
Includes papers on: teamwork among professionals involved with disturbed families; integrating hospital and community services; policy and finance for community care; primary health care; day care and rehabilitation services; community care, community compulsion and the law; the role of the voluntary sector; managing the psychiatric emergency in the community; interventions with long-term clients; coping with drug and alcohol misuse; shifting into community focus; dealing with psychosis in families; liaison psychiatry and primary health care settings; long-term medication and the responsibilities of the team; daily living skills for clients in the community; support for community psychiatric nurses in multidisciplinary teams; principles of evaluation; evaluating community services; and multidisciplinary care in the community for users with mental health problems - guidelines for the future.
Subject terms:
interagency cooperation, joint working, law, intervention, medication, long term care, mental health problems, multidisciplinary services, patients, psychiatry, primary care, rehabilitation, residential care, teamwork, voluntary organisations, assertive outreach, alcohol misuse, community care, community mental health nurses, community mental health services, community mental health teams, day services, drug misuse, families, evaluation;