Search results for ‘Subject term:"mental health problems"’ Sort:
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Roofless in a steel city: learning from the homeless mentally ill
- Author:
- SPENCE Sean A.
- Journal article citation:
- Psychiatric Bulletin, 33(2), February 2009, pp.64-69.
- Publisher:
- Royal College of Psychiatrists
A small, city-wide clinical outreach service for the homeless mentally ill in Sheffield, UK, attained its present configuration 6 years ago. This paper discusses the lessons learnt in the course of the service’s existence. The homeless mentally ill identified by the service have disengaged from the ‘mainstream’ services and society. Most are from disturbed homes, nearly all have had prior contact with psychiatric services and as many as half have served prison terms. As service users, they must be actively sought out and engaged, which places specific demands upon a mental health team: flexibility of approach, patience and a willingness not to judge others’ values. Though largely anecdotal, the inferences drawn in Sheffield may have parallels elsewhere, not least since individual lives can turn upon pivotal (‘anecdotal’) encounters and those evinced by the homeless tell us much about society, psychiatry and the values of contemporary healthcare providers. Also, most of the time, the proposed model has been successful.
Mental health and substance abuse indicators among homeless youth in Denver, Colorado
- Authors:
- MERSCHAM Carrie, van LEEUWEN James M., McGUIRE Megan
- Journal article citation:
- Child Welfare Journal, 88(2), 2009, pp.93-110.
- Publisher:
- Child Welfare League of America
The results of mental health evaluations from 182 homeless youth residing in a Denver, Colorado, shelter are reported. The literature on homeless youth, although developing, is still somewhat limited as it relates to mental health, substance abuse, and trauma. This study was motivated by clinically observed high rates of mental illness, trauma, dangerousness issues, and drug and alcohol abuse. Using archival data from mental health evaluations conducted over two years, variables including gender, age, ethnicity, primary diagnosis, drug of choice, trauma history, suicidal ideation, homicidal ideation, and legal history were assessed. Results discovered significantly higher than expected diagnoses of mental illness and associations between drug of choice and diagnosis, trauma history and suicidal ideation, and trauma history and diagnosis. Results suggest a strong need for co-occurring treatment, trauma-focused therapy, and attention to both mental illness and substance abuse in homeless youth.
“Nuts, schiz, psycho”: an exploration of young homeless people's perceptions and dilemmas of defining mental health
- Authors:
- O'REILLY Michelle, TAYLOR Helen C., VOSTANIS Panos
- Journal article citation:
- Social Science and Medicine, 68(9), May 2009, pp.1737-1744.
- Publisher:
- Elsevier
This research explores the term ‘mental health’ as articulated by a group of young people living in homeless shelters utilising staff in a mental health service. This mental health service was offered in 5 large geographical areas (urban, semi-urban and rural) in England to 18 homeless shelters and we interviewed 25 homeless young people, 5 Mental Health Coordinators and 12 homeless shelter staff. Using discourse analysis of semi-structured interviews, the ideological dilemmas presented by the young people were investigated. They report negative and stigmatising descriptions of mental health despite their involvement with a mental health service. Four key interpretative repertoires are identified; denial of problems, mental health as negative, the need to talk, and challenging prejudice. It is concluded that the term ‘mental health’, which appears in the title of the service (of which they are clients), presents barriers for usage but works to challenge prejudice and educate young people. Discussion of the implications of naming services and the importance of shared meanings are considered.
This is not a pipe
- Author:
- JOHNSON Robin
- Journal article citation:
- A Life in the Day, 13(2), May 2009, pp.26-27.
- Publisher:
- Emerald
This article explores the role that housing support workers can have in reaching out to and engaging with individuals who would ordinarily be reluctant to put themselves in the hands of conventional care or therapy services.
Vulnerable groups in health and social care
- Author:
- LARKIN Mary
- Publisher:
- Sage
- Publication year:
- 2009
- Pagination:
- 208p.
- Place of publication:
- London
This textbook explores the experiences and health and social needs of key vulnerable groups. It presents a social science perspective relevant to everyone exploring how society as a whole cares for the vulnerable. Each chapter defines and explores a vulnerable social group, bringing together theoretical, policy and practice perspectives. The author explores contemporary debates and offers a number of differing and thought provoking viewpoints. She enables the reader to engage with the client group and to reflect upon their own learning and practice in a more meaningful way. Groups covered include: disabled people; children; older people; those living with mental illness; ethnic minorities; and the homeless. Suggestions about further study, chapter activities and a glossary of key concepts support students' learning and develop understanding across the social sciences. The book will be helpful for those taking courses across health and social care and as a reference book for practitioners.
Down and out?: the final report of St Mungo's Call 4 evidence: mental health and street homelessness
- Author:
- ST. MUNGO'S
- Publisher:
- St. Mungo's
- Publication year:
- 2009
- Pagination:
- 63p.
- Place of publication:
- London
More than 90 submissions were received following the Call for Evidence. These came from a range of sectors: mental health organisations, homeless agencies, individual service users and healthcare professionals, local authorities, campaigning groups, Primary Care Trusts, community groups, government departments and other organisations. Oral hearings were also held. This report analyses and reports on the material gathered. It summarises the nature of the mental health and homelessness problem, covering politics and policy, definition of mental illness, gaps in services, and social exclusion. It looks at health care and social care for homeless people, and discusses the recovery journey and the way forward. It includes recommendations, and brief illustrations of good working. The Chief Executive of St Mungo's notes that the report sets out a case for reform, using a range of evidence gathered to "highlight the inadequacy of the current system of treatment, care and support" to meet the mental health needs of homeless people.
Implementing assertive community treatment in diverse settings for people who are homeless with co-occurring mental and addictive disorders: a series of case studies
- Authors:
- NEUMILLER Steven, et al
- Journal article citation:
- Journal of Dual Diagnosis, 5(3), July 2009, pp.239-263.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The Assertive Community Treatment model (ACT), developed more than 30 years ago, was designed to treat individuals with serious mental illness. This qualitative study outlines issues encountered when establishing ACT teams in serving people who are homeless with co-occurring mental and addictive disorders (COD). Administrators from 9 programmes, in 7 states, completed a survey on implementation challenges, modifications to the ACT model, and programme successes. Difficulties related to staffing and funding limitations as well as to difficulties with implementing the ACT model without modifications - several modifications to the model were beneficial to recruiting and retaining consumers. These included an emphasis on housing, additional staff positions not included by ACT, implementing mini-teams within the programme, delivering in-office services in a group format, and placing time-limited services by transitioning consumers to less intensive settings. Successes included reduction in hospitalisations, psychiatric symptoms, and substance abuse. Stabilisation of consumers was attributed largely to housing assistance and maintenance; medication adherence; and delivery of intensive, multidisciplinary services including substance abuse treatment. The authors suggest the need to adapt the ACT model for people who are homeless with COD by tailoring staff and service delivery, and that there is a need for a measure capable of assessing ACT fidelity in the context of both housing models and integrated treatment for the homeless population.
A 12-month follow-up evaluation of integrated treatment for homeless individuals with co-occurring disorders
- Authors:
- MOORE Kathleen A., et al
- Journal article citation:
- Journal of Social Service Research, 35(4), September 2009, pp.322-335.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In the context that individuals with a co-occurring disorder (COD) are at special disadvantage when attempting to secure homeless shelter services, this study examined the effectiveness of the Comprehensive, Continuous, Integrated System of Care (CCISC) model in addressing co-occurring mental health and substance use disorders. Clients were eligible for participation if they had a COD and were homeless or at risk of homelessness, and 48 clients receiving services at a residential programme in central Florida received a comprehensive array of services consistent with the CCISC model. Measures assessing housing, employment, mental health, and substance use were completed at the start, and at 6 and 12 month follow-ups. The results showed significant improvements in housing, employment, mental health and substance use at 12 month follow-up. The researchers concluded that the study validates the effectiveness of the integrated CCISC model of care for use with diverse population groups, and that the results underscore the effectiveness of implementing evidence-based care.
Happiness matters: homeless people's views about breaking the link between homelessness and mental ill health
- Author:
- BILTON Helen
- Publisher:
- St. Mungo's
- Publication year:
- 2009
- Pagination:
- 43p., bibliog.
- Place of publication:
- London
The focus of this peer research was to obtain information on homeless people's own perceptions of their mental health and well-being, what led to their being homeless, the factors that they felt affected their mental health and well-being, support services they received, and the support and services they felt would be helpful. Individual, face-to-face interviews were undertaken with four groups of homeless people at different stages of recovery and with a range of diagnoses: rough sleepers; clients currently living in specialist mental health projects who have known, diagnosed mental health needs; general hostel clients – a combination of rough sleepers and more general homeless populations; and clients known to have mental health needs who have recovered sufficiently to move on into independent accommodation. A total of 103 homeless people took part in interviews and 97 questionnaires were returned. The 12 peer researchers, recruited from among people currently living in St Mungo's, were also valuable in shaping and focusing the research. The findings provide evidence that mental health services for homeless people are not adequate to meet needs.
Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV
- Authors:
- ROYAL Scott W., et al
- Journal article citation:
- AIDS Care, 21(4), April 2009, pp.448-455.
- Publisher:
- Taylor and Francis
The aim of this study is to investigate adherence to highly active antiretroviral therapy (HAART) in persons living with HIV/AIDS (PLWHA) who are homeless or unstably housed. The authors evaluated homeless or unstably housed PLWHA (n=644) in three US cities enrolled in the Housing and Health Study. Using baseline data and controlling for gender, race, age, and education, they examined associations between self-reported two- and Seven-day adherence and access to healthcare, mental health, substance use, and attitudes toward HIV medical therapy. Of the 644 participants, 358 (55%) were currently on HAART. For two-day adherence, 280 (78%) reported missing no prescribed doses (100% adherence), and for seven-day adherence, 291 (81%) reported ≥90% adherence. Logistic regression analyses indicated being younger, not having health insurance, and drug use were associated with missing ≥1 dose over the past two days. Scoring lower on SF-36 mental component summary scale and having greater risk of depression (CES-D) and stress (Perceived Stress Scale) were associated with poorer adherence for both two- and seven-day outcomes. Negative attitudes toward HIV treatment were also associated with lower adherence. Adherence to HIV medications in this population is similar to other groups. Coexisting problems of access to healthcare, higher risk of mental health problems, along with poorer attitudes toward treatment are associated with increased likelihood of missing doses. Comprehensive models of HIV care that include a continuum of medical and social services are essential for treating this population.