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PubMed1989

Canada's homeless.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1992

LAMP in L.A.'s skid row: a model for community-based support services.

In most states, we reneged on our promise to provide community-based program support to persons deinstitutionalized from psychiatric hospitals. Now many people are blaming those with mental illness for their failure to thrive and have begun creating new laws and methods for reinstitutionalization. This chapter describes a community-based program that is demonstrably effective. It involves the full participation of homeless people diagnosed with mental illness and attests to what can work.

Community Mental Health Services↗
PubMed1991

The impact of homelessness on children.

This article reviews and critiques community-based research on the effects of homelessness on children. Homeless children confront serious threats to their ability to succeed and their future well-being. Of particular concern are health problems, hunger, poor nutrition, developmental delays, anxiety, depression, behavioral problems, and educational underachievement. Factors that may mediate the observed outcomes include inadequate shelter conditions, instability in residences and shelters, inadequate services, and barriers to accessing services that are available. Public policy initiatives are needed to meet the needs of homeless children.

Adolescent↗
PubMed1990

Real estate market trends and the displacement of the aged: examination of the linkages in Manhattan.

A real estate market trends analysis of a low-income area on the Upper West Side of Manhattan revealed increases in residential properties of 400% during 1980-1988, and 1,754% in the Manhattan Valley area of this community, compared with 203% in all of Manhattan. An analysis of databases revealed a depletion of 51.9% of the single-room occupancy housing stock in this area. A survey of 115 seniors indicated a population at risk of displacement and vulnerable to homelessness.

Aged↗
PubMed1992

Posttraumatic stress disorder among homeless men and women.

Six hundred homeless men and 300 homeless women in St. Louis were systematically interviewed using the revised Diagnostic Interview Schedule that includes a module for assessment of posttraumatic stress disorder (PTSD). Most subjects with PTSD had an additional life-time psychiatric diagnosis. No consistent pattern of association was apparent, however, between individual diagnoses and either traumatic events or PTSD. In almost three-fourths of both men and women, the onset of PTSD had preceded the onset of homelessness. Childhood histories of abuse and family fighting were predictive of both traumatic events and PTSD. The results suggest that factors leading to PTSD in the study sample began long before the onset of homelessness and may overlap with factors operative in the genesis of homelessness.

Adolescent↗
PubMed2002

Injecting drug use: implications for skin and wound management.

This article, the first of two parts, introduces the difficulties facing nurses working with injecting drug users with skin problems. Drug abuse is increasing globally, and has huge implications for healthcare practitioners. Increasing numbers of tissue viability nurses are also encountering drug injection-induced wounds in their practice, but there is a lack of evidence for management of chronic skin problems in this patient group. Together with rising numbers of injecting drug users, there are increased health implications such as bacteraemia, septicaemia, amputation and skin breakdown. Abscesses and chronic wounds as well as prolonged leg ulceration are common. Drug users may demonstrate chaotic lifestyles, which may inhibit access to usual healthcare provision. Issues relating to healing of these wounds are explored. The second part, which will appear in the next Tissue Viability Supplement, will describe the development of a specialist wound care clinic for homeless drug users.

Abscess↗
PubMedDate not supplied

Experience of family among homeless individuals.

The purposes of this article are to describe family experiences, both childhood and later, of homeless individuals, to propose some theoretical considerations of the influence of the family on homelessness, and to suggest programmatic structures and philosophies that consider the effect of these family experiences on the homeless experience. As part of a study of homeless people's health concerns, 40 homeless people were interviewed for 1 1/2-6 hours, each time using a semi-structured format. During the course of being interviewed, all individuals discussed experiences in their families. The commonalities among individuals' family stories were striking. As a result, experience of family was identified as an important theme in homeless people's lives. A thematic analysis of family stories was performed. As the result of the power of these stories, some theoretical considerations about homelessness that include the experience of family are proposed. Programmatic implications for psychiatric nursing's care of homeless people is discussed.

Adult↗
PubMed1999

[Lifestyle and health status of homeless people around Shibuya Station, Tokyo].

The number of homeless people in Tokyo is estimated to be 3,200-3,300. While studies on the health status of homeless people, including illness, injury and deaths have been previously reported, most of these reports concern the homeless who resided in housing facilities for the homeless or who admitted to hospitals. We undertook a comparison of lifestyle and health status between homeless people and people who live in houses (as a control group). Health status was also analyzed for differences among homeless people. Subjects were asked by questionnaire regarding their age, the length of being homeless, former and present employment, sleeping condition, food, whether they have friends or not, the amount of smoking per day, and Short-Form-36 Health Survey (SF36). As objective findings, measurement of blood pressure and blood testing were also performed. Fifty-three homeless people, 49 male, 4 female, average age 52, from the areas around Shibuya station and Yoyogi park, were enrolled. While 98% of the homeless people had previous employment, 73% were not working when the study was performed. Compared with control group, the homeless had fewer meals per day, fewer friends, excessive smoking, greater history of gastro-duodenal ulcer and injury, greater limitation due to physical problems, and higher general mental health as measured by SF36. The diastolic blood pressure of the homeless was higher than that of the control. The blood testing showed higher white blood cell counts and platelet counts. It was suggested that changes in the social structures were largely influential in causing life, and that access to health care was limited because of financial and social barriers. Further studies with more samples, survey of social volunteers involved in care of homeless and qualitative data would be necessary to find and develop better support system for the homeless.

Adult↗
PubMedDate not supplied

Pregnancy and childbirth: risk factors for homelessness?

A comparison of 704 homeless public assistance families in New York City with 524 families on public assistance who had housing found that pregnancy and recent births were highly correlated with becoming homeless. Thirty-five percent of homeless women were pregnant at the time of the interview, and 26 percent had given birth in the past year, compared with six percent and 11 percent, respectively, of women in the housed sample. In addition, having a baby before age 18 (as had 37 percent of the homeless women and 24 percent of the housed women) was significantly related to homelessness but family size was not.

Family Characteristics↗
PubMed1993

Human rights: the right to receive treatment and care.

In the debates leading to the redesigning of the Mental Health Act in 1983 in the United Kingdom much pressure was exerted by human rights activists and other parliamentary pressure groups to ensure that patients could not be detained or treated 'against their will' without considerable--and at times undesirable--safeguards. This has led to difficulties over 'informed consent' and the setting up of the Mental Health Act Commission. The following examples are given: (a) A case dealing with injuries sustained by a patient while absent from the hospital while under a detention order. (b) The inability for psychotics to receive delayed release injections whilst in community care. (c) The loss of facilities for admission, and the resulting problems of homelessness arising from the hospital closure policy.

Adult↗
PubMed1998

An agency-based representative payee program and improved community tenure of persons with mental illness.

OBJECTIVE: Representative payee programs help severely mentally ill individuals manage money from their Social Security payments to cover expenses for necessities and to avoid homelessness and rehospitalization. This study examined a representative payee program operated by a community mental health center to determine the criteria used by clinicians and ease managers to refer clients to the program and to learn whether participation in the program was associated with reductions in hospitalization. METHODS: The retrospective study included 56 individuals with severe mental illness who were enrolled in the representative payee program at Community Counseling Centers of Chicago for one year and who also had received services from the agency for at least one year before enrollment. Criteria used to refer clients to the representative payee program were determined through chart reviews. Data on state hospitalizations before and after enrollment were available for the entire sample; additional data on Medicaid-funded private hospitalizations were available for a subset of 33 clients. RESULTS: The most common criteria for enrollment in the representative payee program were comorbid substance abuse or dependence (49 percent), a history of homelessness (33 percent), and frequent hospitalizations (32 percent). During the year of participation in the representative payee program, the mean number of days spent in state hospitals decreased markedly compared with the year before enrollment, from 68 days to seven days. A similar reduction was noted in the number of days spent in state and private hospitals, from 97 days to 15 days. CONCLUSIONS: Findings from this pre- and postintervention retrospective study are tentative in the absence of a more rigorous design. However, the results suggest that the representative payee program is quite effective in reducing hospital stays.

Adult↗
PubMed2004

Integrating criminal justice, community healthcare, and support services for adults with severe mental disorders.

Persons with severe mental disorders are overrepresented in our nation's jails and prisons. Factors including cooccurring substance use disorders, homelessness, and lack of access to community services have contributed to this problem, as have gaps between criminal justice, healthcare, and community support systems. In order to address these issues, Project Link was developed by the University of Rochester Department of Psychiatry in collaboration with five local community agencies. Project Link is designed to prevent involvement of individuals with severe mental illness from entering the criminal justice system. While many models of diversion programs exist, they are all dependent on access to appropriate community-based services. This paper will describe the steps that Project Link has taken towards integrating criminal justice, healthcare, and community support services for individuals with severe mental disorders involved in the criminal justice system.

Adult↗
PubMed2004

Ongoing outbreak of tuberculosis in a low-incidence community: a molecular-epidemiological evaluation.

SETTING: Federal State of Hamburg, Germany, 1997-2002. OBJECTIVE: To identify the pathways of tuberculosis (TB) transmission and to evaluate possible risk factors for recent transmission in Hamburg. DESIGN: A prospective, molecular-epidemiological study was performed. Conventional contact tracing and an indepth epidemiological analysis were conducted. RESULTS: A predominant cluster of Mycobacterium tuberculosis strains was identified by IS6110 DNA fingerprinting of 828 TB cases notified during the study period. The cluster expanded from seven cases in 1997 to 38 in June 2002. A single source case could not be identified. Transmission links were confirmed in 20 cases. Twenty-five patients were regular customers at a bar close to the red-light district. Seven patients, including one regular customer in the bar, were staying at a nearby hostel for homeless men, and four were living in a far-away hostel for alcoholic men. Of the 421 close contact persons investigated, 169 (40.1%) had positive tuberculin skin tests, and eight became ill (1.9%). Twelve of 20 cases with confirmed recent transmission could only be determined a posteriori by fingerprinting. CONCLUSIONS: An ongoing outbreak at a local bar indicates chronic alcoholism as a high-risk factor for the dissemination of TB in a large metropolitan area. The fact that conventional contact tracing is insufficient for the detection of chains of transmission in this milieu indicates the need for an improved, location-based approach, e.g., the implementation of an outreach strategy.

Adult↗