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PubMed2006

Why do homeless young people leave home?

OBJECTIVE: To describe the reasons homeless young people leave home and differences between males and females. METHODS: Homeless young people between the ages of 12 and 20 years (n = 692) completed surveys conducted by trained interviewers using Questionnaire Delivery System on laptop computers as part of a large study. Participants indicated the importance of each of 22 reasons for leaving home on a four-point scale, from 'not important' (1) to 'very important' (4). RESULTS: Conflict with parents was the only reason reported as important by at least two-thirds of respondents. Desire for independence and/or adventure was rated as important by nearly one-half of young men and women. Eighteen reasons were rated as 'not or somewhat important' by most young people. These included issues associated with school, sexuality, sexual abuse and trouble with the law. Young women were more likely than young men to report that sexual abuse, anxiety/depression, and/or pregnancy were important reasons for leaving home. The converse held for personal alcohol and drug abuse, trouble with the police, and breach of community order or parole. With few exceptions, importance ratings of the 22 reasons were not highly correlated. CONCLUSIONS AND IMPLICATIONS: Service providers should consider how the diverse elements of family environment contribute to homelessness. A focus on familial problems may lead to other important reasons being overlooked, namely a desire for independence and adventure. Services and supports need to take into account whether young people leave home because of a life crisis or because they seek independence.

Adolescent↗
PubMed2002

[Health situation of homeless in a health care home in Hannover].

BACKGROUND AND AIM: Extension of the medical health care system for social fringe groups by means of a special 'Health Care Apartment' for homeless people with an ambulatory nursing service. Between 55-70 % of the homeless people in Germany are in-patients for medical treatment nearly once a year. Only 10-20 % have a family doctor. METHOD: : The pilot experiment of a special Health Care Apartment for homeless people was scientifically evaluated for approximately one and a half year under socio-medical and socio-economic viewpoints. Every patient passes a standardized interview at admission and discharged with one validated systematic setup and one specifically developed questionnaire. RESULTS: : The mean age of the 36 investigated persons was 48.7. 36.1 % (13) of the patients lived in divorce. About 86.1 % (31) of the patients had secondary school qualifications, 69.4 % (25) had learnt a profession. All were unemployed. Two-thirds of them stated they had been found guilty of a criminal offence within the last few years. 44.5 % (16) had been homeless for 3 or more years. Approximately x of the homeless were addicted to alcohol, according to the employees entrusted with looking after the inmates. The main reasons for the average 8-week stay in the medical department were diseases of the skin and skeletal system, which had caused several hospital admissions in the past. The satisfaction of their own health status improved by 66 % from the day of their admission to the day of their discharge. 72.2 % (26) said they could get easier medical support in the Health Care Apartment. Supported by intensive socio-pedagogical care, 55.5 % (20) of the homeless people could be discharged from the special Health Care Apartment to other arrangements for homeless people, respectively to own apartments. CONCLUSION: : The pilot study of the special Health Care Apartment for homeless people in Hannover closes a gap in the provision of medical care which exists in many major cities. Moreover, hospital admissions for homeless people can be prevented and their social reintegration promoted.

Alcoholism↗
PubMed2001

Music therapy with persons who are indigent and terminally ill.

This paper addresses the music therapy process specific to one subgroup of the general population identified as having terminal illness. This subgroup includes individuals who are impoverished, homeless, and do not have someone to provide them with care at the end of life. Based upon her clinical work at Malachi House, the author identified three distinct phases of the music therapy process with these individuals: engagement, relationship building, and actively dying. The progress of 50 residents through the therapy process was documented over a three-year period, as was the musical and nonmusical content of music therapy sessions. This paper reviews the results of the documentation recorded and offers case examples to represent each phase.

Adult↗
PubMed1993

A demonstration program for homeless male alcohol and other drug abusers.

The National Institute on Alcohol Abuse and Alcoholism, in consultation with the National Institute on Drug Abuse, awarded nine demonstration grants in 1988 for community-based programs addressing issues of the homeless alcohol and other drug (AOD) abusers. Project Connect in Louisville, Kentucky, was one of the nine demonstration grants. The three-year project was designed to address a multitude of needs of the homeless male AOD abuser, including housing, medical, employment/economic, and social support, in addition to treatment for AOD abuse. The present article details the evolution and implementation of Project Connect and describes characteristics of the target population. In addition, the article presents issues and problems that surfaced during program implementation in order to assist other communities that are considering similar programs for their homeless populations.

Adult↗
PubMed1999

Mandated tuberculosis screening in a community of homeless people.

BACKGROUND: To examine the effects of a community program on tuberculosis incidence, prevalence, and transmission requiring users of public facilities to carry cards certifying their compliance with a tuberculosis screening, prophylaxis, and treatment program. Community knowledge of tuberculosis and costs and benefits of the program are described. SETTING: A West Coast "skid row" community with historically high rates of tuberculosis, homelessness, poverty, and use of drugs and alcohol. DESIGN: Analysis of tuberculosis activity in communities in Oregon using Oregon Health Division Tuberculosis Data Bank data. Description of community response and cost considerations. MAIN OUTCOME MEASURES: Rates of active disease, mortality, and skin-test response. Compliance with card use and understanding of tuberculosis control measures. Program expenditures. RESULTS: An 89% drop in active disease in the highest-risk community in Oregon occurred over the first 10 years of the program. Compliance with the program permitting the use of public facilities, based on cooperation with skin testing, radiology, sputum collection, and therapy has been between 33% of converters completing prophylaxis in the worst year to 100% of active cases completing 4-drug therapy in the best. Facilities that provide services have been almost universal in requiring cooperation for participants. Costs have been reduced. CONCLUSION: A program of mandated compliance with tuberculosis skin testing, radiologic and sputum examination and treatment, coupled with education and outreach, succeeded in drastically reducing active tuberculosis, transmission, deaths, and cost in a homeless community.

Adult↗
PubMed1997

Family homelessness: state or trait?

Compares conceptualizations of homelessness as a temporary state through which people pass or a permanent trait that emanates from individual characteristics. Evidence from a longitudinal study of 564 homeless families in New York City and additional secondary sources supports the view that for families, homelessness is a temporary state that is resolved by the provision of subsidized housing. Even for single individuals with severe mental disturbances, housing is a key factor in ending homelessness, although here there is more evidence that social services also contribute. Policy implications are that governments should take a more active role in reducing homelessness by providing access to subsidized housing.

Adult↗
PubMed1991

Ending homelessness. Policy challenges.

The extent and nature of homelessness is discussed. Only after understanding these parameters was the federal government able to develop an appropriate homelessness policy, including an explicit goal to help end, rather than simply address, the problem. The article describes how, with increased information, federal programs for the homeless have evolved, beginning with emergency remedies and shifting to more permanent solutions. Significantly increased cooperation at federal, state, and local levels is called for to effectively address this multifaceted problem. In the long term, we must wage a broad attack on poverty if we are to eradicate the root problems that force people into homelessness.

Adult↗
PubMed1995

Definitional quandaries and other hazards in counting the homeless: an invited commentary.

Complexities of both definition and dynamics suggest that the unit of analysis in research on homelessness may need rethinking. Wright and Devine's corrective effort can be criticized on the grounds that it inflates the shortcomings of the admittedly flawed 1990 S-Night count, applies relative proportions from an unrepresentative local sample, and smuggles in an overly inclusive notion of homelessness.

Adult↗