Homelessness and Mental Illness
The United Nations Economic and Social Council recognizes homelessness as global significance. Over two million people experience homelessness worldwide, and numbers continue to increase. Homelessness is linked to mental illnesses to establish a two-way relationship between social issues. Homelessness stress increases mental illness risk. It also causes anxiety, depression, and sleeplessness and promotes drug abuse that contributes to mental illness.
Homelessness is a traumatic event that causes and exacerbates mental illnesses. On the other hand, mentally ill people have a high homelessness risk due to heightened vulnerability, problems sustaining a job, and social withdrawal. Over 45 % of the homeless population in the US have a mental illness. Common mental illnesses affecting homeless people include depression, bipolar disorder, anxiety, schizophrenia, and drug abuse disorders. The paper will analyze homeless populations’ characteristics and health issues regarding mental illness.
Mental Illness Prevalence among the Homeless Population
The US has approximately 550,000 homeless people at any given night (Gutwinski et al., 2021). 25 % of this population -about 140,000 people- have a severe mental illness, while 45 % of the homeless individuals have some form of a mental health issue. The Substance Abuse and Mental Health Services Administration research indicates that 20 to 25 % of homeless persons in the US have a mental illness. This is a high prevalence, given that only 6 % of the general population are severely ill mentally (National Council for the Homeless, 2009). Mental illness is more prevalent in the homeless population compared to the general population. Enormous health disparities and a high prevalence of preexisting medical conditions account for the high prevalence of mental illness among homeless individuals. The population suffers from diverse medical conditions such as psychotic distress that deteriorate due to lack of access to healthcare, lack of proper social ties, and social determinants of health effects.
Depressive disorder is the most prevalent mental illness among homeless people. Depression and anxiety disorders have a prevalence of 11-57 %. Schizophrenia and psychotic disorders prevalence range between 8 % to 45 %, and the disorder is more prevalent among chronically homeless persons (Hossain et al., 2020). Substance abuse and addictive disorders have 4-61 %, while neurocognitive disorder’s prevalence range between 4 % and 80 %. Hodson et al. (2013) study show self-harm prevalence is 69 %, suicide ideation prevalence is 22 % to 36 %, and suicide attempt prevalence is 9 % to 46 %.
Challenges that Patients face when dealing with Mental Illness and Homelessness
Patients experiencing homelessness and mental illness experience myriad challenges. Mental disorders hinder their ability to carry out like self-care. They behave irrationally, pushing away vital support systems such as friends, family, and caregivers. The disorders also interfere with their ability to with family and caregivers. Mental illnesses also affect homeless people’s physical health because they disregard the need to take precautions against danger and disease. They have high unintentional injuries, violence, hunger, infectious diseases, chronic diseases, and HIV. These factors result in high mortality and morbidity rates among these patients.
Challenges the Community faces Caring for the Homeless and Mentally Sick
Communities bear the burden of providing care to homeless people with mental illness. However, they experience diverse challenges that hinder care provision efforts. They live in poor conditions and remain undiagnosed and untreated in many cases. The US has deinstitutionalized mental illness, which led to a reduction in the bed capacity of indoor psychiatric institutions without enhancing community centers’ capabilities and care model (Yohana, 2013). In addition, communities have a low organizational capacity to provide adequate mental health services. The high mental illness prevalence among homeless people compounds the challenges. These challenges have increased the number of individuals with severe mental illness conditions in temporary shelters and on the streets. This increases the burden of homelessness and mental illness within a given community.
Availability of Resources to cater to Homeless and Mentally Ill
The country lacks adequate resources and facilities to provide mental health services to homeless persons with mental illnesses. Extreme poverty among the homeless, poor insight into their psychiatric needs, dislike for psychiatric treatment, and complexity of their service compound the problem. Homeless people with mental illnesses obtain healthcare services from healthcare centers, hospitals, and facilities that cater to the poor. Such facilities lack the resources needed to provide specialized treatment and service to this population. Homeless people have unique characteristics that make it difficult for normal healthcare centers to provide adequate care. Their living circumstances make it challenging to develop a treatment plan. They also have various needs and disaffiliation that limit their support networks. Various specialized healthcare programs cater to homeless people’s special needs. They include respite centers, residential placement centers, and Johnson-Pew Projects. However, these are few and exclude many homeless persons with mental illnesses.
How Christian Worldview can serve Homeless and Mentally Ill
The Christian worldview can positively impact homeless people’s mental health. Christianity gives people hope that can help homeless persons endure stress by cultivating peace and purpose (Greenstein, 2016). Christians believe there is hope at the end of the tunnel, even in the middle of demoralizing circumstances. In addition, they believe that life is a journey and there is a possibility of change for the better in the future. The Christian worldview can instill hope and belief for a better future among homeless people, creating a positive future outlook. The worldview integration can lift homeless people out of their desolation and distress and create a purpose in their lives. A positive outlook would ease mental distress and give them something to believe in. positive outlook can encourage homeless people to desist from self-harm behaviors such as drug abuse, violence, and suicide ideation. In addition, adopting a Christian worldview can help homeless people develop meaningful social relationships with other believers and create a sense of belonging. These factors can ease mental health problems among the homeless and help them recover.
How Healthcare Providers can be Non-judgmental and Ethical when caring for this Population
Healthcare providers should be non-judgmental when caring for homeless persons with mental illnesses. Providing non-judgmental and holistic care will promote these patients’ overall well-being, including physical, emotional, and psychological health. Healthcare providers should not discriminate or judge the population due to their life predicament, mental illness, or any other characteristic to eliminate the risk of providing judgmental nursing care. They should understand and be sensitive to their needs. In addition, healthcare providers enhance their cultural skills and competence to adequately cater to diverse populations without judgment. In addition, they should obtain informed consent when treating patients, uphold confidentiality, and eliminate vulnerability and exploitation.
The paper shows mental illness is prevalent among the homeless. Mental illness limits a homeless person’s ability to take care of themselves and increases the disease burden on the community. Despite their high numbers, the country has few resources to care for mentally ill homeless people. It is essential to address the problem by establishing adequate specialized facilities that provide mental health services to the homeless. Healthcare providers should integrate a Christian worldview in serving the population and adopt a non-judgmental, ethical approach to improve their health outcomes.
Gutwinski, S., Schreiter, S., Deutscher, K., & Fazel, S. (2021). The prevalence of mental disorders among homeless people in high-income countries: An updated systematic review and meta-regression analysis.PLoS medicine,18(8), e1003750. https://dx.doi.org/10.1371%2Fjournal.pmed.1003750
Deinstitutionalization of people with mental illness: Causes and consequences. (2013).AMA Journal of Ethics,15(10), 886-891.https://doi.org/10.1001/virtualmentor.2013.15.10.mhst1-1310
Greenstein, L. (2016). The of Religion & Spirituality. Retrieved https://www.nami.org/NAMI/December-2016/The-Mental-Health-Benefits-of-Religion-Spiritual
Folh,K.L. (2016). A patient’s rights and the nurse’s responsibility to .Journal of Obstetric, Gynecologic & Neonatal Nursing,45(3), S56.https://doi.org/10.1016/j.jogn.2016.03.138
Hodgson,K.J., Shelton,K.H., Van den Bree,M.B., & Los,F.J. (2013). Psychopathology in young people experiencing homelessness: A systematic review.American Journal of Public Health,103(6), e24-e37.https://doi.org/10.2105/ajph.2013.301318
Hossain,M.M., Sultana,A., Tasnim,S., Fan,Q., Ma,P., McKyer,E.L., & Purohit,N. (2020). Prevalence of mental disorders among people who are homeless: An umbrella review.International Journal of Social Psychiatry,66(6), 528-541.https://doi.org/10.1177/0020764020924689
Yohanna, D. (2013). Deinstitutionalization of people with mental illness: Causes and consequences. Virtual Mentor. American Medical Association. https://doi.org/10.1001/virtualmentor.2013.15.10.mhst1-1310
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