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Journal articles on the topic 'Homeless persons Services for Australia'

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Author: Grafiati

Published: 10 December 2022

Last updated: 29 January 2023

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1

Phillips, Darren, and Ahmed Bawa Kuyini. "Consumer participation at Specialist Homelessness Services: Do the homeless have a say in the services they receive?" International Social Work 61, no. 6 (March 20, 2017): 1095–115. http://dx.doi.org/10.1177/0020872817695644.

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This study in the state of New South Wales, Australia, explored what Specialist Homelessness Services are currently implementing in regard to consumer participation, what is working and what barriers to consumer participation have been encountered by both service users and providers. Three staff members, one consumer volunteer and 10 homeless persons from three services were interviewed. The interviews were analysed using thematic analysis. The study found that while consumers have some opportunities to participate, and that participation is beneficial, there were barriers to participation, such as staff attitudes and the nature of the consumer group. The implications of these findings for staff, consumers and future policy direction are discussed.

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MacWilliams, Judy, Michael Bramwell, Sally Brown, and Margaret O'Connor. "Reaching out to Ray: delivering palliative care services to a homeless person in Melbourne, Australia." International Journal of Palliative Nursing 20, no. 2 (February 2014): 83–88. http://dx.doi.org/10.12968/ijpn.2014.20.2.83.

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3

Teesson, Maree, and Neil Buhrich. "Prevalence of schizophrenia in a refuge for homeless men: a five year follow-up." Psychiatric Bulletin 14, no. 10 (October 1990): 597–600. http://dx.doi.org/10.1192/pb.14.10.597.

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Until the mid 1950s, the management of persons suffering from chronic mental illness in Australia was the responsibility of the large mental hospital. With the advent of psychotropic drugs and concern about the ‘negative’ influence of the institutional environment on patients there was a shift to shorter but more frequent periods of hospital admission. As the pattern of shorter admissions increased, community services for the mentally ill were expanded in the early 1970s. Between 1950 and 1985 in the state of New South Wales, the numbers of patients in large mental hospitals decreased from 256 to 55 per 100 000 population. However, no special arrangements for accommodation, as distinct from treatment, were made for these ex-mental hospital patients. The decline in hospital numbers can be attributed to a general reduction in the length of hospital stays. Initially, there seemed to be no pressing need for extra accommodation in the community as the provision of social security benefits was adequate to allow patients without homes to afford basic accommodation, a situation different to that in the United States (Lamb, 1984).

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Armitt, Kellie-Ann, Janette Young, and Rose Boucaut. "A Qualitative Analysis of Management Perspectives on Seeking to Implement the Foster Cat Project in Residential Aged Care in the Context of COVID-19." International Journal of Environmental Research and Public Health 20, no. 1 (December 31, 2022): 752. http://dx.doi.org/10.3390/ijerph20010752.

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This study explores the challenges facing a pilot project aiming to foster homeless cats in an Australian residential aged care facility. The global COVID-19 pandemic stalled the project but also presented an opportunity to gain reflective insights into the perceived barriers, enablers and tensions involved in seeking to implement pet animal inclusion in residential aged care. Perspectives from aged care management, animal welfare services and researchers/project managers were all sought using semi-structured interviews, and themes developed using a qualitative descriptive analysis. Perceived barriers to the project before and after the pandemic were not dissimilar with four key themes emerging: competing priorities, risk and safety, resources, and timing. All existed differently across stakeholder groups creating tensions to be negotiated. These themes are then mapped to the competencies established by the International Union of Health Promotion and Education (IUHPE) for undertaking health promotion, demonstrating that this skill base can be drawn on when seeking to implement human–animal inclusive projects. Creating supportive healthful environments for frail older persons is a moral imperative of extended lives. Health Promotion skills as outlined in the Ottawa Charter and IUHPE competencies for health promotion workers need to be extended to include animal services, agendas and cultures to promote multi-species health promotion into the future.

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Simon, Anna Brown, and Zane Robinson Wolf. "Mini-Ethnography and Case Studies on Homeless Persons’ Primary Care Needs in an Urban Community." International Journal for Human Caring 26, no. 4 (December 1, 2022): 215–37. http://dx.doi.org/10.20467/humancaring-d-21-00003.

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Homeless persons struggle to access healthcare services and obtain resources to meet basic needs. This study used mini-ethnography, case study, and survey to describe primary care needs of homeless persons in two Pennsylvania cities. Data were obtained using participant observation, field notes, surveys, and document analysis. Five homeless persons and four community volunteers were interviewed. Homeless persons had some options for obtaining primary care services. It was difficult to take prescribed medications and acquire preventive services. Their symptoms often went unattended. Dedicated community volunteers and community agencies assisted homeless persons to obtain basic needs and healthcare services.

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White, S. E. "Health Care Services and Homeless People: The Missing Link." Australian Journal of Primary Health 6, no. 4 (2000): 80. http://dx.doi.org/10.1071/py00038.

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The paper describes an effective and innovative model of referral and service provision, which has been developed collaboratively between the Royal District Nursing Service Homeless Persons' Program and four inner urban public hospitals. The aim of the Royal District Nursing Service (RDNS) Homeless Persons Program (HPP) is twofold: to provide high quality, holistic health care to homeless people and to improve their access to the mainstream public health system. Our fundamental belief is that health is both a personal resource and a human right. The experience of homelessness impacts directly on physical, emotional and social wellbeing, resulting in a perpetual cycle of ill health and transience. Traditionally, homeless people have met with significant difficulties when accessing mainstream health systems. In 1991, the RDNS Homeless Persons' Program began to develop formal policies and protocols with a public hospital emergency department, in relation to the care and discharge planning of homeless people. This collaborative model of referral and continuity has since been refined and replicated in three other inner urban public hospitals. It now forms the basis of an effective, integrated network that acts to improve not only the quality of care offered by the hospitals, but more importantly, the quality of life experienced by the homeless people involved.

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Jagpal, Parbir, Nigel Barnes, Richard Lowrie, Amitava Banerjee, and Vibhu Paudyal. "Clinical Pharmacy Intervention for Persons Experiencing Homelessness: Evaluation of Patient Perspectives in Service Design and Development." Pharmacy 7, no. 4 (November 13, 2019): 153. http://dx.doi.org/10.3390/pharmacy7040153.

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Persons experiencing homelessness have a high prevalence of severe mental health problems, alcohol dependence, substance misuse and infectious hepatitis C, and face up to twelve times higher mortality rates compared to the general population. They also face barriers to accessing healthcare. However, clinical pharmacy services are currently not available to homeless populations in England. The aim of this study was to conduct public involvement sessions with persons experiencing homelessness with a view to inform the design of patient-centred clinical pharmacy healthcare services. Qualitative methodology was used, using a focus group with homeless persons from emergency shelters and one to one engagement with those sleeping rough, using a topic guide. A total of nine homeless persons took part—seven males and two females. The participants of the sessions said that patient-centred clinical pharmacy services delivered for homeless persons would address many of their unmet needs around access to medicines, their understanding of prescribed medicines and holistic management of their health. The service would be able to make a positive impact on their health outcomes by screening for health conditions, facilitating better integration across services, referral and liaison with other services, and minimising misuse of prescribed medicines. The findings of this study will be used to inform the development, implementation and evaluation of a patient-centred clinical pharmacy service tailored to meet the specific needs of the homeless population.

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8

James, Franklin J. "Counting homeless persons with surveys of users of services for the homeless." Housing Policy Debate 2, no. 3 (January 1991): 733–53. http://dx.doi.org/10.1080/10511482.1991.9521071.

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McNeil, Ryan, and Manal Guirguis-Younger. "Illicit drug use as a challenge to the delivery of end-of-life care services to homeless persons: Perceptions of health and social services professionals." Palliative Medicine 26, no. 4 (April 4, 2011): 350–59. http://dx.doi.org/10.1177/0269216311402713.

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Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the challenges of end-of-life care services to homeless illicit drug users based on data collected during a national study on end-of-life care services delivery to homeless persons in Canada. The authors conducted qualitative interviews with 50 health and social services professionals involved in health services delivery to homeless persons in five cities. Interviews were transcribed verbatim and analysed thematically. Themes were organised into two domains. First, barriers preventing homeless illicit drug users from accessing end-of-life care services, such as competing priorities (e.g. withdrawal management), lack of trust in healthcare providers and discrimination. Second, challenges to end-of-life care services delivery to this population in health and social care settings, including non-disclosure of illicit drug use, pain and symptom management, interruptions in care, and lack of experience with addictions. The authors identify a need for increased research on the role of harm reduction in end-of-life care settings to address these challenges.

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DiBlasio, Frederick A., and John R. Belcher. "Gender differences among homeless persons: Special services for women." American Journal of Orthopsychiatry 65, no. 1 (1995): 131–37. http://dx.doi.org/10.1037/h0079596.

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Rowe, Michael, Michael A. Hoge, and Deborah Fisk. "Services for mentally ill homeless persons: Street-level integration." American Journal of Orthopsychiatry 68, no. 3 (1998): 490–96. http://dx.doi.org/10.1037/h0080358.

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12

Belcher, John R., and Frederick A. DiBlasio. "The needs of depressed homeless persons: Designing appropriate services." Community Mental Health Journal 26, no. 3 (June 1990): 255–66. http://dx.doi.org/10.1007/bf00752776.

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13

Vance, David. "Barriers to Use of Services by Older Homeless People." Psychological Reports 75, no. 3 (December 1994): 1377–78. http://dx.doi.org/10.2466/pr0.1994.75.3.1377.

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Analysis of responses during participant observation and face-to-face interviews of four homeless elders and six service providers indicated that the four elders comprehended and used the service environment; however, hopelessness (learned helplessness) appears to be the largest personal obstacle to use of such resources by elderly homeless persons to change their situation.

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Ivers, Jo-Hanna, Lina Zgaga, Bernie O’Donoghue-Hynes, Aisling Heary, Brian Gallwey, and Joe Barry. "Five-year standardised mortality ratios in a cohort of homeless people in Dublin." BMJ Open 9, no. 1 (January 2019): e023010. http://dx.doi.org/10.1136/bmjopen-2018-023010.

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ObjectiveTo calculate standardised mortality ratios (SMRs) for a cohort of homeless people in the Dublin region over a 5-year period and to examine leading causes of death.SettingHomeless services reporting deaths from homeless persons in their care across the Dublin Homeless Region.MethodsDeath data among people who experience homelessness was acquired from the Dublin Region Homeless Executive (2011–2015) and validated from both death certificates and records from the Dublin Coroner’s Office.ParticipantsTwo hundred and nine deaths were recorded; of these 201 were verified (n=156 males, 77.6%). Deaths that could not be verified by certificate or coroners record were excluded from the study.ResultsSMRs were 3–10 times higher in homeless men and 6–10 times higher in homeless women compared with the general population. Drug and alcohol-related deaths were the leading cause of death, accounting for 38.4% of deaths in homeless individuals. These were followed by circulatory (20%) and respiratory causes (13%).ConclusionMortality rates among homeless persons are exceptionally high. Services and programmes, particularly housing and those targeting overdose and alcoholism, are urgently needed to prevent premature mortality in this vulnerable population.

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Győrffy, Zsuzsa, Sándor Békási, Bence Döbrössy, Virág Katalin Bognár, Nóra Radó, Emília Morva, Szabolcs Zsigri, Péter Tari, and Edmond Girasek. "Exploratory attitude survey of homeless persons regarding telecare services in shelters providing mid- and long-term accommodation: The importance of trust." PLOS ONE 17, no. 1 (January 6, 2022): e0261145. http://dx.doi.org/10.1371/journal.pone.0261145.

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Background With the expansion of digital health, it is imperative to consider intervention techniques in order not to be the cause of even more social health inequalities in underserved populations struggling with chronic diseases. Telemedicine solutions for homeless persons might compensate for shortcomings in access to valuable health services in different settings. The main aim of our research was to examine the attitudes and openness of homeless persons regarding telecare on a Hungarian sample. Methods Quantitative survey among homeless people (n = 98) was completed in 4 shelters providing mid- and long-term accommodation in Budapest, Hungary. Attitudes regarding healthcare service accessibility and telecare were measured by a self-developed questionnaire of the research team. Telecare attitude comparison was made with data of a Hungarian weighted reference group of non-homeless persons recruited from 2 primary care units (n = 110). Results A significant fraction of homeless people with mid- or long-term residency in homeless shelters did not oppose the use of telecare via live online video consultation and there was no difference compared to the national reference group (averages of 3.09 vs. 3.15, respectively). Results of the homeless group indicate that those more satisfied with healthcare services, in general, manifest more openness to telecare. It is clearly demonstrated by the multivariate analysis that those participants in the homeless group who had problems getting health care in the last year definitely preferred in-person doctor-patient consultations. Conclusion Digital health technologies offer a potentially important new pathway for the prevention and treatment of chronic conditions among homeless persons. Based on the attitudes towards telecare, initiating an on-site telecare program for mid- and long-term residents of homeless shelters might enable better care continuity. Our results draw attention to the key factors including building trust in the implementation of such programs among underserved and other vulnerable patient groups.

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Biederman, Donna J., Julia C. Gamble, Sally Wilson, Laura K. Duff, Erin Bristow, and Laura M. Wiederhoeft. "Transitional Care for Homeless Persons: An Opportunity for Nursing Leadership, Innovation, and Creativity." Creative Nursing 22, no. 2 (2016): 76–81. http://dx.doi.org/10.1891/1078-4535.22.2.76.

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Homelessness in the United States is decreasing. However, homeless persons exhibit high levels of illness and frequently move between institutional and community settings. These moves are complicated by a complex health care and service industry landscape that is often difficult to navigate. In this article, we describe an innovative transitional care program for homeless persons that augments nurse-led transitional care with community health workers who provide accompaniment and linkage to services for program participants. This model offers promise in surmounting the myriad structural barriers to health and health care that many homeless persons in our communities routinely face.

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Boesveldt, Nienke Fredrika. "Denying homeless persons access to municipal support." International Journal of Human Rights in Healthcare 12, no. 3 (July 19, 2019): 179–91. http://dx.doi.org/10.1108/ijhrh-01-2018-0005.

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Purpose The purpose of this paper is to focus on the denial of social support to homeless persons and related societal effects of new local governance arrangements. Design/methodology/approach Analysis of new data and secondary evaluative and comparative data on the policies, administrative structures and management styles of Copenhagen, Glasgow and Amsterdam have brought better understanding of the elements of local governance arrangements that influence the number of homeless persons who are denied access to services and the number of persons sleeping rough who are not eligible for social support. Theoretical explanations for the impact of governance arrangements on these processes and societal effects are considered. Findings It appears that while the body of research, reports and policy documents on non-eligibility for homelessness services is growing, legal responses at best remain vague, and policies are still in the process of being developed. Modest progress on policy goals, and even more so on policy instruments, leading to less detrimental outcomes, can be explained by centralising and decentralising trends and the relationships between state and society. The latter may also be indicative of how the increased focus on the legal problems of some EU migrants can be explained. Research limitations/implications The two points in time documented for the case studies are relevant in understanding processes underlying the current circumstances of homeless persons and homeless migrants and offer an interdisciplinary insight into governance and politics, law, and public and health service perspectives. Social implications Good policy practice, as this paper shows, can lead to a difference in individual lives. Originality/value Much is unknown about considerations inside government. This paper contributes by combining theoretical and insider perspectives.

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Barnes, Jessica, Larry Segars, Jason Wasserman, Patrick Karabon, and Tracey A. Taylor. "611. Infectious Disease Management of Homeless and Non-Homeless Populations in United States Emergency Departments." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S366. http://dx.doi.org/10.1093/ofid/ofaa439.805.

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Abstract Background Studies have long documented the increased emergency department usage in the United States by homeless persons compared to their housed counterparts, as well as an increased overall prevalence of infectious diseases. However, there is a gap in knowledge on the treatment that homeless persons receive for these infectious diseases within United States emergency departments compared to their housed counterparts. This study seeks to understand this potential difference in treatment, including diagnostic services tested, procedures performed, and medications prescribed. Methods This study utilized a retrospective, cohort study design to analyze data from the 2007-2010 National Hospital Ambulatory Medical Care Survey (NHAMCS) database. Complex sample logistic regression analysis was used to compare variables, including diagnostic services, procedures, and medication classes prescribed between homeless and private residence individuals seeking emergency department treatment for infectious diseases. This provided an odds ratio to compare the two populations, which was then adjusted for confounding variables. Results Compared to private residence individuals, homeless persons were more likely (OR: 10.99, p< 0.05, CI: 1.08-111.40) to receive sutures or staples when presenting with an infectious disease in United States emergency departments. Compared to private residence persons, homeless individuals were less likely (OR: 0.29, p< 0.05, CI: 0.10-0.87) to be provided medications or immunizations when presenting with an infectious disease in United States emergency departments, and significant differences were detected in prescribing habits of multiple medication classes. Conclusion This study detected a significant difference in suturing/stapling and medication prescribing patterns for homeless persons with an infectious disease in United States emergency departments, compared to their housed counterparts. These results provide a platform for continual research. Disclosures All Authors: No reported disclosures

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Pascual, Juan Carlos, Angeles Malagón, Jose M. Arcega, Jose M. Gines, Ricard Navinés, Alfredo Gurrea, Carlos Garcia-Ribera, and Antoni Bulbena. "Utilization of psychiatric emergency services by homeless persons in Spain." General Hospital Psychiatry 30, no. 1 (January 2008): 14–19. http://dx.doi.org/10.1016/j.genhosppsych.2007.08.006.

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Wittman, Friedner, Douglas Polcin, and Dave Sheridan. "The architecture of recovery: two kinds of housing assistance for chronic homeless persons with substance use disorders." Drugs and Alcohol Today 17, no. 3 (September 4, 2017): 157–67. http://dx.doi.org/10.1108/dat-12-2016-0032.

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Purpose Roughly half a million persons in the USA are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. The paper aims to discuss these issues. Design/methodology/approach The authors examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals. Findings The authors found two predominant housing models that reflect different service goals: sober living houses (SLHs) and housing first (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders, and other problems. Research limitations/implications If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of “recovery,” roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing. Originality/value This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon architecture and community planning principles.

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Stenius-Ayoade, Agnes, Johan G. Eriksson, Hannu Kautiainen, Mika Gissler, and Peija Haaramo. "Duration of homelessness and its relationship to use of hospital and emergency department services in Helsinki, Finland." Scandinavian Journal of Public Health 48, no. 3 (June 14, 2019): 259–66. http://dx.doi.org/10.1177/1403494819854008.

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Aims: Homelessness is associated with poor health outcomes and increased use of hospital and emergency department (ED) services. Little is known about the duration of homelessness in relation to health care service use. The aim of this study was to examine the use of hospital and ED services among the homeless in Helsinki, Finland, and for the first time, to examine the relationship between service use and duration of homelessness. Methods: Six hundred and eighty-three persons staying at least one night in a shelter between September 2009 and September 2010 were followed until the end of 2014. Using negative binominal regression analysis we calculated the use of hospital and ED services and compared the use with that of a matched control group ( N = 1361). We also analyzed service use in relation to the time spent homeless during follow-up. Results: The mean time spent homeless during the follow-up was 8.5 months, one third was temporarily homeless (less than 2% of the follow-up time), but recurrent episodes of homelessness were also common. The study group’s incidence rate ratios for medical-surgical hospital days was 6.23 (95% CI: 4.73 to 8.21), for psychiatric hospital days 43.11 (95% CI: 23.02 to 80.74) and for ED visits 10.21 (95% CI: 8.77 to 11.90), compared with controls. The number of medical-surgical hospital days and ED visits/person-year increased as homelessness was prolonged, but the pattern was opposite for psychiatric hospital days. Conclusions: Homeless persons are heavy users of hospital and ED services, and there is also increased use among those temporarily homeless.

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Dixon, Lisa, Nancy Friedman, and Anthony Lehman. "Housing Patterns of Homeless Mentally Ill Persons Receiving Assertive Treatment Services." Psychiatric Services 44, no. 3 (March 1993): 286–88. http://dx.doi.org/10.1176/ps.44.3.286.

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Booth, Sue. "Eating rough: food sources and acquisition practices of homeless young people in Adelaide, South Australia." Public Health Nutrition 9, no. 2 (April 2006): 212–18. http://dx.doi.org/10.1079/phn2005848.

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AbstractObjectiveThe aim of this study was to determine the food sources and acquisition practices used by homeless youth in Adelaide. This work is part of a larger study that aimed to examine the extent and nature of food insecurity among homeless youth.DesignCross-sectional design involving quantitative and qualitative methods.SettingFour health and welfare inner-city agencies serving homeless youth in Adelaide, South Australia.SubjectsA sample of 150 homeless youth aged between 15 and 24 years recruited from these agencies. Fifteen were selected via snowball sampling for interview.ResultsUse of welfare food sources was high (63%). Food from welfare agencies was supplemented by unorthodox food acquisition methods such as theft (65%), begging for money for food (61%), begging for food items (44%) and asking for help from friends and relatives (34%). Reasons given for non-usage of welfare food services included affordability, access, being too busy, shame or embarrassment.ConclusionsFood insecurity is a salient issue for some homeless youth in Adelaide. Clarifying food acquisition practices of food-insecure homeless youth is essential for rational planning and improvement of food-related services to meet their needs. Such an understanding also underpins the development of broader public policy responses that improve individual and household skills and resources to acquire food and ensure food security. Nutrition professionals, welfare professionals and policy-makers need to work sensitively with welfare food agencies and others to improve food access and food security for homeless youth.

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Prasad, V. "Translating Universal Health Care for the Homeless: Barriers and potential facilitating factors for accessing health care amongst street dwellers in India." Health, Culture and Society 2, no. 1 (April 23, 2012): 71–88. http://dx.doi.org/10.5195/hcs.2012.74.

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Urban health policy has remained a neglected area in India, and amongst the urban poor, the homeless remain the most deprived, neglected and stigmatized group. While they suffer from a large burden of disease, there are a variety of reasons that prevent them from accessing the available health care services – particularly in the public health sector. These barriers have been poorly understood and documented. This report, based upon a detailed study of homeless participants in New Delhi, India, seeks to highlight the systemic changes that would be required within public health systems to enable street dwellers to avail of their services and realise the conceptual ambit of ' health for all' in the context of homeless persons.

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Gordon, Adam J., Melissa L. Montlack, Paul Freyder, Diane Johnson, Thuy Bui, and Jennifer Williams. "The Allegheny Initiative for Mental Health Integration for the Homeless: Integrating Heterogeneous Health Services for Homeless Persons." American Journal of Public Health 97, no. 3 (March 2007): 401–5. http://dx.doi.org/10.2105/ajph.2006.094284.

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Kasai, Nao, Sanae Sugita, and Masato Dohi. "A Study on the Actual Conditions of Support for Homeless Persons in Australia." Journal of the City Planning Institute of Japan 45.3 (2010): 757–62. http://dx.doi.org/10.11361/journalcpij.45.3.757.

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Kasai, Nao, Sanae Sugita, and Masato Dohi. "A Study on the Actual Conditions of Support for Homeless Persons in Australia." Journal of the City Planning Institute of Japan 45 (2010): 127. http://dx.doi.org/10.11361/cpij1.45.0.127.0.

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Recoche, Katrina, Margaret O'Connor, and Rosemary Clerehan. "Palliative Care for Underserved Populations in Australia: Homeless Persons A Discourse-Historical Approach." Journal of Pain and Symptom Management 56, no. 6 (December 2018): e23. http://dx.doi.org/10.1016/j.jpainsymman.2018.10.011.

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Swigart, Valerie, and Randall Kolb. "Homeless Persons' Decisions to Accept or Reject Public Health Disease-Detection Services." Public Health Nursing 21, no. 2 (March 2004): 162–70. http://dx.doi.org/10.1111/j.0737-1209.2004.021210.x.

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Lehman, Anthony F., Lisa Dixon, Jeffrey S. Hoch, Bruce Deforge, Eimer Kernan, and Richard Frank. "Cost-effectiveness of assertive community treatment for homeless persons with severe mental illness." British Journal of Psychiatry 174, no. 4 (April 1999): 346–52. http://dx.doi.org/10.1192/bjp.174.4.346.

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BackgroundHomelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed.AimsTo evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland.MethodsA total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed.ResultsCompared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0. 58 in favour of ACT. Patterns of care and costs varied according to race.ConclusionACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.

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Sumerlin, John R., and Gayle Privette. "Humanistic Constructs and Counseling Homeless Men." Psychological Reports 75, no. 1 (August 1994): 611–26. http://dx.doi.org/10.2466/pr0.1994.75.1.611.

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The present humanistic model for counseling homeless men assumed that counseling goals evolve from each client's internal frame of reference and may include a positive adaptation to his homeless experience. The model encompasses Rogers' necessary components of psychotherapy, Sullivan's interpersonal theory of psychiatry, Adler's use of wellness and encouragement, and Privette's peak-performance contribution. Factor analysis of history of homelessness, background data, ratings of subjective health and of happiness, and scores on Jones and Crandall's Short Index of Self-actualization yielded nine factors relevant to counseling. Empirical support was reported for placing a counseling services program in a multiservice facility for homeless persons.

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Lipmann, Bryan. "Providing Housing and Care to Elderly Homeless Men and Women in Australia." Care Management Journals 4, no. 1 (March 2003): 23–30. http://dx.doi.org/10.1891/cmaj.4.1.23.57472.

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People who are unemployed and who lack the resources to buy adequate food, shelter, or basic health care services face an endless struggle to survive. It is frequently a degrading and humiliating experience. The elderly homeless, who are often frail and sick, are particularly disadvantaged in this struggle. Yet resources are often available to welfare providers to care for the aged homeless. All that is needed is a willingness for providers and government agencies to acknowledge the existence of homelessness among the elderly and be prepared to alleviate the problem.

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Sinova, L. "SOCIAL AND LEGAL PROTECTION OF CHILD NEGLECT AND HOMELESSNESS DURING QUARANTINE." Bulletin of Taras Shevchenko National University of Kyiv. Legal Studies, no. 117 (2021): 74–78. http://dx.doi.org/10.17721/1728-2195/2021/2.117-14.

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The article examines the features of the legal status of child neglect and homelessness, determines the place of this category of persons in society and the state. Child neglect and homelessness are considered as a separate category that needs social and legal protection from the state and charitable organizations, especially during the coronavirus pandemic (COVID-19). Today, the problem of homeless people and homeless children in Ukraine distorts the social environment, destroys the physical, mental and spiritual health of people, reduces their vital, social and creative activity, worsens morale, as well as creates tension in society. The main reasons for this situation were a sharp decline in income and living standards due to the coronavirus pandemic (COVID-19) and structural changes in the economy, unprofitability of many manufacturing enterprises, imperfect financial and credit mechanisms, the sharp increase in existing and hidden unemployment, unpreparedness of training and social institutions, as well as law enforcement agencies to work with such categories of the population in the market conditions. The general principles of social protection of homeless persons and homeless children established by the legislation are determined. It provides legal regulation for relations in society, which are aimed at realization by homeless persons and homeless children of their rights and freedoms provided by the Constitution and legislation of Ukraine. It also creates conditions for public and charitable organizations working in the field of social protection. The conditions and active growth of the number of homeless people and homeless children during quarantine are studied. The author points out the need to comply with the current legislation in the field of social and legal protection of this category of persons, especially during quarantine, as health should be a strategic direction of human life. Thus, the state should protect and help homeless citizens and homeless children according to the Constitution of Ukraine, as a person, his life and health, honor and dignity, inviolability and security are recognized in Ukraine as the highest social value. The maintenance and upbringing of orphans and children deprived of parental care is the responsibility of the state. Keywords: homelessness, child neglect, life circumstances, health care, quarantine, social assistance, social services, orphanhood.

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Hossain, R., I. Burcul, J. Dai, R. Hossain, S. Strobel, Z. Ma, and S. Jamani. "LO70: Emergency department use and migration patterns of people experiencing homelessness." CJEM 22, S1 (May 2020): S33. http://dx.doi.org/10.1017/cem.2020.125.

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Introduction: Understanding how homeless patients interact with healthcare systems can be challenging. The nature of the population is such that identifying and following these persons can be severely limited by data. Previous studies have used survey data which relies on self-reporting and selected samples such as those persons admitted to homeless shelters (Gray et al. 2011). Other studies have been able to leverage administrative data but only for selected local geographic areas (Somers et al. 2016, Tompkins et al 2003). It is possible that the current literature has not examined a large proportion of homeless persons and their healthcare use. This is concerning because this population can have higher associated medical costs and greater medical resource utilization especially with regards to psychiatric and emergency department (ED) resources (Tulloch et al. 2012, Forchuk et al, 2015). Methods: Administrative health data (2010 to 2017) is used to analyze ambulatory care records for homeless individuals in Ontario, Canada. Uniquely, we are able to use ED contacts as a way of identifying homeless migrations from region to region within Ontario. Using a network analysis we identify high impact ED nodes and discrete hospital networks where homeless patients congregate. We are also able to more fully characterize this population's demographics, health issues, and disposition from the ED. Results: We provide a more complete understanding of migration patterns for homeless individuals, across Ontario and their concomitant ED use and hospitalizations. The three most frequented regions in Ontario (n = 640,897) were Toronto Central (35.96%), Hamilton Niagara Halimand Brant (8.9%) and Champlain (7.84%). In subsequent visits, the majority of patients presented to different EDs, however a subgroup who always presented to the same site was present. Over the 7 year period, migration between visits occurred most often between urban areas, and increased as a whole. Conclusion: The results of the study allow for the enhancement care coordination for vulnerable populations and enhance the availability and delivery of services for sub-groups of homelessness whose care needs may differ based on migration patterns. Services can be coordinated between jurisdictions for homeless individuals, and appropriate referrals can be made across the health care system. Further evidence is provided for a novel method of mapping migration among the homeless and its associations and effects on ED use.

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Vitko, J. S., and A. A. Lebedeva. "Practice with Homeless Persons: the Prospect of the “Invisible” Personality Return." Social Psychology and Society 12, no. 4 (2021): 146–69. http://dx.doi.org/10.17759/sps.2021120409.

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Objective. The article analyzes the practices of homeless assistance programs and the possibility of developing a methodological approach, where the restoration of the lost subjectivity of the individual will become one of the methodological foundations of the psychology of homelessness. Background. The problem of homelessness is urgent both for Russia and foreign countries. Improving the effectiveness of the re-socialization practices for people living on the street implies a deeper understanding of the psychology of the homeless by social services. Methodology. This article considers the methodological principles of the historical-evolutionary approach (A.G. Asmolov), the approach to the analysis of cultural and personal development from the viewpoint of the chronotope (N.N. Tolstykh), the principle of supra-situational activity (V.A. Petro¬vsky), the idea of personality development pathways in challenging conditions (D.A. Leontiev), etc. Conclusions. It is concluded that assistance to the homeless is of an ad hoc nature and mostly includes the provision of material and emergency support. The authors propose a comprehensive model based on the idea of the homeless personality returning and upholding the following principles: 1) retention of activity on the side of the person, 2) effort on the part of the person, 3) maintenance of oversituational activity, 4) reliance on the personality, its potential, 5) support and organization of social relations, 6) polysystem.

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Testani-Dufour, Linda, Lesa Green, Ruth Green, and Kimberly Ferren Carter. "Establishing Outreach Health Services for Homeless Persons: An Emerging Role for Nurse Managers." Journal of Community Health Nursing 13, no. 4 (December 1, 1996): 221–35. http://dx.doi.org/10.1207/s15327655jchn1304_2.

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Bregman, Lucy. "Funeral for a Homeless Vagrant? Religious and Social Margins." Religions 12, no. 1 (January 1, 2021): 30. http://dx.doi.org/10.3390/rel12010030.

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A “homeless vagrant” was the term used by Protestant clergy of the first half of the twentieth century for a man without name, family or history who died on the street. Clergy were asked to perform a funeral for him, but as his religious status was unknown, his funeral posed a problem for them. How could one preach a hopeful Christian message, for one who may not have had faith in Christ? This paper uses pastors’ manuals and sermon collections to understand how this kind of “problem funeral” was interpreted as an example of a marginal death both religiously and socially. Although there were no mourners, the purpose of the funeral was worship of God, who was always ready to receive us. The homeless vagrant’s funeral was also an occasion for reproach, against the anonymity, impersonality and moral danger of urban life. The homeless vagrant’s extreme isolation and abandonment made him a warning to all. The paper closes with the contrast between this view of death on the street, and that conveyed in recent Homeless Persons Memorial Day services, organized by activists for the homeless. The latter see the homeless as persons with names and stories, part of a counter-community in cities. The tone of reproach is much more prominent here, too. Society has failed these people.

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Moore, Gaye, Elizabeth Manias, and Marie Frances Gerdtz. "Complex health service needs for people who are homeless." Australian Health Review 35, no. 4 (2011): 480. http://dx.doi.org/10.1071/ah10967.

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Background. Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing. Objective. To examine the perceptions and experiences of homeless people in relation to their health service needs as well as those of service providers involved with their care. Design. A purposive sampling approach was undertaken with a thematic framework analysis of semi-structured interviews. Participants. Interviews were undertaken with 20 homeless people who accessed the emergency department in an acute hospital in Melbourne, Australia and 27 service providers involved in hospital and community care. Results. Six key themes were identified from interviews: complexity of care needs, respect for homeless people and co-workers, engagement as a key strategy in continued care, lack of after-hour services, lack of appropriate accommodation and complexity of services. Conclusions. Findings revealed the complex and diverse nature of health concerns in homeless people. The demand on hospital services continues to increase and unless government policies take into consideration the psychosocial demands of the communities most vulnerable people efforts to divert hospital demand will continue to fail. What is known about the topic? Homeless people have complex healthcare needs and are high users of emergency departments (EDs). The increasing demand on hospital services has led to a focus by the Australian State, Territory and Federal Governments on strategies to divert homeless people from presenting to the ED. What does this paper add? This paper gives an insight into the experiences of homeless people and health service provides who are directly involved in their care. This insight gives important focus on the health needs and service responses that currently exist and the ongoing challenges that face homeless people and the health professionals responding to those needs. What are the implications for practitioners? To adequately respond to the needs of homeless people safe and supportive accommodation is a crucial component of services required to try and break the cycle of representation to the emergency department. Individual engagement strategies with coordinated care between hospital and community are required to address the complex care needs and psychosocial issues.

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Draper, Brian, and Lee-Fay Low. "Psychiatric services for the “old” old." International Psychogeriatrics 22, no. 4 (March 15, 2010): 582–88. http://dx.doi.org/10.1017/s1041610210000293.

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ABSTRACTBackground: Few studies have specifically examined mental health service delivery to persons aged over 84 years, often described as the “old” old. Our aim was to compare mental health service provision in Australia to persons aged 85 years and over with the “young” old and other age groups. We hypothesized that the “old” old would differ from the “young” old (65–84 years) by diagnostic category, rates of specialist psychiatric hospital admission, and use of Medicare funded psychiatric consultations in the community.Methods: Mental health service delivery data for 2001–02 to 2005–06 was obtained from Medicare Australia on consultant psychiatrist office-based, home visit and private hospital services subsidized by the national healthcare program and the National Hospital Morbidity database for separations (admitted episodes of patient care) from all public and most private hospitals in Australia on measures of age, gender, psychiatric diagnosis, location and type of psychiatric care.Results: Use of specialist psychiatric services in the community per annum per 1000 persons declined with age in men and women from 137.28 and 191.87 respectively in those aged 20–64 years to 11.84 and 14.76 respectively in those over 84 years. However, men and women over 84 years received psychiatric home visits at 377% and 472% respectively of the rates of persons under 65. The annual hospital separation rate per 1000 persons for specialist psychiatric care was lowest in those aged over 84 (3.98) but for inpatient non-specialized psychiatric care was highest in those over 84 (21.20). Depression was the most common diagnosis in specialized psychiatric hospitalization in those aged over 84 while organic disorders predominated in non-specialized care in each age group over 64 years with the highest rates in those aged over 84.Conclusion: Mental health service delivery to persons aged over 84 is distinctly different to that provided to other aged groups being largely provided in non-specialist hospital and residential settings.

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Steinhaus, Douglas A., Debra A. Harley, and Jackie Rogers. "Homelessness and People with Affective Disorders and other Mental Illnesses." Journal of Applied Rehabilitation Counseling 35, no. 1 (March 1, 2004): 36–40. http://dx.doi.org/10.1891/0047-2220.35.1.36.

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Homelessness is defined as lacking a fixed, regular and adequate night-time residence (National Coalition for the Homeless, 2002). Many people met this definition in the United States and throughout the world. A significant percentage of this population also reports some level of mental health problem including mood disorders. Mood disorders, or affective disorders, are defined as psychopathologic conditions in which a pervasive disturbance of mood constitutes the core manifestation (Berkow, 1992). This article discusses existing services and issues to aid persons who are homeless and have a mental disorder.

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Lee, Seung-Hyun, Jae-In Ryu, and Se-Hwan Jung. "Differences in Utilization of Medical and Dental Services among Homeless People in South Korea." International Journal of Environmental Research and Public Health 17, no. 15 (July 23, 2020): 5304. http://dx.doi.org/10.3390/ijerph17155304.

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(1) Background: Homelessness contributes to both needs for care and barriers to access. This study aimed to explore the utilization of medical or dental services using Andersen’s model for a vulnerable population of homeless in South Korea. (2) Methods: The data were applied from the first national survey for homeless people in South Korea, 2016. Totally 2032 persons participated in the interview survey. This study team requested the raw data through the public portal and analyzed them. (3) Results: The participants who were homeless for more than ten years, staying in small rooming house or shelter, non-employed, earning less than 500,000 won per month, and having a medical condition showed a significantly higher chance of using Medicaid. The use of outreach programs had a significant relationship with gender, duration of homelessness, and monthly income. Among dental patients, the homeless who did not consume alcohol, stayed in a shelter, and were employed had higher chances of using dental service. (4) Conclusions: Medicaid service was strongly related to enabling factors but outreach programs with predisposing factors. Dental service showed strong relationships with the enabling domain, but the pattern was opposite: the jobless had less chance to avail it. The policymakers need to consider these domains of service utilization to provide equitable access to healthcare services.

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Pakzad, Sarah, Paul-Émile Bourque, Jimmy Bourque, Tim Aubry, Lise Gallant, Stefanie R. LeBlanc, and John Tivendell. "A Comparison of the Use of Physical and Mental Health Services by Homeless People With Severe Mental Health Problems in the Moncton Area Through the At Home/Chez Soi Program." Canadian Journal of Community Mental Health 36, no. 2 (October 1, 2017): 77–105. http://dx.doi.org/10.7870/cjcmh-2017-024.

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The At Home / Chez Soi demonstration project was conducted to investigate the effectiveness of the Housing First model in 5 Canadian cities. Using a randomized controlled trial design, this study evaluates the impact of this project on the use of health services by people with severe and persistent mental health problems and a history of homelessness in the greater Moncton area. The sample comprised 193 homeless persons, 95 in the control group and 98 in the treatment group. The results show a significant difference between the 2 groups only in the number of days of hospitalization, particularly in the psychiatric unit. Factors associated with the use of health services by people who are homeless and who have severe mental health problems need to be further investigated.

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Mahler, Beatrice, Gerard de Vries, Rob van Hest, Dan Gainaru, Dee Menezes, Gilda Popescu, Alistair Story, and Ibrahim Abubakar. "Use of targeted mobile X-ray screening and computer-aided detection software to identify tuberculosis among high-risk groups in Romania: descriptive results of the E-DETECT TB active case-finding project." BMJ Open 11, no. 8 (August 2021): e045289. http://dx.doi.org/10.1136/bmjopen-2020-045289.

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ObjectiveTo implement and assess the mobile X-ray unit (MXU) equipped with digital radiography, computer-aided detection (CAD) software and molecular point of care tests to improve early tuberculosis (TB) diagnosis in vulnerable populations in a TB outreach screening programme in Romania.DesignDescriptive study.SettingsPrisons in Bucharest and other cities in the southern part of Romania, homeless shelters and services for problem drug users in Bucharest, and Roma populations in Bucharest and Craiova.Participants5510 individuals attended the MXU service; 5003 persons were radiologically screened, 61% prisoners, 15% prison staff, 11% Roma population, 10% homeless persons and/or problem drug users and 3% other.InterventionsRadiological digital chest X-ray (CXR) screening of people at risk for TB, followed by CAD and human reading of the CXRs, and further TB diagnostics when the pulmonologist classified the CXR as suggestive for TB.Primary and secondary outcome measuresTen bacteriologically confirmed TB cases were identified translating into an overall yield of 200 per 100 000 persons screened (95% CIs of 109 to 368 per 100 000). Prevalence rates among homeless persons and/or problem drug users (826/100 000; 95% CI 326 to 2105/100 000) and the Roma population (345/100 000; 95% CI 95 to 1251/100 000) were particularly high.ResultsThe human reader classified 6.4% (n=317) of the CXRs as suspect for TB (of which 32 were highly suggestive for TB); 16.3% of all CXRs had a CAD4TB version 6 score >50. All 10 diagnosed TB patients had a CAD4TB score >50; 9 had a CAD4TB score >60.ConclusionsGiven the high TB prevalence rates found among homeless persons and problem drug users and in the Roma population, targeted active case finding has the potential to deliver a major contribution to TB control in Romania.

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Shamroukh, Mervat, and Heba Hosney. "E-governance as a Mechanism for Improving Social Care Services for Homeless Older Persons." Egyptian Journal of Social Work 12, no. 1 (June 1, 2021): 127–48. http://dx.doi.org/10.21608/ejsw.2021.66018.1130.

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Solomon, Phyllis. "Services to severely mentally disabled homeless persons and to emergency food and shelter providers." Psychosocial Rehabilitation Journal 12, no. 2 (1988): 3–13. http://dx.doi.org/10.1037/h0099556.

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Levine, Irene S., and Debra J. Rog. "Mental health services for homeless mentally ill persons: Federal initiatives and current service trends." American Psychologist 45, no. 8 (1990): 963–68. http://dx.doi.org/10.1037/0003-066x.45.8.963.

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47

Jones, Audrey L., Roxanne Thomas, Daniel O. Hedayati, Shaddy K. Saba, James Conley, and Adam J. Gordon. "Patient predictors and utilization of health services within a medical home for homeless persons." Substance Abuse 39, no. 3 (March 15, 2018): 354–60. http://dx.doi.org/10.1080/08897077.2018.1437500.

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48

Djuric, Corinne M., and Beth Vottero. "Primary care services tailored for adult and adolescent homeless persons: a scoping review protocol." JBI Evidence Synthesis 18, no. 9 (June 9, 2020): 2031–37. http://dx.doi.org/10.11124/jbisrir-d-19-00331.

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49

Wong, Yin-Ling Irene. "Utilization of community-based services among homeless persons: An application of a theoretical model." Journal of Community Psychology 27, no. 3 (May 1999): 327–45. http://dx.doi.org/10.1002/(sici)1520-6629(199905)27:3<327::aid-jcop7>3.0.co;2-u.

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Gutwinski, Stefan, Stefanie Schreiter, Karl Deutscher, and Seena Fazel. "The prevalence of mental disorders among homeless people in high-income countries: An updated systematic review and meta-regression analysis." PLOS Medicine 18, no. 8 (August 23, 2021): e1003750. http://dx.doi.org/10.1371/journal.pmed.1003750.

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Background Homelessness continues to be a pressing public health concern in many countries, and mental disorders in homeless persons contribute to their high rates of morbidity and mortality. Many primary studies have estimated prevalence rates for mental disorders in homeless individuals. We conducted a systematic review and meta-analysis of studies on the prevalence of any mental disorder and major psychiatric diagnoses in clearly defined homeless populations in any high-income country. Methods and findings We systematically searched for observational studies that estimated prevalence rates of mental disorders in samples of homeless individuals, using Medline, Embase, PsycInfo, and Google Scholar. We updated a previous systematic review and meta-analysis conducted in 2007, and searched until 1 April 2021. Studies were included if they sampled exclusively homeless persons, diagnosed mental disorders by standardized criteria using validated methods, provided point or up to 12-month prevalence rates, and were conducted in high-income countries. We identified 39 publications with a total of 8,049 participants. Study quality was assessed using the JBI critical appraisal tool for prevalence studies and a risk of bias tool. Random effects meta-analyses of prevalence rates were conducted, and heterogeneity was assessed by meta-regression analyses. The mean prevalence of any current mental disorder was estimated at 76.2% (95% CI 64.0% to 86.6%). The most common diagnostic categories were alcohol use disorders, at 36.7% (95% CI 27.7% to 46.2%), and drug use disorders, at 21.7% (95% CI 13.1% to 31.7%), followed by schizophrenia spectrum disorders (12.4% [95% CI 9.5% to 15.7%]) and major depression (12.6% [95% CI 8.0% to 18.2%]). We found substantial heterogeneity in prevalence rates between studies, which was partially explained by sampling method, study location, and the sex distribution of participants. Limitations included lack of information on certain subpopulations (e.g., women and immigrants) and unmet healthcare needs. Conclusions Public health and policy interventions to improve the health of homeless persons should consider the pattern and extent of psychiatric morbidity. Our findings suggest that the burden of psychiatric morbidity in homeless persons is substantial, and should lead to regular reviews of how healthcare services assess, treat, and follow up homeless people. The high burden of substance use disorders and schizophrenia spectrum disorders need particular attention in service development. This systematic review and meta-analysis has been registered with PROSPERO (CRD42018085216). Trial registration PROSPERO CRD42018085216.

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