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References

Carlisle, T., Hatvani, G., Heagney, C., Holmes, A., Jones, S., Vale, Z. (2017) Housing first: permanent supported accommodation for people with psychosis who have experienced chronic homelessness. Sage Journals, 25(1), 56-59. doi: 10.1177/1039856216669916.

Google Images, Creative Commons license

NAMI. (2018). Group homes. National Alliance on Mental Illness – North Carolina, para. 1-6. https://naminc.org/group-homes/

 

Presentation Script:

 

Although many projects and groups have been set up to support those who are homeless, very little research has been conducted on how to better the lives of those who are homeless suffering from mental illnesses such as schizophrenia. Schizophrenia is a medical disorder in which an individual loses their sense of how they think, behave, and perceive reality (NIMH, 2020, para. 2). In one study, data was collected from other research projects to determine the overall wellbeing of homeless people. The meta-analysis found 16.3% of individuals who were homeless had some form of schizophrenia (Ayano et al., 2019, p. 9). To understand schizophrenia and the effects on North Carolina it is important to understand the lack of healthcare access many homeless individuals experiences. It can be difficult to create a stable atmosphere when the individual does not have access to basic healthcare. In one study conducted in Australia, homeless individuals were provided housing through the program to determine if stable living situations would improve their mental health illnesses.  The study recognized that individuals who are homeless and suffering mental illnesses can still be independent homeowners when given the proper tools to create a better life for themselves. This concept, called “housing first” improved the lives of those suffering from mental illness and homelessness. Instead of instituting the “housing first” principles, North Carolina utilizes a similar method known as “group homes”. The differences between these two principles can be found in the slide. Group homes allow people with similar life experiences to live together in a comforting and nonjudgmental environment. A group home consists of six beds, which allows staff to know each person’s individual needs to take care of them the best way possible. This approach can be beneficial, as it respects the dignity of the person. However, “housing first” is an effective alternative in some cases. “Housing first” allows individuals to determine on their own, in a supportive environment, what treatment plans work best for them. North Carolina must invest in alternative treatment plans, such as “housing first”, to end the cycle of homelessness and improve the lives of those suffering from schizophrenia and homelessness.

 

Explication of Research:

 

As of January 2020, more than 9,000 individuals experienced homelessness in North Carolina. 1,272 of these people were experiencing some sort of mental or physical disability (USICH, para. 1). The mental health challenges faced by those who are homeless is a well-known public health issue in North Carolina. Although many projects and groups have been set up to support those who are homeless, very little research has been conducted on how to better the lives of those who are homeless suffering from mental illnesses. A common mental illness that can be found in homeless populations is schizophrenia.  Schizophrenia is a medical disorder in which an individual loses their sense of how they think, behave, and perceive reality (NIMH, 2020, para. 2). However, very little research has been conducted on how to better improve individuals’ lives who are suffering specifically from schizophrenia and homelessness. When discussing the topic of homelessness in North Carolina it needs to be understood exactly how schizophrenia and homelessness are connected, as well as what can be done to better improve these individuals’ lives.

Compared to the general population, homelessness and mental health issues tend to have trends that are closely linked. In a study conducted by BMC Psychiatry data was collected from other research projects to determine the overall wellbeing of homeless people. The meta-analysis found 16.3% of individuals who were homeless had some form of schizophrenia (Ayano et al., 2019, p. 9). It was concluded that “schizophrenia and other psychotic disorders were higher among homeless people as the reported prevalence in the general population. These findings underline schizophrenia and other psychotic disorders as a significant and serious global public health issue among homeless people,” (Ayano et al., 2019, p. 9). The mental health challenges faced by those who are homeless in North Carolina leads to a difficult and repetitive cycle of homelessness. To break this cycle, it is important to effectively determine solutions that would benefit the well-being of those suffering from schizophrenia and homelessness.

Homeless individuals lack the healthcare needed to live healthy lives. Many individuals who are homeless suffer not only from psychological disorders but also from physical conditions such as hepatitis C and cardiovascular diseases. An example of the overall lack of health access for homeless people is displayed in a study reported in the Internal Medicine Journal. In the study, it was discovered that “homeless men have significant medical needs beyond the need for treatment of addictions and mental health; these particularly comprise of hepatitis C and cardiovascular risk and disease and can be addressed comprehensively in a hospital outreach” (Boston et al., 2018, p. 459). To understand schizophrenia and the effects on North Carolina it is important to understand the lack of healthcare access many homeless individuals experiences. Many conditions can easily be treated when medical care is given. However, it can be difficult to create a stable home when an individual does not have access to the basic healthcare they need to survive.

In one study conducted in Australia, homeless individuals were provided housing through the program to determine if stable living situations would improve their mental health illnesses. The study recognized that individuals who are homeless and suffering mental illnesses can still be independent homeowners when given the proper tools to create a better life for themselves. This concept, called “housing first” improved the lives of those suffering from mental illness and homelessness. “‘Housing first’ principles lead to housing stability, optimism, improved continuity, and reduced psychiatric admission. The cycle of crisis admission, discharge and disengagement can be interrupted but requires a different approach for those for whom traditional approach unsuccessful” (Carlisle et al., 2017, p. 58). The results indicate that those who are suffering from mental illness can improve their lives when they are treated with the dignity of being consumers in society. This broke the cycle of homelessness and better improved their overall health.

Instead of instituting the “housing first” principles, North Carolina utilizes a similar method known as “group homes”. Group homes allow people with similar life experiences to live together in a comforting and nonjudgmental environment. A group home consists of six beds, which allows staff to know each person’s individual needs to take care of them the best way possible. The goal of group homes is to provide a supportive environment that will allow the individuals to grow together while having the medical support needed. This approach can be beneficial, as it respects the dignity of the homeless individual. However, more can be done in North Carolina to better the lives of those suffering from homelessness and schizophrenia.

One such solution that can be done is giving homes to those in need, like the study conducted in Australia. The sense of independence has been proven in other trials to be beneficial in improving homeless people’s overall wellbeing. Housing first would allow individuals to have a home and still be provided the support needed to help treat their mental illness. In the “housing first” initiative the individual would be treated with the respect they deserve, and not forced to receive treatment in order to receive housing. Although living in a group has its own benefits, such as being supported by others, it does not allow for the same independence of being a homeowner. Not only this but “housing first” allows individuals to determine on their own, in a supportive environment, what treatment plans work best for them. Individuals are responsible for their own decisions while still being in a controlled and supportive environment.

Some cases of schizophrenia and homeless are not easily treatable which is why the cycle needs to be broken. North Carolina has instituted ways to better improve the lives of those who are homeless and schizophrenic, such as group homes. However, housing first is a way to effectively treat homelessness in a manner that respects the dignity of the individual in an appropriate manner when other treatment options are found to be ineffective. North Carolina must invest in alternative treatment plans, such as “housing first”, to end the cycle of homelessness and improve the lives of those suffering from schizophrenia and homelessness.

 

References

Ayano, G., Shumet, S., & Tesfaw, G. (2019). The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis. BMC Psychiatry, 19(370), 1-14. https://doi.org/10.1186/s12888-019-2361-7.

Boston, B., Brown, M.A., Camac, A., Dowdell, L., Francois, R., Gellatley, W., Zekry, A. (2018). Medical complications of homelessness: A neglected side of mental health. Internal Medicine Journal, 49(2019), 445-460. doi: 10.1111/imj.14139.

Carlisle, T., Hatvani, G., Heagney, C., Holmes, A., Jones, S., Vale, Z. (2017) Housing first: permanent supported accommodation for people with psychosis who have experienced chronic homelessness. Sage Journals, 25(1), 56-59. doi: 10.1177/1039856216669916.

NAMI. (2018). Group homes. National Alliance on Mental Illness – North Carolina, para. 1-6. https://naminc.org/group-homes/.

NIMH. (2020). Schizophrenia. National Institute of Mental Health, para, 1-24. https://www.nimh.nih.gov/health/topics/schizophrenia.

USICH. North Carolina Homelessness Statistics. United States Interagency Council on Homelessness, para. 1-3. https://www.usich.gov/homelessness-statistics/nc/

 

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