The Homeless Cry

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Another woman sitting outside on the already hot sidewalk with us explained that the guard has to deal with so much crap all the time he was probably just frustrated and took it out on her. But Talina continued to share her story. She was living with a friend, a precarious situation that she said would not last more than a few days, and then what?

She had been evicted from her own apartment under false charges, had taken the landlord to court, but he'd lied under oath! How can they lie under oath and get away with it? So the court had upheld the eviction. She was "this close" to living on the street herself. My heart is in anguish within me, the terrors of death have fallen upon me. Fear and trembling come upon me, and horror overwhelms me. And I say, "O that I had wings like a dove! I would fly away and be at rest; truly, I would flee far away; I would lodge in the wilderness; I would hurry to find a shelter for myself from the raging wind and tempest.

Talina said the thought of being homeless again was terrifying to her. After all, she had to be clean! And do you know what it's like for a woman alone on the street? She was on her own, the mother of four grown children one an addict, one disabled, one in college, another living out of the area and had been the victim of a physically abusive husband. She'd had to get out of that situation for fear of her own life if not her sanity.

If only she could get some help from the various agencies and shelters and support organizations, if she could only have her own place, by herself, safe Don't they know that they are just one paycheck away from being on the street too? She was a trained CNA and wanted to go to nursing school, had paralegal training, but she couldn't get a job.

She goes to the public library every day to search online for jobs, send out resumes, and wait for responses that don't come. Why is this happening? Confuse, O Lord, confound their speech; for I see violence and strife in the city. Day and night they go around it on its walls, and iniquity and trouble are within it; ruin is in its midst; oppression and fraud do not depart from its marketplace. She told us story after story of how one person or another had victimized her, defrauded her, lied to her, cheated her, abused her, and she was exhausted by it, holding on now only by a thin thread of sanity and strength.

Her life was surrounded by violence and strife, iniquity and trouble. It is not enemies who taunt me -- I could bear that; it is not adversaries who deal insolently with me -- I could hide from them. But it is you, my equal, my companion, my familiar friend, with whom I kept pleasant company; we walked in the house of God with the throng. Let death come upon them; let them go down alive to Sheol; for evil is in their homes and in their hearts.

Talina said she'd had lost the support of her youngest daughter, a teenager, because her abusive husband had lied about Talina to her and shut her out. Other family members had ignored her plight, and her own family back in the Northeast could not help because they were all addicts. Those closest to her were no help, and probably would only make things worse.

As we talked with Talina and three other women sitting in the blazing hot morning sun on the sidewalk in front of the Gateway Center for nearly two hours, all their stories came out one at a time in bits and pieces. There was Valerie, a year-old who slept under the nearby bridge, had no shoes and a bad cut on one big toe with a dirt-caked band-aid she was trying to clean off, who wanted to be a famous country singer. She sang two songs for us that she'd written, her Allison Krauss-like voice sounding like an angel.

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One song had the repeating line, "my life is like a roller coaster" and was saturated with pain and fear, and another song was about an abusive father and a victimized mother who nevertheless had to stay with the dangerous man. Clinicians who work with homeless people in primary health care clinics confirm the high frequency of psychiatric disorders in their patients. Brickner and coworkers , in listing the common health problems encountered in a primary care program serving homeless people in shelters in New York City, placed alcoholism and then psychiatric disorders at the top of the list.

The Health Care for the Homeless program's service data, pooled from sites in major cities across the country, show that, whatever the presenting problem, the primary care practitioners also frequently observed a mental or emotional disorder. The authors estimated that 30 to 40 percent of patients have psychiatric disorders Wright and Weber, Clinicians were twice as likely to record a psychiatric diagnosis in white patients than in black or Hispanic patients.

Try not to Cry... A Heart Touching Video - (Homeless)

There was also a higher prevalence of almost every category of physical illness in patients with psychiatric diagnoses than in those without. Mental disorders are very frequent in homeless populations generally and among homeless people who seek health care. In both groups mental disorders are found that can be considered both a cause and a consequence of homelessness.

The central problem for homeless people with mental illnesses is the lack of community-based treatment facilities and adequate housing. In addition, the special characteristics of this patient group present particular challenges for treatment. These patients often have already had negative experiences with mental health care, often in understaffed, underfunded institutions, and are determined not to accept further treatment. Some have had unpleasant adverse reactions to antipsychotic medications or remember having been abused in the mental health care system; some homeless people lack insight into the reality of their illness and their need for ongoing treatment, but others who are aware of their problems simply do not believe that they will receive appropriate treatment if they accept an offer of care.

In most cases, they lack the support of friends or family, are suspicious of authority figures including providers of treatment , and are slow to develop a trusting therapeutic relationship. As is the case with the homeless in general, their material resources and access to public support programs are extremely limited see Chapter 4. From the perspective of mental health service providers, homeless patients are often perceived as less desirable or less rewarding. They may be slow to accept a therapist's sincere efforts to help, but quick to express their negative feelings about the mental health service system.

A therapist may be frustrated by failures of homeless patients to keep appointments; and clinics may be unwelcoming to dirty, disheveled, or disorganized patients who frighten away others. The treatment and rehabilitation of a severely mentally ill homeless person requires the marshaling of major financial and professional resources. Treatment requires enormous patience; considerable clinical skill; and the capacity to mobilize an array of treatment, residential, and rehabilitation resources to meet the needs of a particular patient Breakey, Although ambulatory treatment for mentally ill patients is preferred in most cases, hospital admission may be necessary for treating some patients with severely distressing and disabling symptoms, or for the protection of others if a person is violent.

Psychiatric treatment providers are frequently frustrated in their efforts to help the most severely disturbed because of the lack of access to inpatient treatment facilities. The committee received reports from several cities and states that stated that because the supply of psychiatric beds is limited, some poor patients have great difficulty gaining access to voluntary inpatient care; occasionally there may even be a waiting period of several days at a public hospital for emergency involuntary psychiatric admission. Consent for outpatient or inpatient treatment often can be obtained from a homeless patient relatively easily.

For hospital care, voluntary admission is greatly preferred over involuntary commitment and facilitates the development of a constructive doctor—patient relationship. When a patient is unwilling to accept treatment but is clearly dangerous to himor herself or others, civil commitment procedures are available. However, problems arise when a patient is ill and behaves in a manner that is self-jeopardizing or is offensive, embarrassing, or frightening to others. Because these people are not unequivocally dangerous to themselves or others, they cannot be involuntarily committed.

Another problem confronting clinicians is a person who is neither offensive not dangerous but who is resistant to treatment because of delusions arising from the mental illness itself. Mental health workers may believe that medication and supportive care could substantially help a mentally ill person cope, but the patient is legally entitled to refuse treatment. Mentally ill homeless people have attracted considerable attention from the news media. One of a series of articles in The New York Times in late called attention to a successful new approach to outreach, treatment, and rehabilitation Goleman, The program was described by the journalist as "a partnership between modern psychiatry and older humanitarian traditions.

Mental health workers find Timothy huddled in a pile of garbage in a stairwell on West 68th Street. He says the Mafia is after him and laughs oddly. From his confused account, it appears that he has been hiding in garbage for at least two months. He resists efforts to move him to a shelter, preferring the stairwell. March 4. After several false starts, Timothy is finally brought into the office of Project Reachout for treatment. One drug, then another is tried. He is put on a regimen of Prolixin, an anti-psychotic drug that diminishes agitation and delusions.

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March Meanwhile, a psychiatrist records improvement in Timothy's mental condition; his thinking is clearer, he is more alert, feeling better about himself. The patient starts to take showers. April He agrees to leave the stairwell behind, accepting a tiny hotel room from the project. May He starts working in the kitchen at Fountain House, an organization that helps chronic schizophrenics to take part in society again. After project workers apply in his behalf, he receives his first Government disability payment.

He begins work as a messenger at Manufacturers Hanover Trust bank offices. A project worker initially accompanies him to take over if he fails. He moves into a room of his own at the St. Francis Residence. There is a cable hookup for the color television he hopes to get. The room is newly painted. On the floor by the closet is a blue plastic bucket containing three pairs of filthy shoes and six umbrellas, mementos of his street days.

In whatever setting homeless adults are studied, alcoholism is the most frequent single disorder diagnosed. The exception is women who are homeless with their families. Severe and intractable alcohol disorders have historically been thought to be especially prevalent among homeless people. Early accounts often attributed the high frequency of alcohol problems among homeless men to their inherent shiftlessness and failure to obtain gainful employment.

Anderson asserted that "practically all homeless men drink when liquor is available. The only sober moments for many hoboes and tramps are when they are without funds. More recent studies, however, suggest that this perception may be stereotypical rather than real. It is now estimated that approximately 25 to 40 percent of homeless men suffer from serious alcohol problems, and that this level has been reasonably consistent over time Mulkern and Spence, ; Stark, ; Schutt and Garrett, in press. This is nevertheless a high figure when compared with that in the general population, in which the most frequently reported figures are 11 to 15 percent for men and 2 to 4 percent for women.

The prevalence of alcoholism for domiciled adults in the epidemiological catchment areas studied by NIMH is 12 percent for men and 2 percent for women J. The emergence of a new homeless population further calls into question the meaning of previous findings. Current descriptive studies reveal a population that is younger and more heterogeneous than skid row populations.

It includes 1 higher proportions of women and minority group members, such as blacks and Hispanics; 2 alarming numbers of families with young children; and 3 an increased proportion of people with mental illnesses and histories of drug abuse. Despite these changes, serious alcohol problems are common among homeless adults and remain important in understanding this population see Table Current studies also document the fact that homeless people with alcohol problems are more often physically disabled than homeless people without such problems.

As a consequence, they are more likely to use health care services Fischer, ; Fisher and Breakey, ; Koegel and Burnam, a,b. Wright and Weber have identified specific disorders that occur more frequently among homeless alcoholics than other homeless people; these include acute disorders, such as trauma, serious skin problems, and severe upper respiratory infections, along with chronic disorders such as cardiac disease, hypertension, and active tuberculosis.

What is the relationship between homelessness and serious alcohol problems? Observers have indicated that many homeless adult individuals who suffer from alcoholism and alcohol abuse are undomiciled to begin with because of their drinking. In a study of homeless male alcoholics in Baltimore, 59 percent reported that drinking caused them to become homeless Fischer and Breakey, Others may have become "environmental alcohol abusers" Shandler and Shipley, , adapting to a homeless subculture that encourages drinking.

For homeless individuals, drinking is often seen as the way to make it through a day Morgan et al. In the past, many alcoholics lived in SRO housing. With the decline in the number of SRO units nationwide see Chapter 2 , many alcoholic single men and women have become homeless. Today many of the country's emergency shelters will not accept anyone who has been drinking.

Instead, many homeless alcohol abusers sleep on the streets. In sum, the causal relationships between problems with alcohol and homelessness are complex, and precise knowledge of them may not be possible or even as therapeutically relevant as one might hope. There is a large general literature on treating people who have problems with alcohol, even though the scientific evaluation of treatment in this area is relatively recent.

Effective approaches to this population might have to include several elements, for example, detoxification, convalescence, and entry into specialized alcohol-free living environments combined with supportive treatment programs. Detoxification is the indispensable first step in treatment; access to detoxification needs to be widely and readily available.

Experience suggests that many people entering detoxification facilities will progress no further, and that a small number of people account for the majority of admissions. It is not always possible, however, to predict who will progress further with treatment; a common clinical experience is that, after multiple short-term admissions, some people elect to continue, and eventually they achieve genuine gains. In recent years disagreement has arisen over the optimal structure of detoxification programs.

Traditionally, detoxification has been undertaken in an inpatient medical setting. More recently, nonmedical detoxification programs have arisen see, e. The latter have attracted much attention because of their markedly lower cost and reportedly equivalent effectiveness McGovern, Ideally, a mixture of both would be available. There is little doubt that many people seeking detoxification can be handled in a nonmedical program Shaw et al. However, withdrawal from alcohol in people with serious concurrent medical or psychiatric disorders is best undertaken in a hospital setting; many homeless people fall into this category.

After detoxification, some people are unable or unwilling to take advantage of the currently available rehabilitation alternatives, which at present require entry into a specialized alcohol treatment system. Some of these difficulties could be resolved if there were an intermediate stage in the treatment process between detoxification and specialized treatment Blumberg et al. The goal of such a convalescent stage would be to facilitate complete recovery from the physical and mental ravages of the individual's last period of alcohol intake.

A safe setting, perhaps best outside of, but closely connected to, a medical facility, could provide protection, adequate nutrition, rest, and an opportunity to assess the future realistically. Extended medical and psychiatric evaluations, which are problematic in detoxification settings, could be performed, and consequent therapeutic measures could be proposed.

Specialized treatment and active rehabilitation for alcohol-related problems are complex a forthcoming Institute of Medicine study will explore this subject in detail. Some homeless people with alcohol-related problems may eventually enroll in specialized treatment. However, access to such specialized treatment is far from universal, and the shortage of facilities is serious. Furthermore, there is an extreme shortage of the specialized housing arrangements that are needed to support rehabilitation efforts.

Residential opportunities are essential to enable the alcoholic homeless person to get away from the streets, where inducements to resume drinking are ever present.

Then the homeless man revealed his identity…

There are few concrete data describing the extent of drug abuse among homeless individuals. Most studies about the homeless combine alcohol and drug abuse together under the heading of substance abuse. Those that separate the two provide some minimal information about illicit drug use. Estimates of homeless individual adults with drug problems range from a low of 10 percent reported by users of Johnson-Pew clinics nationwide Wright and Weber, to Data from the Johnson-Pew HCH projects in 16 cities show that age, ethnicity, and drug abuse are correlated Wright, The strongest correlate of drug abuse is age.

As with the general domiciled population, rates of illicit drug abuse are highest among younger HCH clients and fall off with increasing age, especially after the age of This is almost the opposite of alcohol abuse, which is found to be least prevalent among younger homeless people. Whether this is more commonly encountered among homeless people who abuse drugs compared with the remainder of the drug-abusing population is not clear. Nevertheless, as the clinical syndromes associated with AIDS increase in the general population, especially among those who abuse parenteral drugs, it will be an increasing problem among the homeless as well.

Meaningful comparisons to the rates of AIDS in each of those urban centers are not available, but one reference point is the rate for the U. Other illnesses more commonly encountered in patients who abuse parenteral drugs are hepatitis, skin infections, abscesses, thrombophlebitis, bacterial endocarditis, and tuberculosis. Other, more exotic infections that are not frequent in the United States are more common among drug abusers, such as malaria, which can be transmitted among patients who share needles.

SADRI specially analyzed its main data base, which consisted of all clients with two or more visits who abused drugs, and found that some disorders were more common among drug abusers than among non-drug abusers. To some extent, however, the differences could be ascribed to various demographic characteristics, specifically, age and the presence of other disorders such as alcohol abuse or mental illness. Using this series of multivariant analyses, which controlled statistically for age, sex, ethnicity, and family status and for alcohol abuse and mental illness, the following disorders were found more commonly among homeless people who were drug abusers: AIDS, liver disease, cardiac disease, peripheral venous stasis disease, and chronic disorders such as diabetes and diseases of the liver and genitourinary tract.

Although the exact relationship between homelessness and drug abuse and these illnesses is unclear, most of the findings are not surprising. AIDS and liver disease, for example, are associated with an increased frequency of hepatitis exposure among drug abusers. Finally, a point must be made about the comorbidity caused by mental illness, alcoholism and alcohol abuse, and illicit drug abuse. There is a growing concern among those who work with homeless people about clients with dual and multiple diagnoses further exacerbated by a higher prevalence of many acute and chronic physical illnesses.

For example, the HCH data point to correlations among drug abuse, alcohol abuse, and mental illness. Among drug abusers, 42 percent of the men and 41 percent of the women who visited HCH projects and gave evidence of that diagnosis could also be classified as mentally ill; 59 percent of the male clients and 46 percent of the female clients who abused drugs also evidenced a problem with alcohol Wright, In another recent study drawn from a broad geographic base, the Veterans Administration Homeless Chronically Mentally Ill program reported that of the homeless for whom evaluations were performed, 32 percent had combined diagnoses of alcohol and drug abuse.

Sixty-four percent had been hospitalized for any treatment for mental illness, alcoholism, or drug abuse. Because this latter figure is less than the sum of the prevalence rates for homeless veterans seen for each diagnosis 33 percent reported being hospitalized for psychiatric illness, 44 percent for alcoholism, and 14 percent for drug abuse , it appears that many of these hospitalizations were for dual or multiple diagnoses Rosenheck et al.

There are two major problems that relate specifically to homeless people with multiple diagnoses. During the site visits, it was repeatedly emphasized to the committee members by those who work with the homeless that homeless people with dual and multiple diagnoses are among the most difficult to entice into treatment.

Second, when outreach efforts are successful, there often are no appropriate programs into which such homeless people can be enrolled. Each separate diagnosis correlates to a specific treatment modality and treatment system. These programs frequently exclude those with secondary and tertiary diagnoses of other illnesses. It is rare to find programs that will address a combination of diagnoses on other than the most episodic of terms.

Perhaps the most distressing and dramatic health problems caused by homelesshess are those experienced by homeless families with children. Although the adult members of homeless families appear to be in better health than homeless single adults, they are still in poorer health than the general population.

Using data from the HCH projects in 16 cities, Wright and Weber described 1, adult family members who were seeking health care; they represented 15 percent of the total adult population of the 16 programs. The authors concluded that in comparison with the NAMCS population, ''homeless adult family members are.

In a study comparing homeless women living in New York City welfare hotels with women living in low-income housing projects, Chavkin et al. With regard to mental illness, although many homeless mothers have emotional problems, most do not suffer from a major mental illness e. Furthermore, in contrast to adult homeless individuals, a relatively small percentage of homeless mothers had ever been hospitalized for psychiatric reasons Bassuk et al.

Wright and Weber found that various chronic physical disorders are nearly twice as common among homeless children as among ambulatory children in the general population.

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Illnesses such as anemia, malnutrition, and refractory asthma were many times more common among homeless children. Acker et al. Although there is no precise information indicating that homeless children are more vulnerable to contracting such illnesses as diphtheria, tetanus, measles, or polio, existing epidemiologic data suggest that they are a high-risk group. Using data from the HCH projects, Wright and Weber reported that the rate of chronic physical disorders is nearly twice that observed among the children in the NAMCS population in general. Whether geographic mobility and residential instability will make these children a greater health risk to the general population is unknown, but it is a potential public health problem of concern.

While access to food—or, more appropriately, adequate and appropriate nutrition—is a problem for homeless people of all ages, it is an especially critical issue for children and youths. Many welfare hotels where homeless families reside do not provide cooking facilities or refrigerators:. For a hot meal, families must either violate safety codes by "smuggling" a hot plate into their room or use the little money they have to eat in a restaurant. This means that families usually rely on canned goods, dry cereals and other non-perishable items for nourishment. Lack of refrigeration is particularly problematic for mothers with infants who must devise other methods for keeping milk or formula cold, such as using toilet tanks as coolers.

Gallagher, Homeless children between the ages of 6 months and 2 years were at higher risk for iron deficiency, leading the authors to conclude that "this may indicate the presence of other nutritional deficiencies and should be the subject of further investigation. In addition to physical health problems, homeless children appear to suffer greater emotional and developmental problems.

Kronenfeld and colleagues , in their report on children living at the Urban Family Center, a residential facility for homeless families on public assistance in New York City, found that homeless children were having serious problems in school. Children living in this facility were usually 2 or more years behind their age-appropriate grade level in reading and mathematics, often had discipline problems, and were frequently truant. Bassuk and colleagues , , described serious developmental, emotional, and learning problems in a population of homeless children residing in family shelters in Massachusetts.

One-third of the children manifested more than two developmental lags.

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In this study, the schoolage children were depressed and anxious; half of them required further psychiatric evaluation. Many had severe learning difficulties: 43 percent had already failed to complete a grade and 25 percent were in special classes. It is difficult to determine the extent to which homelessness per se was the principal variable accounting for each of these findings, but a comparison to poor, domiciled children documented that homelessness makes a major contribution Bassuk and Rosenberg, With regard to homeless youths and adolescents, Wright and Weber reported that substance abuse, sexually transmitted diseases, and pregnancy were more prevalent among the homeless adolescents seen in the HCH projects than among the same age group in the domiciled population reported in the NAMCS study.

However, as with the HCH project population, the major exceptions were pregnancy and sexually transmitted diseases. Both sets of findings might be attributed to the fact that these teenagers tend to be more sexually active at a younger age, even prior to becoming homeless. Given that AIDS is a disease that can be transmitted through sexual contact, the staff of the Larkin Street Youth Center in San Francisco expressed serious concern to the committee members during the site visit to that facility that AIDS may spread among runaway youths.

Homeless people experience a wide range of illnesses and injuries to an extent that is much greater than that experienced by the population as a whole. First of all, health problems themselves, directly or indirectly, may cause or contribute to a person's becoming or remaining homeless. The leading example is major mental illness, especially schizophrenia, in the absence of treatment facilities and supportive housing arrangements.

Second, the condition of homelessness and the exigencies of life of a homeless person may cause and exacerbate a wide range of health problems. Just as ill health can cause homelessness, so can homelessness cause ill health. Examples of this include skin disorders and the sequelae of a traumatic injury. Finally, the state of being homeless makes the treatment and management of most illnesses more difficult even if services are available.

Examples of this can be found for alcoholism and nearly any chronic illness, such as diabetes or hypertension. As with all other aspects of the problems of homeless people, data on their health problems and health care needs are partial, fragmentary, and incomplete. Still, enough is known about the health problems of homeless people to provide basic descriptive information and draw inferences for the purposes of programmatic intervention.

The data in the tables indicate the percentage of the various subgroups within the client population who have been diagnosed with the various disorders listed.

Homeless 5 years ago, this family was on the verge again.

Thus, in Table , The rates of occurrence are given for adult clients only in 16 cities and are for the total number of people seen and for those seen more than once. This latter group is then divided further by sex, ethnic group, and age. In all tables, "NA" indicates that the data are not available at this time. Department of Health and Human Services, Explanations or the abbreviations and terms used in Tables to are as follows:. View in own window. Unless otherwise noted, all case studies in this chapter are drawn from a background paper prepared for this report, "Homelessness: A Medical Viewpoint," Vicic and Doherty, by William Vicic, M.

The names, of course, are fictitious; the circumstances and clinical details are real and are drawn from Dr. Vicic's and Ms.

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Doherty's professional experiences working with the homeless. In several site visits, committee members heard repeated reference to the high prevalence of sexual assaults against homeless women. One shelter staff member commented: "It's not a question of whether a homeless woman will be raped, but simply a question of when.

It is best utilized as a measure of functional impairment and as an indication of the extent of the need for help. Turn recording back on. National Center for Biotechnology Information , U. Search term. Types of Interactions Between Health and Homelessness In examining the relationship between homelessness and health, the committee observed that there are three different types of interactions: 1 Some health problems precede and causally contribute to homelessness, 2 others are consequences of homelessness, and 3 homelessness complicates the treatment of many illnesses.

Health Problems That Cause Homelessness Certain illnesses and health problems are frequent antecedents of homelessness.

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In addition to accidents, various common illnesses such as the degenerative diseases that accompany old age can also lead to homelessness: James Barnam, now 62 years old, has worked regularly since age 17, but has never found a job with secure employee benefits. Health Problems That Result from Being Homeless Homelessness increases the risk of developing health problems such as diseases of the extremities and skin disorders; it increases the possibility of trauma, especially as a result of physical assault or rape Kelly, Homelessness as a Complicating Factor in Health Care For even the most routine medical treatment, the state of being homeless makes the provision of care extraordinarily difficult.

The following case illustrates the various problems involved in treating a homeless man with another common chronic medical problem, hypertension: Tyrone Harrison is black, 26 years old, and homeless because he cannot find a job. General Health Problems of Homeless Adults Although homeless people are susceptible to the same range of diseases that occurs in the general population, the conditions discussed below appear to be especially prevalent among homeless people.

Traumatic Disorders Contusions, lacerations, sprains, bruises, and superficial burns are more commonly reported in the homeless population TRAUMA in Tables and Chronic Diseases The proportion of adults seen more than once in the HCH clinics who suffer from various chronic illnesses e. Miscellaneous Health Problems Foot problems occur with a greater frequency among homeless people. Clinical Problems in Providing Mental Health Care for the Homeless The central problem for homeless people with mental illnesses is the lack of community-based treatment facilities and adequate housing.

For the first time, Timothy expresses interest in washing his clothes. Alcoholism and Alcohol Abuse In whatever setting homeless adults are studied, alcoholism is the most frequent single disorder diagnosed. Illnesses Associated with Abuse of Drugs Other Than Alcohol There are few concrete data describing the extent of drug abuse among homeless individuals.

Comorbidity Finally, a point must be made about the comorbidity caused by mental illness, alcoholism and alcohol abuse, and illicit drug abuse. Health Problems of Homeless Families, Children, and Youths Perhaps the most distressing and dramatic health problems caused by homelesshess are those experienced by homeless families with children. Many welfare hotels where homeless families reside do not provide cooking facilities or refrigerators: For a hot meal, families must either violate safety codes by "smuggling" a hot plate into their room or use the little money they have to eat in a restaurant.

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  7. Gallagher, Acker et al. Summary Homeless people experience a wide range of illnesses and injuries to an extent that is much greater than that experienced by the population as a whole. Key to Abbreviations and Explanatory Notes for Tables to The data in the tables indicate the percentage of the various subgroups within the client population who have been diagnosed with the various disorders listed. Explanations or the abbreviations and terms used in Tables to are as follows: View in own window Acute Disorders Tables and INF Infestational ailments e.

    References Acker, P. Fierman, and B. An assessment of parameters of health care and nutrition in homeless children. American Journal of Diseases of Children 4 Alstrom, C. Lindelius, and L. Mortality among homeless men. British Journal of Addiction Anderson, N. Chicago: University of Chicago Press. Annis, H. Geisbrecht, A. Ogborne, and R. Toronto: Addiction Research Foundation of Ontario. Arce, A. Identifying and characterizing the mentally ill among the homeless. Lamb, editor. Washington, D. Tadlock, and M. Tax ID The Resident Relief Foundation. I never thought I would struggle a day in my life Cassandra G.

    South Jordan, UT Cassandra thought she was bettering her life for her family by taking a better job with an increase in salary. The Government Shutdown put this senior at risk of being homeless. Linda J. Haward, CA Ms. Facing eviction during a temporary job gap. Las Vegas, NV Emmy is a hard-working mom of 2 disabled boys. Steven R. Valencia, CA We were able to keep Steven from being evicted and homeless for the first time in his life, just 2 days after his 63rd birthday.