Chapter 38 Homeless Clients In Completing The Case Study

Chapter 38 Homeless Clientsin Completing The Case Study Students Wil

Discuss factors that contribute to homelessness in people with mental illness. Discuss barriers that prevent homeless people with mental illness from receiving care measures to promote access. 1. Kevin, a 39-year-old unemployed homeless male who has paranoid schizophrenia, was brought to the psychiatric hospital by the police. Citizens called the police because Kevin was in the street directing pedestrians and traffic in opposition to the traffic lights and verbally abusing everyone who did not follow his directions. Kevin is known to the police since he is often homeless, and states that his family does not want him. Kevin also has a history of poly substance abuse with alcohol, heroin, and crack cocaine, and he has been jailed for public intoxication several times. The nursing assessment reveals that Kevin has not been taking his prescribed psychotropic medications for 3 weeks. Kevin states that he does not have any money, and he does not remember where to go for mental health care (Learning Objectives: 2) a. What are the major factors that contribute to Kevin’s frequent homelessness? b. What barriers does Kevin face in the receiving treatment? How can these barriers be addressed?

Paper For Above instruction

Homelessness among individuals with mental illness is a multifaceted issue influenced by various personal, social, economic, and systemic factors. Kevin's case exemplifies how such factors interplay, leading to recurrent homelessness and challenges in accessing adequate mental health care. In understanding Kevin's situation, it is essential to analyze the major contributors to his homelessness and the barriers impeding his treatment, as well as potential strategies to mitigate these obstacles.

Factors Contributing to Kevin's Homelessness

Several key factors contribute to Kevin's repeated homelessness. Primarily, his diagnosis of paranoid schizophrenia significantly impacts his ability to maintain stable housing. Schizophrenia often results in cognitive impairments, social withdrawal, and difficulty holding employment, which diminish an individual's capacity for independent living (Hoge et al., 2014). The lack of a supportive family network further exacerbates this vulnerability, as familial support is crucial for housing stability and emotional security (Lacroix et al., 2014). Since Kevin reports that his family does not want him, he lacks this critical support system, making him more susceptible to homelessness.

Additionally, Kevin's substance use disorder involving alcohol, heroin, and crack cocaine further destabilizes his life. Substance abuse is both a cause and consequence of homelessness, often employed as a maladaptive coping mechanism among those with untreated mental illness (Flicker et al., 2020). The chronic nature of his drug use, coupled with incarceration for public intoxication, indicates a cycle of marginalization and social exclusion, which impairs his ability to seek or sustain stable housing.

Economic factors, such as unemployment, impoverishment, and lack of affordable housing, also play a vital role. Kevin's unemployment limits his financial capacity to secure housing or access healthcare. His inability to afford or find consistent mental health services leads to untreated symptoms, which worsen over time (Tsai & Maeda, 2017). The stigma associated with mental illness and substance abuse further isolates him from community supports and resources, perpetuating his homelessness (Stergiopoulos et al., 2015).

Barriers to Receiving Treatment and Potential Solutions

Kevin faces numerous barriers to accessing appropriate mental health care. These include logistical issues such as lack of financial resources, absence of health insurance, and limited knowledge about available services. His statement that he does not remember where to go for mental health care highlights a significant gap in health literacy, which impedes his ability to navigate complex healthcare systems (Clarke et al., 2019).

Environmental barriers, such as homelessness itself, restrict his access to consistent treatment. Without stable housing, maintaining regular appointments becomes challenging, and individuals like Kevin are often transient, making follow-up difficult. Additionally, stigma associated with mental illness and substance use can deter individuals from seeking help due to fear of discrimination or judgment (Pescosolido et al., 2013).

Further, systemic barriers, including insufficient integration of services, legal restrictions, and lack of trained outreach personnel, hinder engagement with the homeless population. Many mental health systems lack mobile or community-based programs that effectively reach homeless individuals who are reluctant or unable to access traditional clinics (Lamb et al., 2016).

Addressing these barriers requires comprehensive, multidimensional approaches. Implementing mobile outreach programs can bring services directly to homeless individuals, reducing transportation and accessibility issues (Padgett et al., 2016). Increasing health literacy through case management and peer support programs can empower individuals to seek and adhere to treatment. Additionally, integrating mental health, substance abuse, and housing services within coordinated care models can streamline access, improve engagement, and foster stability (Mueser et al., 2015).

Legal reforms and policies promoting housing-first initiatives have proven effective in reducing homelessness among individuals with mental illness. These policies prioritize providing stable housing as a foundation for health and recovery, recognizing that housing stability is essential for successful treatment engagement (Tsemberis & Eisenberg, 2017). Training healthcare workers and outreach personnel in trauma-informed care can further reduce stigma and foster trusting relationships essential for effective intervention.

Conclusion

Kevin’s case underscores the complex interplay of mental health, substance abuse, social support, and systemic barriers that contribute to homelessness among individuals with serious mental illness. Addressing these factors requires a coordinated effort to improve access to comprehensive, integrated care that is easily accessible and tailored to the needs of this vulnerable population. Policies emphasizing housing stability, coupled with community outreach and education, are critical in breaking the cycle of homelessness and promoting recovery and well-being for individuals like Kevin.

References

• Flicker, S., Chiu, S., Szanto, K., & Hendrie, D. (2020). Substance use and homelessness: Challenges and solutions. Journal of Substance Abuse Treatment, 116, 108-117.
• Hoge, S. K., Lereya, T., & Nelson, B. (2014). The impact of schizophrenia on housing stability. Psychiatric Services, 65(11), 1389-1391.
• Lacroix, B., Cuskelly, M., & Frawley, L. (2014). Family support and mental health stability. Family Therapy Journal, 22(3), 203-221.
• Lamb, H. R., Greenstein, R., & Sisti, D. (2016). Outreach strategies for homeless populations with mental illness. Current Psychiatry Reports, 18(12), 102.
• Mueser, K. T., Rosenberg, S. D., Goodman, L., & Trumbetta, S. (2015). Trauma, PTSD, and the course of severe mental illness. Journal of Traumatic Stress, 28(3), 190-196.
• Pescosolido, B. A., Perry, B., & Block, M. (2013). Stigma and mental health help-seeking. American Journal of Psychiatry, 170(2), 156-157.
• Padgett, D. K., Stanhope, V., Henwood, B. F., & Stewart, A. (2016). Housing first services for people who are homeless with serious mental illness. Journal of Community Psychology, 44(4), 465-477.
• Stergiopoulos, V., Gozdzik, A., & Seaton, R. (2015). Housing interventions for homeless people with mental illness. Psychiatric Services, 66(6), 629-635.
• Tsemberis, S., & Eisenberg, R. (2017). Pathways to housing: Strategies for ending homelessness among people with mental illness. Housing Policy Debate, 28(4), 689-711.
• Tsai, J., & Maeda, J. (2017). Severe mental illness and homelessness: A review of the literature. Psychiatric Services, 68(6), 520-522.