Issues of Vulnerability of Adolescent Homelessness - Article Example

Vulnerability of Adolescent Homelessness and Self-Awareness The capa of an individual to be wounded physically, mentally or emotionally by virtue of his age, sex, race, religion, illness or any such determinant is known as vulnerability (CARNA, 2005). People who are vulnerable are seen in everyday nursing practice and pose a challenge to nursing professionalism and leadership. Common vulnerable groups encountered in nursing practice are elderly, young children, mentally ill patients, poor patients, patients with debilitating chronic illnesses like cancer and the homeless. These individuals are dependent on the care givers for their day-to-day activities and this makes them subjects of in-discriminatory practice and exploitation. Vulnerability is a major issue in health care system which affects care and outcome of those subjected to it. The Code of Ethics and Code of Conduct of Nursing of most of the countries in the world have discussed about issues of vulnerability and how to handle it. It is important for nurses to be aware about issues pertaining to the vulnerable group and how to prevent vulnerability so that comprehensive and justful care can be provided to each and every individual irrespective of his age, sex, race, religion, ethnicity, socioeconomic status and health status. Nurses, being the main diplomats of health system have a major role in the health care of any individual and their actions influence the overall well being of patients under their care (Nettina, 2006). In this essay, the vulnerability of a specific population, the homeless adolescents will be discussed with reference to demographics, personal attitudes, biases and stereotypes, effect of research on the topic, reflection of the information gained through research on the health care and perceptions of the information. Demographics The McKinney-Vento Homeless Assistance Act has defined homeless individual as "someone without a fixed, regular place to stay; lacks an adequate nighttime residence; lives in a welfare hotel, transitional living program or place without regular sleeping accommodations; or lives in a shared residence with other persons due to the loss of ones housing or economic hardship." Adolescent homelessness may be defined as "youth living in shelters, on the streets, and at group homes; couch surfers; and those doubled up with other families" (Tierney et al, 2008). According to the National Alliance to End Homelessness, 2006; cited in Tierney et al, 2008), each year, in the United States, about 3.5 million people experience homelessness. Of these, about one million are youth and more than 750, 000 are school going children. The National Law center on Homelessness and Poverty (2004; cited in Tierney et al, 2008) has reported that "1.35 million young people experience homelessness each year." According to Ringwalt et al (1998; cited in Tierney et al, 2008), about 5 percent of American Youth are likely to experience homelessness at some point of time in their life. The US conference of Mayors (2005; cited in Tierney et al, 2008) has reported that "Unaccompanied youth living on the street without a parent or guardian account for 3% of the urban homeless population." The Wilder research Center (2001; cited in Tierney et al, 2008) has also reported that "approximately 186,000 youth are in shared housing at any given time." Demographics of homelessness in Log Angeles is provided in tables 1- 5. Personal awareness of Homelessness Each and everyone of us have certain biases, stereotypes and attitudes towards homeless youth. Personally, I always stereotyped homeless youth as criminal-minded lazy people who never wished to work and enjoyed life through sex, alcohol and drugs. Although, I beloved that this was not applicable to all because, I knew some homeless people who were thrown to streets because of bad parents. When there is employment all over for all age-groups and all times of socio-economic strata and education, I often wondered why these people would not pick up some job or the other for their livelihood and live in low-income housing. I witnessed several homeless youth begging here and there and I know that many use the money procured thus for smoking, alcohol and drugs. I always wondered as to why they resorted to pleasurable things even in such poor states. There are many service providers to take care of the homeless youth and provide employment opportunities and I often wondered as to why this population never approached such agencies. Impact of Research on Personal Attitudes The impact of research on my personal attitudes was enormous and my opinion and bias about the homeless youth changed drastically. Homelessness among adolescents is a very important issue because it leads to several negative consequences. Some research has shown that homeless adolescents are more likely to engage in antisocial activities related to sexual activity, alcoholism and drug abuse. Sex is exchanged for money, food and shelter. Use of sex for survival has contributed to higher rates of teenage pregnancy among homeless adolescent females, single mothers and acute poverty. Homelessness also leads to frustration and development of suicidal thoughts. Thompson et al (2004; cited in Tierney et al, 2008) reported that more than 75 percent of the homeless youth develop suicidal tendencies. Homelessness during adolescence is a risk factor for homelessness during adulthood and this can pass on to the next generation too. Homelessness also contributes to increased stress, criminality, victimization, addiction, development of mental disorders like post traumatic stress disorder, depression, suicidal behaviours, increased health problems and increased mortality and morbidity rates. Homeless individuals are often subjects of social stigma which led to self-blame and guilt and feelings of shame (Kidd, 2007). There are several causes for homelessness of the adolescents. While poverty is an obvious cause in most cases, other risk factors include parental criminality, drug abuse and alcohol abuse in parents, abusive home environments, disrupted home environments, increased household moves, domestic violence and marital discord between parents. Such and other negative experiences at home contribute to various other consequences like poor performance at school, conduct problems and conflicts with teachers (Kidd, 2007). How Knowledge Affects the Delivery of Healthcare to the Homeless Homeless youth are often vulnerable even in health care sector. In a study by Ensign and Bell (2004), the researchers found that homeless youth were often embarrassed about seeking health care during illness, especially illness related to sex, substance abuse or alcoholism. Female homeless youngsters were often feared about safety. According to Osgood et al (2010), services provided to the homeless youth are deficit in several ways including inappropriate eligibility criteria for exclusion from services related to youth, lack of appropriate funding during transition from youth to adulthood at a time when support is needed, deficits in the existing systems of care for adolescents and inappropriate access to all homeless adolescents due to multiple service systems. Hudson et al (2008) identified four barriers with reference to care from various servce providers and they are "authoritative communication, one-way communication, disrespect, and empathy." The authors stressed on the need for development of services and agencies which employed service providers with an understanding of the developmental and emotional needs of homeless youth, especially those who ran away from homes due to various circumstances. Osgood et al (2010) proposed that developmental appropriate support system needs to be included for provision of support to homeless adolescents. Some such policies include inclusion of supportive programs even during transition period, improvement of existing supportive systems, coordination of multiple systems towards single coherent system and increasing and expanding accessibility of the services to wider range of population of homeless. According to OSullivan and Lussier-Duynstee (2010), "the impact of homelessness on youth’s social functioning and health status should be raised at the community level, particularly by community nurses and other health professions who interact with adolescents who are homeless." The authors recommended use of Kingdon’s multiple streams model by nurses for advocacy for homeless youth through which accurate definition and re-framing of adolescent homelessness as a priority for policy for various policy makers happens. References College and Association of Registered Nurses of Alberta (CARNA). (2005). Position Statement on Vulnerability. Retrieved on 9th June, 20101 from http://www.nurses.ab.ca/Carna-Admin/Uploads/Vulnerability.pdf Ensign, J., and Bell, M. (2004). Illness Experiences of Homeless Youth. Qual Health Res., 14, 1239. Hudson, A.L., Nyamathi, A., and Sweat, J. (2008). Homeless Youths Interpersonal Prospectives of health Care Providers. Issues in Mental Health Nursing, 29, 1277–1289, Kidd, S.A. (2007). Youth Homelessness and Social Stigma. J Youth Adolescence, 36, 291–299. Los Angeles Homeless Services Authority or LAHSA. (2009). 2009 Greater Los Angeles Homeless Count Report. Retrieved on June 9th 2010 from www.lahsa.org. Nettina, S.M. (2006). Lippincott Manual of Nursing Practice. 8th edition. Singapore: Lippincott Williams and Wilkins. Osgood, D.W., Foster, M., E., and Courtney, M.E. (2010). Vulnerable Populations and the Transition to Adulthood. Spring, 20(1), 209- 229. OSullivan, J., and Lussier-Duynstee, P. (2006). Policy, Politics and Nursing Practice, 7, 73. Tierney, W.G., Gupton, J.T., and Hallett, R.E. (2008). Transitions to Adulthood for Homeless Adolescents: Education and Public Policy. USC Center for Higher Education Policy Analysis. Read More