Community-Based Programs for Vulnerable Population of the Homeless - Research Paper Example

? Community Based Programs for Vulnerable Population of the Homeless. It is anticipated that about, 3.5 million homeless people or 1% of the population is homeless in America today. In any case, the recession has only worsened the situation with the rate of homelessness increasing by 3% between 2008 and 2009. This essay discusses on the state of homelessness in the USA with a focus on Tacoma-Pierce county, Washington this essay explores substance abuse among the homeless and the risk of HIV and AIDS associated with this habit. Introduction Poverty is a major cause of homelessness with thousands of American households unable to make enough income to afford housing. The 2008 Out of Reach Research Survey quoted the Fair Market Rent for a 2-bedroom unit at $298 in Washington, implying that a household must earn around $20 to afford a 2-bedroom apartment against an average wage of $14 this leaves households grappling with the option of choosing between buying food and paying rent (Terry, 2008). Single parents’ often single mothers escaping from abusive spouses make up the homeless population since most of them struggle to provide for their households. People with mental illnesses also contribute to homelessness since people with debilitating mental illness can’t get or maintain employment. A certain percentage of the homeless are drug and substance abuse addicts drugs and substance abuse disrupts income generating ventures while some addicts cannot afford rehabilitation and short of income, these addicts end up vanguard. On being released from prison, ex convicts look forward with enthusiasm to life after prison but soon they have to deal with suspicious and uneasy employers who can’t trust them and end up jobless, this is a prelude to homelessness and some frustrated, revert to crime. Orphaned children who age out of the foster care system often end up homeless due to lack of an elaborate transition system and life skills to enable them acquire financial independence. According to the Washington State Point in Time Count of Homeless Persons census of 2006, there were 1058 sheltered homeless persons in Pierce town, 340 unsheltered homeless persons making up a total of 1398 homeless persons. Of the total homeless, population 267 people were found to be chronically homeless with 134 living in shelters while 133 were unsheltered. Chronic homelessness is defined by the United States Department of Housing and Urban Development as an individual who has no home and is disabled for a continuous period of one year or more an or a disabled person with about four episodes of homelessness in the past three years (Chesney, 2008). Providing general healthcare support and rehabilitation among the substance addicted segment of the homeless people Different researchers and welfare providers estimate that 25-35% of all homeless persons in Tacoma are substance and drug addicts. In this essay, I will seek to investigate the causes of homelessness in Tacoma-Pierce county and possible solutions. Drug and substance abuse is a precipitating and also a consequence of homelessness. It is estimated that the prevalence of substance abuse among the homeless is approximately 20-35% with less than 25% of the people in need of treatment for substance abuse unable to access those services due to structural and interpersonal barriers exacerbated by the constraints of homelessness. Even when they gain access to treatment the challenge of consistent effective treatment is overwhelming when the patient is homeless this has been the case with many rehabilitation facilities recording over 70% drop out rates among the homeless this results in relapse. Housing has been identified as a critical factor to the recovery or consistency in accessing rehabilitation among the homeless substance addicts with those rehabilitation facilities offering accommodation to the patients recording lower drop out rates. Research has indicated therapeutic communities modified for homeless patients to be cost effective and efficient for homeless persons. Interagency collaboration is usually recommended in treatment programs for homeless substance addicts in order to provide the multiple needs of the patients in the context of scarce community resources. Programs targeting women must take into account their unique experiences such as physical and sexual abuse and motherhood. While discussing drug and substance abuse it is important to mention that substance abuse and mental disorders are inextricably connected with some patients exhibiting both conditions. It is estimated that less than a quarter of homeless patients receive treatment. The main cause of this negligence being that those responsible for providing these services generally prefer to serve the more desirable non-homeless patients Disaffiliation is one factor that makes many homeless patients forego treatment. This is because devoid of those personal supports that enable people sustain themselves in society, and most homeless people lack the motivation to comply with the treatment regimen. Distrust and disenchantment with service providers has also been cited as a reason why the homeless patients would avoid treatment, a condition that is found more in women than in men, especially women with experiences of domestic violence. Confidentiality and mandated reporting can be prohibitive especially for some segments of the homeless such as the undocumented immigrants, domestic violence victims and runaway juveniles (Boyd, 2007). Due to their geographical instability and resultant unpredictability in scheduling, engaging the homeless in a long term treatment program can be very complicated. Due to their multiple problems and a myriad of needs the homeless patients can pose many problems to the service provider especially where they disagree on priorities to the patient. Some solutions to providing treatment and supporting drug and substance addicts have been suggested. Outreach, which in essence is making contact with the homeless individual in his/her own environment, has been shown to be consistently successful in targeting and contacting homeless substance abusers who were previously unengaged. Providing patients with practical assistance such as housing or employment has proved to be successful in enrolling patients who would otherwise not have cooperated (McNamara, 2008). Providing the service in a safer non-threatening environment has been proved to successful in engaging patients. This is especially effective for subgroups with special concerns over confidentiality and mandated reporting. Motivation interviewing has also been successful for some groups like dually diagnosed men who believe that therapy will help them have control over their actions. Family oriented treatment has been used successfully on runaway youths where the youths where those who primarily take care are involved individually by the therapist using motivational tools appropriate for a family context and the youths’ development. Use of peers has been successful in engaging cocaine users in psychiatric and obstetric services where a professionally directed peer has been used (McNamara, 2008).The importance of housing and employment to the rehabilitation process cannot be over emphasized, where patients revert to homelessness relapse is highly likely. Project: HIV and AIDS screening of the homeless in Tacoma and provision of free hypodermic syringes An important part of drugs and substance abuse management is HIV and AIDS screening. This is because of the hazardous use, reuse and sharing of syringes among the drug addicts. In this project, we sought the technical, material and moral support of the National Coalition for the Homeless Pierce County Division and Pierce County AIDS Foundation. In a very laconic description, the human immune-deficiency virus (HIV) is a virus strain that destroys the body’s immune system by mutating the T-cells group of white blood cells. Over the course of time the T cells die and the HIV virus multiplies unabated. As more of the T cells are decimated, the immune system weakens exposing the body to opportunistic infections. When left unmanaged, AIDS progresses through four stages eventually deteriorating to full blown AIDS. A brief analysis of statistics at the Pierce County AIDS Foundation deducted that the Pierce County AIDS Foundation (PCAF) serves over 1800 HIV positive patients and that a huge percentage of the patients are characteristically poor with a low average level of education. The majority are women, people of color, injection drug users and teenagers. Of the homeless people screened 36% of HIV positive were people of color while 18% were found to have acquired the virus through drug injection, 18% were infected through heterosexual sex and 29% of the infected were women. Twenty four percent of the infected were youths below 30 years of age. Moreover, over 25% of the people screened in 2005 were homeless or were at risk of homelessness. I was engaged with the PCAF as a volunteer. It is estimated that 3.5 % of the homeless people in the USA is HIV positive compared to just 0.4% in the general public (Centers for Disease Control and Prevention, 2009). The correlation between HIV/AIDS and homelessness is intricate, for a start, the cost of medication and HIV/AIDS management very high, equally high is the risk of unemployment for the infected due to frequent HIV related complications and discrimination in employment. Living conditions of the homeless may also increase the risk of HIV infection, not to mention the disproportionately large number of homeless people suffering from substance abuse. Most of the homeless people abusing substance are into the hazardous habit of using, sharing and reusing syringes to intravenously inject drugs. This habit alone has been responsible for the infection of 13% of the population in Pierce County. The deplorable living conditions of the homeless increase the risk of HIV infection due to lack of privacy and difficulty in nurturing stable relationships. In my project, I engaged both PCAF and the National Coalition for the Homeless (NHC) my aim was to screen for HIV and provide free hypodermic syringes to the homeless drug and substance addicts. I secured the support of two other volunteers working for PCAF in my project. Through partnership with PCAF, we were able to obtain over 2000 units of hypodermic syringes most of them donated by the network of PCAF donors and financiers. The NHC staff was of great assistance to us not only did they allow us to access homeless people housed in their facilities, but also invited us to screen the homeless for HIV and supply the substance addicts with hypodermic syringes during meal times when most of the homeless are accessible. They also directed us to where unsheltered homeless people could be found and couched us on how to interact with them, one staff member even offered to introduce us to them. The Pierce County AIDS Foundation supported us with 1200 testing kits and trained us on how to use the kits and record the data. Of the around 1500 official figure of the homeless in Tacoma-pierce county, we were able to access 926 homeless people with 639 agreeing do undergo the screening, thus we had a success rate of 69%. Our provision of free hypodermic syringes was indiscriminate as the NHC staff advised us against specifically targeting substance addicts to avoid reprisals and resentment but on comparing the names of those supplied with the official PCAF record, we discovered that we had accessed 134 of the 271 recorded substance addicts with all of them agreeing to be screened and acquiring free hypodermic syringes or having access to the same since the remainder of the 2000 syringes we had was put in the NHC/ PCAF dispensers. Thus our project had a 49.4% success rate among the substance addicts. The estimated cost of a HIV testing kit in the USA is $1.50 therefore the cost of the 1200 free kits we secured from PCAF is $1800 and since the kits were secured free of charge we saved $1800 on this. The cost of a hypodermic syringe is on average $0.95 thus the cost of the 2000 free syringes we secured through PCAF network of partners is $1900. This is not even counting the invaluable moral, technical and any other material support we secured from our partners in this project. On average, we saved an estimated figure of $4000 and its fair to say that this project would not have been successful without the could not have succeed without the support from associate organizations. Possible sources of funding We identified the United States Department of Housing and Urban Development as a possible source of funding or in the least we could count on them to provide support infrastructure for the vulnerable segment of the homeless that is HIV positive. It is our believe that these infected people have the best chance of survival under the care of supportive housing similar to the services provided by the United States Department of Housing and Urban Development as there is evidence that people under this system patients have four times more like hood to survival and to adhere to ARTs routine than those left out in the cold (National Alliance to End Homelessness, 2010). The Washington State Department of Social and Health Services is another possible source of funding or material support that we identified, this is because of their established system of support to substance addicts across the spectrum. And thus we can call on them to support the substance addicts in the Tacoma-Pierce county area and in our case the homeless substance addicts. Conclusion Homelessness is prevalent all over America as the statistics indicate. It is, therefore, important that the contributing factors are addressed on a national scale through the federal government and timely intervention among the different states. Individuals and corporate can also mobilize resources and support the homeless in their own capacity. References: Boyd, M. (2007). Psychiatric nursing, Philadelphia, Pa: London. Centers for Disease Control and Prevention: http://www.cdc.gov/. Retrieved on 26th November, 2012. Chesney, M. & Anderson B. (2008) caring for the vulnerable: perspectives in nursing theory, practice, and research. Jones and Bartlett Publishers: Sudbury, Mass. McNamara, R. (2008). Homelessness in America Westport, Conn: Praeger. National Alliance to End Homelessness: http://www.nationalhomeless.org. Retrieved on 26th November, 2012. Terry, M. (2008) Encyclopedia of social work. NASW Press: Washington, D.C. Wright, J. & Donley, A. (2011) Poor and homeless in the Sunshine State: down and out in theme park nation. 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