Health and Homelessness - Essay Example

Health and Homelessness Health and Homelessness The incidence of homelessness can have very serious and dire consequences on all those who are affected. These consequences can be physical, psychological, and even mental. The worst of this homelessness problem is that on average, homeless people get an average natural life of 47 years (Acheson Report 1998). The annual average is currently at 77 years, which is 30 years more than what homeless people get to live. The existence of poor mental or physical health and dependency are what may sometimes lead to homelessness. This often makes it difficult for these people to engage in/with different services that may assist them. Furthermore, the services that are present are not well-equipped or even ready to deal with or respond to the needs of the homeless. This makes it particularly difficult for homeless people to live and operate as well as people (general public) who are not facing the problem of homelessness. This paper will examine some of the health problems and issues associated with homelessness, and how the government is trying to make amends in order to salvage the situation. Being homeless is an issue faced by people who are not in a position to find living quarters that are supportive, decent, secure, and affordable (Baggott 2007). Majority of homeless people tend to be families and single young people. It is in these groups that there are a higher number of people, especially young people, who use drugs and other illicit/illegal substances. This ultimately affects their physical and mental health, and without the proper access to medical and health services, it is impossible for them to fully recover and live normal lives (Naidoo & wills 2008). Their health problems deteriorate, and the only time they might get to visit different medical centers is during emergencies. This implies that homeless people only get to visit medical healthcare centers in case of accidents, or chronic illnesses. Common health predicaments and service issues Drugs In the case of homeless people, especially rough sleepers, there is a higher rate of morbidity and mortality as compared to the general population. What this implies is that homeless people tend to have a lower or average lifespan than the general population. In this instance, the main problem is drug overdependence, and the exploitation of intravenous drugs, which results in the spread of diseases and viruses such as HIV, Hepatitis B & C, cellulitis, among others (Baggott, Allsop & Jones 2005). Furthermore, the use of schedule 1 drugs that are not meant for medicinal purposes such as heroin and crack cocaine also increases the mortality and morbidity among the homeless people. The use of such drugs makes it hard for medical practitioners to deal or treat individuals with different medical problems. Sometimes, homeless people can just get into different medical centers just to get drugs, which prevents the process of rehabilitation (Baggot 2011). Drug treatments have now different nationally accepted outcomes. The prescription of drugs to homeless patients depends on the patients, the general practitioners, and the drug workers. The different individual circumstances might also aid in determining the outcomes of the strategies employed to cater to the different individuals present (CSDH 2008). Detoxification can only work with the cessation of drug use and/or provision from drug workers. Frenzied users may not prefer such an approach since it is not practicable or realistic. The first thing that the medical practitioner or drug worker should do is to try and stabilize the patient. This is both in the psychological and social setting. Often, this is hard as with homeless people, the odds or frequency of relapse are often higher than for the general population (Carr et al. 2007). Physical health is vital and this means reducing the amount of drug intake among the homeless population. This is identified as harm reduction, which involves sensitizing the population on the effects of criminal activities and the benefits of family/social relationships. Medical services need to have the proper avenue to address the plight of homeless drug users. By having the equipment necessary, drug workers may be in a position to check up on the homeless population on certain specified or unspecified days to ensure that the people are adhering to the set programmes (Graham 2007). This may also give them an avenue to get regular check-ups and have different avenues to also socialize and address their plight, especially with relation to drug use and addiction. This ensures that homeless people also have ways of tackling one of the biggest threats to homelessness mortality in the region (Watkins 2008). Alcohol Alcohol dependence among the homeless population is not something new, especially with the other complications that most of them suffer, for example; the neurological, cardiovascular, and gastrointestinal complications that exist among most of the population. Depression and suicide are not to be forgotten whenever the above are mentioned, because a high number of homeless people are suffering from depression due to the conditions they are exposed to on a regular basis (Hodgson & Irving 2007). The risk of suicide through different means is a common theme among homeless people in the UK, and this should be a matter of concern among all the policy makers present. Normally, homeless people will visit the general practitioner (GP) or drug worker with an urgent detoxification request (Scriven & Garman 2007). When this happens, it should not be a matter of prescribing different strategies for the patient without proper analysis and assessment of the patient in question. Preliminary assessment must be conducted from the GP, and support must be offered to guarantee or ascertain the proper rehabilitation of the patient. The lack of or failure to carry out a proper assessment might lead to seizures from the patient, which might not end well for the GP and the patient facing the alcohol dependency issues (Kemm et al. 2004). In some instances, the patient may end up dying while receiving treatment for the alcohol dependence within the first 24 hours of uncontrolled detoxification. In a monitored environment, homeless person(s) looking for urgent help may attain the necessary and adequate attention for their problems (Naidoo & Wills 2008). Mental Health Schizophrenia, anxiety, and drug-stimulated psychosis are just a few of the mental problems that homeless people face. It may be difficult to say whether mental health or illness and homelessness are directly linked, but it may be safe to assume that mental health among the homeless is both an effect and a cause (Klein 2010). What this implies is that, between the two populations (the homeless and the general), mental illness among the homeless is overly represented. This is as compared to the general population, where even the criminal activities connected to the homeless people is recorded as being less than in the general population. In this group, personality disorders, schizophrenia, and substance abuse are the basic and most common conditions that most homeless people suffer from, thus; increasing the chances of a criminal history among the person(s) involved (Watkins 2008). Whenever homeless people are involved in criminal activities, it is probably because they need to feed some drug habit or alcohol dependence. There are very few cases of criminal activities that are violent, and unfortunately, only a third of the homeless people get the attention they need to reduce the effects of their mental states (Labonte & Schrecker 2007). In other cases, especially for elderly people, mental disorders or illness may be the main cause behind their homelessness. Whenever GPs are confronted with such cases, it is crucial to identify the steps needed to ensure that such patients get the medication and attention they need. Psychiatry services are crucial in this stage, especially when one encounters a mentally ill person with a criminal past. A care planning process should be put into place, which ensures proper integration into some of the health services present (Carr et al. 2007). Physical health The relationship between all the above-mentioned factors and physical health is not up for discussion. When individuals are affected as much as the homeless people are, it may be difficult to maintain good physical health (Larkin 2009). It is expected that perhaps sleeping on the streets or in different sub-standard accommodation can have different negative effects on the human body. Furthermore, the chances of being a victim of violence on the street is increased significantly for the homeless, thus; making the possibility of being in good health a distant dream. More often than not, this violence is often carried out by members of the general public, who find it amusing to do so. Respiratory problems, stomach pains, and joint and muscle issues are just examples of what homeless people go through regularly, and it does not stop there (Baggott 2011). Different statistics indicate that a higher number of homeless people are bound to be registered with GPs, a number significantly higher than that of the general public (Marmot Review 2010). The presence of untreated medical conditions is also higher among this population than the general public, which means that sometimes, it is difficult for them to go to seek medical attention (Carr et al. 2007). Emergency services are used more by homeless people, especially in cases where the medical issue can no longer be ignored. A&E services record a high number of cases among the homeless population, meaning that they only seek medical attention when it is an emergency. Health service issues Whenever homelessness is mentioned, people do not take into account the number of people actually involved. This number continues to grow and the age group consists of all people, from the young to the old. One thing worth mentioning, however, is the trouble these people go through in order to get or acquire medical attention/services (Orme et al. 2003). Homeless people, more often than not, do not consider health and other related issues to be a priority for them. It is only a matter of survival when it comes to homeless individuals, and their next meal. Other needs such as employment and temporary shelter are their most pressing needs, which take center stage in their lives (Naidoo & Wills 2008). This prevents them from taking care of their immediate medical needs, despite the problems that might arise if these issues are ignored for long. Furthermore, the notion that exists between the homeless people and the general population may sometimes hinder the provision of proper and adequate medical attention. It is often a matter of ‘them and us’ attitude, which often gives GPs a bad reputation, especially when dealing with homeless people. The homeless often feel that they do not feel supported, making it difficult for them to voice their concerns about their plight (Wanless 2002). This, in turn, affects their self-esteem, especially when they lack the motivation, sense of purpose, and even the confidence to do what they need to do regularly. This leads to apathy and a sense of indifference when it comes to seeking medical attention for whatever ails them. The lack of knowledge of when and how to seek medical attention is also a factor that hinders the provision of quality care among the homeless, which means that more people remain affected by the system put in place, or the system that they have put in place. Some recommendations have been put across to ensure that the plight of the homeless people is heard. There is a need for national recognition, especially when it comes to the health needs of the homeless. Policy makers are tasked with the responsibility of ensuring that organizations, for example; Healthwatch England, have the necessary skills and understanding to engage with, and consult homeless people on what best suits their medical needs (DH 2006). This means that when a homeless person cannot or does not know how to handle their medical needs, it is the organization’s prerogative to ensure that they are well educated on the subject. Also, there should be structured supervision for sectors, both voluntary and health commissions, on how best to work together for the overall good of the people in need of different medical services (Watkins 2008). The coming together of all the above mentioned players in the field can guarantee and ascertain that homeless people do not feel the need to hide in shame whenever they need to seek medical attention. These players can provide the support structure greatly needed to promote good health among the homeless people affected throughout the region (Wilkinson & Pickett 2010). The progression of chronic diseases and issues that the homeless face may be a problem that may not easily go away, especially since there is more to be done to ensure that their plight is addressed beforehand. This is to allow the necessary parties to provide the necessary conditions to improve on the quality of life faced by the homeless (Wilson & Mabhala 2009). The longer they stay without getting the help they need, the more money is spent trying to rehabilitate and provide for them when they are too far gone. More can be done on the assessment, collection, and analysis of data on the homeless. Once this is done and as per the required standards, it is possible to know how many there are, and how they can be attended to by various organizations (Graham & Kelly 2004). There is not enough data to inform the commissioning bodies of what is going on, and what needs to be done to ease the quandary of the homeless people in the region. An improvement in such a sector can enable governing bodies and all policy makers to protect the integrity of the homeless, and involve them in the improvement of their medical awareness, and ultimately, their lives. Furthermore, once this gap is filled, it is possible for people to be fully aware of the situation and help in any way they can (Scriven & Garman 2007). Debates rage on as to whether it is better for the homeless to be treated exclusively through specialized general practices, or if they should be dealt with through mainstream practices. When dealing with the homeless, it may be difficult for them to accept the mainstream practices. It is vital to start with the specialized practices, and then gradually move them to the mainstream practice (NICE 2012). In a larger urban setting, this may be possible, but for the rural setting, advising the homeless population to start at mainstream practices would be the best way to handle the medical challenges they face. In the case of a specialized practice, there needs to be personal commitment on the part of the practitioner and the patient. Only through this commitment can they both achieve the results they desire to meet (Watkins 2008). Primary care organizations should be in a position to provide resources to aid some of the homelessness services that exist, create more multiagency relations that will ultimately share protocols and procedures on the care of homeless people, and finally, acquire understanding on the complete number of homeless persons in the region so as to allow the effective provision of quality care (NICE 2012). Liaising with hospitals may also relieve pressure from the homelessness services by reducing the number of patients that these services attend to daily, weekly, or monthly. In the accident and emergency departments, homeless people are often overly represented. This means that they are there to seek treatment on their use, or rather misuse of drugs and other related substances (DH 2006). Hospitals can protect the homeless by providing them with substitute medication that may not lead to abuse or addiction. Obstacles to the provision of proper care for the homeless As with any project or agenda, there are bound to be obstacles that hinder the progress of such strategies. With regards to homeless people, the issues of stigmatization, segregation, lack of alternatives make it particularly challenging for there to be progress in the provision of proper health care for them (Kelly, Morgan, Ellis et al. 2010). The lack of involvement on their part is also a huge obstacle in this primary care agenda, which can be attributed to the lack of social involvement among the homeless group. Irrespective of the status that people hold in society, they should be allowed or given an avenue to be part of the decisions being made about them. This can allow the stakeholders and all players involved to know of the gap that exists, and how to reduce it (Watkins 2008). To this end, everyone will be a part of the bigger picture, which is; to improve on the health and lives of all homeless people. It is difficult to ascertain the exact number of homeless people in the region, since the defining nature of the homeless by the local authorities does not include people who stay at bed and breakfasts, hostels, or on friends’ couches. This group is known as the out of sight group, who might not particularly be eligible for help from the local groups or authorities (DH 2006). There should be new ways to measure or count the number of homeless people in the region, and through the Local Government; it may be possible to find out the number of rough sleepers in the region. Being the most vulnerable and excluded group in society, the homeless tend to become indifferent to their plight, which means that all they wish to do is survive for a night, and the rest may take care of itself (Naidoo & Will 2008). The above should not be the case for a society that believes in the protection and care of its own. The commencement of projects, for example; No Second Night Out, is meant to ensure that no people in London sleep rough at night, which means that no person should have a place to sleep that is not safe, secure, above standard, and protected (NICE 2012). It is also vital to note the role that other parties play in the progress of getting the homeless the attention they need, for example; the nursing fraternity. Nurses are crucial in ensuring that the homeless get the appropriate care they need as they are better equipped to deal with this client group (Weightman, Ellis, Cullum et al. 2005). In conclusion, the issue of homelessness and its relation to health should be addressed because it seems that as an effect and a cause, it is an impediment to the growth and development of any thriving and flourishing society. By addressing the gap that exists between the general population and the homeless, it is possible to address the issue of proper care in both groups, thus; ensuring that everybody gets to enjoy standard, quality life (Wright 2002). Models that provide an oversight into the provision of proper care for the homeless should be implemented to avoid digressing from the main objective, which is to care and cater to a rising population regardless of their social status and/or their home address. References Acheson Report 1998, Independent inquiry into inequalities in health, HMSO, London. Baggott, R 2007, Understanding health policy, Policy Press, Bristol. Baggott, R 2011, Public health policy and politics. Palgrave Macmillan, Basingstoke. Baggott, R, Allsop, J, & Jones, K 2005, Speaking for patients and carers: health consumer groups and the policy process, Palgrave Macmillan, Hampshire. Carr, S et al. 2007, An introduction to public health and epidemiology. 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