Transitions of Mentally Ill Patients from Adult Care Facilities to Community Housing - Research Paper Example

Transitions of mentally ill patients from Adult Care Facilities to Community housing Empire College Table of Contents 1 Purpose 4 1.2 Significance to Nursing 5 1.3 Theoretical Framework 6 1.4 Application of Theory 8 2.0 Literature Review 9 2.1 Research Questions 13 3. 0 Research Design 13 Conclusion 14 References 15 1.0 Introduction One of the greatest needs for individuals to recover from mental illness is the availability of secure, safe and affordable housing with appropriate support. This is very essential in ensuring that there will be a smooth transition of these patients from the care facilities to the community setting (Nelson, 2010). One of the major challenges that face individuals with mental disorders is homelessness and lack of appropriate housing making the transition and their recovery process difficult to attain (L J Drury, 2003). As a result of lack of quality and affordable housing, many people with disabilities are living in the streets, in homeless shelters or in substandard and inaccessible housing. This has made patients follow up and support difficult to attain. For others, lack of permanent housing has led them to remain in the inappropriate institutional setting i.e. Adult care facilities. There is a need for the public mental health officials to take a more active role in the creation and enhancement of housing opportunities among the mentally ill individuals. In the recent years, the housing needs have increased, housing resources have become less available, and the housing markets have tightened making it difficult to get the appropriate housing. According to Tsemberis, Joseph, Stefancic, & Lambert-Wacey (2012) being homeless or under-housed worsens the mental health problems of the individuals, worsens their mental health issues and addictions as well as strains the public health sector such as the hospital beds, residential treatment programs, emergency rooms and in some places the jails. Recovery is difficult to achieve, and it often results in a relapse of the mental illness putting a huge strain and unnecessary burden on the mental health care systems and corrections systems (Kloos & Shah, 2009). The importance of proper housing in the recovery process is clear. Lin J Drury (2003) states that lack of settled accommodation among the mentally ill patient’s results to unnecessary hospital admissions increasing the overall costs to the public pursuit. Unsuitable housing and lack of housing related support results to an escalation in the care needs potentially triggering hospital admissions. Moreover, problems of housing among the mentally ill individuals reduce the confidence of the individuals that they can live independently in the community. As a result, there is an increase in pressure for residential care or institutional care. According to statistical estimates, if the country invested in 1.6 billion dollars annually in housing support services, it would generate a net saving of 3.41 billion dollars for the public pursue. This includes $315 million in health services costs resulting from poor housing and $414 million associated with costs of crime and $95 million cost of homelessness (Hanrahan, Luchins, Savage, & Goldman, 2001). 1.1 Purpose Housing is a basic human right and shelter is a basic prerequisite for health. Having access to a home or affordable housing is an essential component of the recovery process among individuals with mental health conditions. It has become a challenge in ensuring a smooth transition from the adult care facilities to community housing due to inadequate access to housing putting a lot of strain on the care facilities. Thus, the paper seeks to identify measures and strategies for enhancing proper safe community housing access among the adult mentally ill patients. 1.2 Significance to Nursing It is important to provide support to individuals with mental illness in maintaining and securing appropriate housing. According to Novoa et al., (2014) individuals that are adequately supported and have the functional, necessary functional capacity, their transition to living in the community setting is an essential step in the attainment of recovery. For individuals suffering from mental conditions such as bipolar disorders and schizophrenia and other mental disabilities, appropriate living in the community is important to ensure that the individual returns to a healthy level of functioning. Mental health issues have been identified as key risk factors for homelessness. In the United States, it has been estimated that 55 to 75 percent of the homeless adults have some experience of mental illness. According to Dorvil, Morin, Beaulieu, & Robert (2005) individuals with mental illness are at a greater risk of homelessness due to poor support networks, uncoordinated service systems, high levels of stigmatization and social isolation within the service system and the society. Individuals with mental conditions also encounter multiple challenges in housing access, being economically disadvantaged as well as discrimination in the private rental market. Good housing is essential for good mental health. When it is placed as part of an effective mental health recovery process, housing provides the basis where individuals are able to build a more independent life and can be able to return to their normal activities such as education and work whilst still receiving support and the necessary help that they require (Shaw, 2004). It is important for the mental health care providers to work hard in hard with the housing providers to make adult care facilities to community housing transition easier as well as provide the necessary support and advice to help individuals to navigate the system appropriately. It is important for the mentally ill patients to have access to appropriate housing especially those recovering from mental health problems. Appropriate quality, safe and affordable housing underpins our mental and physical well-being (Baillargeon, Hoge, & Penn, 2010). Individuals that have mental disabilities especially those with serious mental illness find it quite difficult to maintain and secure good quality accommodation. An essential determinant for the rate of readmissions among the mentally ill patients is the type of situation that they are discharged as individuals who are discharged to low quality housing situations have a higher rate of hospital readmission. The quality of community housing is a very critical effect of the relapse rate of the patients making recovery difficult to attain (Rosenheck, 2000). Thus, by stipulating measures and interventions of enhancing appropriate access to housing among the adult mentally ill patients will provide a great benefit to the patients and health care system. 1.3 Theoretical Framework The recovery of a mentally ill patient has been considered as a journey and sometimes a lifelong journey where the mentally ill individual is expected to attain self-esteem, independence to be a meaningful community member. The recovery-focused care among in the adult care facilities has a role of working with the individuals strengths, encourage hope, coping skills, resilience and self-acceptance to enhance their physical health. The care should client centered and holistically centered in an effort to meeting the patient’s needs. A recovery transitional orientation in providing the clients services is key in ensuring that the patients receive services that meet their needs. Among the key external resources that support the recovery process of the mentally ill patients, entail the provision of social support, secure housing provision, meaningful activity, professional assistance, medication and networking of the appropriate services to enhance the quality of care provision. Adequately supported persons are the functional full capacity of transitioning to living in the community setting thus it is an essential process in attainment of recovery (Lin J Drury, 2003). Housing plays an essential role as to whether or not individuals with mental health problems make a successful transition from the health care facilities to the community and sustain a meaningful community leaving. Recovery focused health services form a central component of the mental health services to make it fit for the patients and health care providers. Within the heart of the recovery process is a set of values on the patients right of building a meaningful life for themselves without or continuing with the presence of symptoms that relate to the medical condition (Krieger & Higgins, 2002). Thus, housing providers ought to play an important role in enabling the patients to recover, maintain tenancy as well as live independently through offering support and accommodation (Trupin, Wood, & Harris, 1999). One of the great challenges facing individuals with mental disorders is homelessness and lack of appropriate housing making the transition and their recovery process difficult to attain. Because of lack of quality and affordable housing, many people with disabilities are living in the streets, in homeless shelters or in substandard and inaccessible housing. Safe, affordable and secure housing is essential in enabling individuals to work and live effectively in the community. Without a settled place of living, treatment access, follow-up access, and support, enabling genuine recovery, as well as social inclusion, can be impeded. In order to ensure a successful transition of mentally ill patients from the care facilities to the community setting, the provision of appropriate housing is pre-request. Housing provides the basis for patients to recover, receive support and return to their normal ways of life (Jacobs, 2011). Decent safe and affordable housing is one of the significant factors that affect patient’s mental health. Poor housing such as overcrowded houses can result in the poor overall health of the patient. It can make the recovery process among the mentally ill individuals or substance use problems much more difficult (Depla, de Graaf, van Busschbach, & Heeren, 2003). Good quality housing has been stipulated as a necessary underpinning of good health as well as participation in the larger society. For individuals who suffer from mental illness, having a secure and a settled place to live is essential to ensuring a smooth transition to the community that is critical to recovery. 1.4 Application of Theory Montgomery et al. (2008) conducted a research to determine factors associated with homeless among adults and young individuals. From the study results, homelessness was associated to be as a result of their own mental health issues or experience resulting from their parents. Unstable housing in childhood was related to chronic homelessness in adulthood. From the study results, it was also evident that individuals with mental illness represented a large cohort of homeless in the population. As well, the significant of mental illness amongst the homeless persons was much higher that experienced in the general population. A conclusion from the study was that individuals suffering from mental illness were at a greater risk of incarceration and therefore homelessness post-release thus, mental illness is key in influencing upon the daily lives of individuals to become homeless. Another study was conducted by Evans, Wells, Chan, & Saltzman, (2000) to determine the characteristics and most preferred housing options among adults with mental illness. The study revealed that the most preferred housing option was their own homes, followed closely by public and private housing. Other forms of housing stipulated in the study included the family home, boarding house either alone or shared as well as unsupervised home groups. The preferred housing characteristics included a location that was transport services, safe, comfortable, secure, independent and of choice, affordable and that which provided social opportunity and privacy. 2.0 Literature Review Housing is about more than a place of sleeping, but it is also tied to an individual’s physical well-being, social well-being, and mental well-being. According to Appel et al. (2012) housing should be an affordable, secure and private place that protects the individual. Good housing is essential to maintaining and rebuilding independence, confidence, as well as social networks. Individuals who suffer from mental conditions and have access to safe, secure and affordable housing are more likely to get a job, social support and have a better quality of life than the homeless and those whose housing does not meet their needs (Smith, Smith, Kearns, & Abbott, 1994). One of the biggest challenges facing individuals suffering from mental illness is the availability of housing making the transition from the adult care facilities to the community housing a difficult. Having a mental condition can make keeping and finding a home to be quite a challenging issue. For others, the effect of the mental conditions makes them lose their homes or leaves them in a precarious housing situation. It is important for individuals suffering from mental conditions to have a secure and safe place to live, as it is an essential part of the individual’s recovery process making the transition to be smooth (Amore & Howden-Chapman, 2012). This promotes the access to services that enable the mentally ill individuals to live independently as possible. In other instances Depla, Pols, et al. (2003) states that affordable housing may be available, but it is located in unsafe and hard to access areas making it difficult to provide support services and enhance follow-up of the patients. A settled home is essential for good mental health. However individuals suffering from mental conditions will far less likely be homeowners and are likely to live in unstable environments where it is difficult for support services to access (H Thomson, Petticrew, & Morrison, 2001). Safe, secure and affordable housing is one of the greatest needs that individuals with mental illness need with appropriate support to make the transition from the acute care setting to community housing a success. Being homeless or under house worsens the health situation of the individual and more so it puts a strain on the health care system as they will be forced to accommodate the individual (Shaw, 2004). More so, it is very difficult for the individual to recovery and the relapse rate of the individual is very high. This puts an unnecessary burden on the mental health care systems, addiction and corrections systems as a result of the extra treatment costs that they incur. Appropriate housing is important for good mental health especially when it is part of an effective recovery pathway. It will provide the individual sick and recovering from the mental condition a basis to build an independent life to be able to return to their normal ways of life (Evans et al., 2000). If the mental health providers and the housing providers work together in Unisom it will be easier to provide support and advice to help, the individuals navigate the system well in the transition period promoting total recovery. Availability of affordable, safe and quality housing is essential in promoting the individuals physical and mental well-being. According to a study carried out by Simpson, Hyde, & Faragher, (1989) individuals suffering from mental health conditions are more likely to live in rented houses one and a half times more with a greater uncertainty on how they will remain in their current homes. They are likely to be unhappy about their housing more twice than those without mental conditions and four times likely for their situation to be linked with poor health. In the recent times, mental illness has frequently been cited as a reason for tenancy breakdown and housing problems resulting in a relapse of the mental illness (Krieger & Higgins, 2002). It has often been considered as a reason for the individual being admitted or readmitted to the care facility. Secure and safe housing is critical in enabling individuals to work and take part in the community life. Persons, who have a settled life and a place to live, their access to treatment, support to enhance a complete recovery process is easy to achieve. During the transition period, individuals that are effectively supported and have the complete functional capacity in their system, transitioning into the community way of life becomes easy and is an important step to enhance recovery. According to Smith et al. (1994) quality community housing are important in enhancing recovery by reducing stigma. Community living is essential in helping reduction of stigma as they are less lonely, more accepted and provide a greater quality of life. A relationship also exists between the qualities of housing options among individuals with severe mental conditions, their functioning as well as the quality of life. As well, the types of situations determine a key determinant of the readmission rates among the mentally ill patients that they are discharged depending on the quality of housing situations. In this regards, the quality of housing has been determined to have a critical effect on the person relapse rate. Thus, housing interventions during the transition period have been proved more important than the psychiatric services for the individual’s ability of living well in the community (Srebnik, Livingston, Gordon, & King, 1995). Mental health issues have been identified as key risk factors for homelessness. The relationship between mental health and homelessness has been found to be reciprocal. A study that was conducted by Kendrick, Sibbald, Burns, & Freeling, (1991) found that a third of the homeless individuals were suffering from a mental illness. Homeless has also been considered as a risk factor for mental disorders such as depression. Thus, homeless exacerbate the conditions of individuals suffering from mental conditions making their conditions difficult to manage. Individuals with mental issues face a risk of becoming homeless as a result of uncoordinated care, social isolation, poor support networks as well as high levels of stigmatization that they face. To better manage the situation, more holistic, integrated and assisted approaches are essential in better managing the complex and overlapping needs of the patients with mental health issues in an effort of reducing the risk of homelessness and associated housing stress. According to Lauber, Anthony, Ajdacic-Gross, & Rössler (2004) no model of housing has a capability of meeting all the needs of people with mental illnesses. However, a three fundamental public mental health system component ought to incorporate a good housing option that includes independence, affordability and accessibility. With good planning, the components will be attained in an array of housing programs and types. Support for housing is essential to improving the health of the individuals as it helps in reducing the overall demand for social care and health services. Ensuring that the patients have a settled place to live aids in the recovery process (Hilary Thomson, Thomas, Sellstrom, & Petticrew, 2009). Treatment planning and adequate individualized care among the mental health teams have a responsibility of ensuring that the particular needs in relation to housing and accommodation are addressed at the care levels. This should be done in consultation with the carers, service users as well as the relevant agencies in the community (Appel et al., 2012). Housing associations should also be involved in designing and delivering services that enable positive health outcomes. This will be better achieved if they work in partnership with the mental health providers in an effort of providing better outcomes and pathways for the service users. There is also a role for the community health teams to provide specialist information and support for the non-statutory agencies and primary care in regard to the recovery approaches specifically in regards to the need of mainstreaming housing to enhance personal recovery among persons suffering from mental disabilities. It is important to provide opportunities for independent housing that should be provided by the appropriate authorities in regard to the service user’s needs. 2.1 Research Questions The following are the research questions to be used for the study: 1) What issues on access to housing are affecting the transition of adult care facilities to the community housing? 2) What are the health problems that the mental health patients experience due to poor housing? 3) What measures and strategies can be implemented to enhance access to safe housing among the mentally ill patients in enhancing a smooth transition? 3. 0 Research Design Quantitative descriptive cross-sectional research design will be used for the study. The method is appropriate since it aims at looking at issues affecting community housing among the mentally ill, determining the health problems associated and describing measures and interventions of enhance access to safe housing for a smooth transition. The target population used for the study is the mentally ill adult patient transitioning from the adult care facilities to community housing. Collection of information will be from secondary sources on the relevant study topic. A group of six members will be involved in the research process to ensure that the stipulated purpose is achieved. Before taking part in the study, the members will be educated on the importance of the study to facilitate a smooth process and consent of taking part in the study will be sought. The collected data will be cleaned, organized, coded and categorized after collection. The data will then be analyzed using Microsoft Office Word and Excel. Data analyzed will then be presented in the form of tables, graphs and pie charts for easier interpretation. Conclusion The main purpose of the study is to identify measures and strategies for enhancing proper safe community housing access among the adult mentally ill patients. One of the greatest needs for individuals to recover from mental illness is the availability of secure, safe and affordable housing with appropriate support that is essential for ensuring that there will be a smooth transition of patients from the care facilities to the community setting. One of the major challenges facing individuals with mental disorders is homelessness and lack of appropriate housing making the transition and their recovery process difficult to attain. References Amore, K., & Howden-Chapman, P. L. (2012). Mental health and homelessness. In International Encyclopedia of Housing and Home (pp. 268–273). doi:10.1016/B978-0-08-047163-1.00336-2 Appel, P. W., Tsemberis, S., Joseph, H., Stefancic, A., & Lambert-Wacey, D. (2012). Housing First for Severely Mentally Ill Homeless Methadone Patients. Journal of Addictive Diseases. Baillargeon, J., Hoge, S. K., & Penn, J. V. (2010). 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