The Growing Number of Homeless People - Research Paper Example

? Homelessness within the Veteran Population Homeless people are increasing steadily over the past years, and along with this increase is also the increase of homeless veterans. It is very disconcerting to know that instead of leading productive lives after going home from the war, these veterans instead succumb to numerous mental and physical illnesses, rendering them unable to work or even keep house. In order to treat former military personnel as well as to prevent the increase of homeless veterans, many programs must be conducted in order for them to be able to reintegrate back into society, get past most of the trauma they have experienced in the battlefield, as well as to get medical help and be given homes to come home to. Homelessness within the Veteran Population The ushering of a new millennium saw the rise of numerous homeless people in the country today. Among these homeless people are actual war veterans who have served in the armed forces, who were eventually never able to reintegrate into the society. Around 25%-46% of the homeless people’s population composed of war veterans (Gamache, Rosenheck, & Tessler, 2002, and O'Toole, Conde-Martel, Gibbon, Hanusa, & Fine, 2003). Due to the migrative nature of military services, aside from not being able to establish a hometown most of these veterans may not have been able to keep in touch with their families, making them feel isolated and not wanting to settle down (Gamache, et al., 2002). Being in the military service not only lessens the ties of some soldiers to their families, but also their ties to society also get affected. The stressful nature of being in service could cause changes in how army people would be getting along with the rest of the general public, and in addition to that are the post-traumatic stress disorders (PTSD) that they may have suffered while in the battle field and long after they have been discharged. People who were able to serve under military service under non-combat jobs such as clerical and medic work can attest to the number of soldiers that were being drafted as well as to their concerns and other needs. By being also aware of the possible effects of the war on military personnel, understanding with regards as to what they went through would be of much help, especially for legislators and other government servants (Liang & Boyd, 2010). Most of the people included in the population of homeless veterans were men, while the rest of the members of the population were females. Majority of them were white Caucasians, and the rest were from different ethnical races and backgrounds (Stack, Cortina, Samples, Zapata, & Arcand, 2000). Due to the higher prevalence of PTSD among former army personnel, most of them would complain numerous symptoms such as sleep disturbances, joint pains, headaches, and other chronic fatigue symptoms, which could greatly affect their overall wellbeing (Kang, Natelson, Mahan, Lee, & Murphy, 2003). PTSD was also linked to lower ratings of overall health, increase in absenteeism, higher rates of sick call visits, and stronger symptom severity (Hoge, Terhakopian, Castro, Messer, & Engel, 2007). The problems associated with PTSD do not just stop on their physical symptoms, but also extend to their psyche. Psychotic disorders, substance abuse, anxiety disorders, suicidal attempts and sexual abuse are also reported to be associated with trauma experienced during military service, and if not treated properly could affect the person throughout his or her lifetime (Tiet, Finney, & Moos, 2006). Although the Department of Veterans’ Affairs (VA) offers services that could help soldiers and veterans to be able to integrate into society again, there are numerous requirements to be fulfilled in order to obtain any form of psychiatric treatment (Liang & Boyd, 2010). In the long run, many veterans just choose not to get any form of treatment, and in the long run suffer numerous physical and psychiatric illnesses due to benefit and pension accessibility problems, thus failing to get their needed care (Himmelstein, Lasser, McCormick, Bor, Boyd, & Woolhander, 2007). It is alarming to know that wars could cause so much distress to so many people that many of them have reduced social and physical capacities. Still, it is also good to know that some former military personnel also enjoy their lives after serving their duties. Many of them even have success in their jobs and families, which is also because of the pro-marriage and pro-family policies and benefits in the military (Usdansky, London, & Wilmoth, 2009). For those who did not have the chance to get treatment however, the long-term effects of not receiving any form of psychiatric debriefing or treatment of many veterans, this eroded their capacity to remain as social beings, and this process makes them detached and isolated, making them unfit for keeping jobs, families, and even homes (Kasparow & Rosenheck, 2007). Thus, it can be attributed to mental instability as well as financial problems the cause of homelessness in many of the war veterans. Being a veteran has many benefits that can be availed as part of the payment for the valor, patriotism, and bravery in the line of duty. In order to repay the efforts of veterans during the wars that they have served under, the VA was conceptualized and created to fulfill the veterans’ needs, especially after being discharged or during old age. The Department of Veterans Affairs or VA is a large segment of the government that is capable of offering many services to veterans and their corresponding dependents. They are also able to provide medical assistance as necessary by establishing hospitals that cater to veterans and their direct dependents (Department of Veterans Affairs, 2007). Among the programs or services supported and funded through the VA includes but may be limited to: employment assistance, supported permanent housing, case management, rehabilitation, shelter for veterans who may not seek help, referral for medical treatment for physical and psychiatric disorders to include substance abuse (Department of Veterans Affairs, 2007). However, in spite of the large amounts of funding for the VA to operate, it is still criticized due to numerous veterans who were unable to reap their benefits. Comparisons between VA-care and non-VA care were conducted and inefficiencies to the VA systems were exposed (Agha, Lofgren, VanRuiswyk, & Layde, 2000). Records show that VA patient populations have poorer health status, more medical conditions, and use up much more medical resources compared to the general population (Agha et al., 2000). Despite taking into account of the educational attainment, status of employment, and financial income of the VA patients, their health conditions were still significantly lower as compared to non-VA patients. Conditions of Most Homeless Veterans Most of the homeless veterans that were able to get in contact with outreach programs were reported to have several health and psychiatric conditions in common: unemployed; suffering from some form of psychiatric disorder; and being under substance abuse (McGuire, Rosenheck, & Kasparow, 2003). Veterans who did not have any permanent residence or were staying with either family or friends were also considered homeless. There is also a higher mortality risk among homeless veterans in comparison to the general populace, which can also be attributed to poor health conditions, prior hospitalizations due to alcohol or any other substance dependence, as well as untreated psychiatric disorders (Kasparow & Rosenheck, 2000). Substance abuse is most often associated with psychiatric disorders, and due to the stressful nature of the former jobs of veterans, they could develop substance abuse as a means of coping with their anxieties during their services (Benda, 2004). This could alleviate traumatic disorders, and even more so after serving the army. Another thing is that veterans are more likely than non-veterans to attempt suicide especially when things are getting harder for them to handle. Since the mental balance of these veterans could also dictate their tendencies to either commit suicide or have aggression bouts, their psyche must also be discerned as early as possible to prevent mortality or morbidity (Tiet, Finney, & Moos, 2006). Former military personnel may also be sufferers of childhood trauma, or have prior anxiety disorders or family problems which made them choose to voluntarily serve in the military, and this in turn added up to their future mental instability upon discharge from service (Gamache, Rosenheck, & Tessler, 2002). With regards to physical wellbeing, it was shown through research that although the elderly patients are more likely to finish their medical treatments compared to young patients, the presence of an underlying psychiatric problem becomes a major hindrance to treatment (Stack et al., 2000). Because homeless veterans were less likely to undergo hospitalization due to physical, financial and mental instabilities, most of them would remain untreated for any underlying symptoms. It is therefore not surprising that when being asked about their overall health, most would answer that their health is very poor, or fair (Nyamathi, et al., 2004). The presence of chronic health problems most often remove the capacity of homeless veterans to become mobile, which in turn could cause their deaths. Coupling problems such as physical and mental instability with the lack of debriefing and proper programs to help cope veterans in living with ordinary people again, instead of seeking help in hospitals, these veterans would rather isolate themselves, to the point of running away from shelters or places where they usually stay, becoming homeless in the process. Still another problem for veterans would be the denial of their benefits overall, especially those who were disabled. Due to the denial of basic needs, homeless people, veteran or otherwise would result to mortality. Mentally-ill patients would be more liable to abuse substances even more upon non-receipt of their benefits (Rosenheck, Dausey, Frisman, & Kasparow, 2000). Overall mortality of homeless veterans can be attributed to poor physical and mental health as well as the presence of substance abuse. Thus is the importance of proper implementation of hospitalization programs as well as other psychiatric services of the VA for the overall return of the physical and mental wellbeing of former military personnel (Liang & Boyd, 2010). Impact of Other Factors Several other factors may affect homeless veterans in terms of getting services from VA, as well as maintaining their physical and mental health in order to keep their homes. One is the problem of getting their proper medical treatment. Due to numerous requirements in order to even get entertained, most veterans would just let themselves suffer in the streets instead of doing numerous follow-ups (Liang & Boyd, 2010). Not only it is a tiresome activity, but it would also drain them of the few dollars that they have. Also, due to the mental condition of veterans, it would be very hard for them to be able to process requirements on their own, and this would even be a harder problem for those who not only have no homes, but no families as well. Another factor that could affect the veterans’ capacity to get better health and social services would be their culture and ethnicity (Washington, Villa, Brown, Damron-Rodriguez, & Harada, 2005). While white Caucasian veterans were most likely to get ambulatory and inpatient hospital care, colored races have lower rates of getting medical service in a year. Due to the differences in the healthcare services of different people, some patients would rather not go to hospitals due to them expecting to be rejected or even be discriminated against. Although VA is committed to deliver good healthcare services to all its members, many of its colored members are not able to get proper medical treatment due to them either not having health insurance but also having feelings of being discriminated against in hospitals. In order for veteran patients that have a minority background to get proper treatment, they would have to go on the laborious method of finding hospitals that would give them proper services. Also, most patients would not go seek treatment after having negative or unsatisfactory services in hospitals (Washington, et al., 2005). The socio-economic status of the veteran could also affect them in such a way that aside from their problems with mental instability, the lack of resources to be able to fulfill basic human needs could drive them into homelessness. These people that were most likely to become homeless were mostly of low-income backgrounds, have low-levels of educational attainment, and were unemployed (Agha, et al., 2000). Since these veterans are in dire need of many things, it would be even harder for them to attain them because one way or another, they would need presence of mind in dealing with their everyday needs, and by having problems with their mental and physical health they might not be able to do so. The last factor that affect homeless veterans overall would be their gender status. Even while during in active service, women are not very much well-represented due to not having that many numbers as compared to men, thus they are also misrepresented during surveys of homeless people and homeless veterans (Gamache, Rosenheck, & Tessler, 2002). Aside from the presence of mental stress as well as other possible physical debilitations, women are equally subjected to financial problems are much as the men are, and are equally susceptible to problems such as PTSD and depression. As compared to non-veterans, they are more likely to become homeless not only due to lack of support from their families, but also due to them not starting to have a family before they were deployed to service. Also, while it is presumed that female veterans are equally eligible for benefits as much as the men are, they are not able to gain any because most programs are made historically made for the benefits of men serving in the army. Programs Available for Veterans Many programs are currently available for veterans in the country, and can be availed by either the homeless or non-homeless. It is mandatory for the military to provide services for their former soldiers that would enable them to be prepared, find, and keep proper jobs, making them live as independently as possible. This is also applicable to those who became disabled due to their duties. In order to be able to live in normal society again, former military personnel undergo many psychiatric procedures, counseling, as well as follow-ups so that they may be able to function well in terms of socialization with civilians. Included in the list are livelihood programs, disability compensations, pensions, vocational rehabilitation and employment, educational assistance for dependents, public health assistance, refill prescriptions, mental health recuperation, burial services, among others (Department of Veterans Affairs, 2012). Other hospitals and mental health facilities collaborate with VA in order to accommodate most of their patients who need both physical and psychiatric treatment (Kasparow & Rosenheck, 2007). An example would be the implementation of critical time intervention for former homeless veterans that were under inpatient care in the VA and are assessed to be ready to start living outside. This project was done in several states, and the success rates were recorded (Kasparow & Rosenheck, 2007). By sustaining the program for the veteran patients, this would help in their reintegration and return to society as it would be a proper follow-up for their mental state. Another effective program for homeless veterans would be the undertaking of vocational rehabilitation. Veterans were given compensated work therapy in order to gain skills that can be of use once they are ready to leave the facility. (Drebing, et al., 2005). By adding incentives such as cash to the program, patients were more likely to remain. Also, the incentives were effective in keeping the patients away from drugs and alcohol, and in the long run were able to find competitive employment, earning up to 68% higher wages than those who were not given such treatment. Veterans who were able to participate in such programs were able to create goals, have potential to return to supported employment, and were able to become proactive in their road to better health (Drebing, et al., 2005). The enhanced incentives also made the successful transition of veteran patients from being inside healthcare facilities to their living in the outside world. Not only was the treatment successful in reclaiming their mental balance but also their capacity to properly work alongside normal people. Another program that is available to homeless veterans is simply the rehabilitation for substance abuse. Due to the possible dual nature of the mental instability of former veterans such as the combination of substance abuse and post-traumatic stress disorder (PTSD), it is possible that a different approach would be given to them as treatment method. (Benda, 2004). By undergoing life transformations, as well as facing past traumas and accepting them as a part of themselves while at the same time letting them go, participants were able to experience a decrease in aggression, readmission of their substance abuse, enhanced ego identity, reduced depression and an overall positive spiritual well-being (Benda, 2004). The transformations of the experiences of both male and female veterans such as sexual harassment, childhood abuse, combat exposure, aggression and depression were due to the formation of new and positive identities, as well as the changes associated with their behavioral patterns. The participants were able to form new and meaningful relationships, improve their self-efficacy during work, satisfaction due to work, as well as setting up positive and attainable personal goals. However, the program has a high success rate when female veterans are treated separately from the male veterans, as unwanted comments or advances may happen should there be a mix of both genders during treatment. Conclusions and Recommendations Indeed, there are numerous ways by which the VA could help their former staff to become fully acquainted again with the ordinary way of life. However, it seems that the VA was not able to cater to the needs of their veterans due to the large number of veterans that are currently being counted as homeless people. As much as 46% of the total members of the population of the reported homeless people are actual war veterans, and of this 46% roughly less than 10% are females, which make them rather underrepresented. Most of these homeless patriots were under severe stress, which renders them incapable of keep stable jobs, families, or even simply keeping their own home. There are several factors that could affect homelessness as well as the lack of medical attention to most homeless veterans. Being mentally unstable, suffering from PTSD and other anxiety disorders as well as the presence of substance abuse could make them incapable of holding jobs, among others. Other factors such as their economic background, culture and ethnicity could also greatly affect their affinity for homelessness. Due to the number of trauma that they have received in the battlefield, as well as the depression that they acquired during in service, these former military servants must be eligible of rehabilitation, counseling and vocational programs for them to be able to regain their mental balance, which in turn could help them cope in living in the civilian world once more. By undergoing several psychiatric methods of healing, substance abuse rehabilitations, as well as having counseling sessions and incentive-associated vocational trainings, former homeless veterans can have the chance of regaining their normal way of living. By being physically and mentally fit, they could once again serve the country and become part of the strong human resource, as much as they were when they were still in service. The utmost support of the VA and its affiliate hospitals, legislators as well as the government itself would be a big help in keeping veterans at their best shape in the years to come. References Agha, Z., Lofgren, R., VanRuiswyk, J., & Layde, P. (2000). Are patients at veterans affairs medical centers sicker? a comparative analysis of health status and medical resource use. Archives of Internal Medicine , 160 (21): 3252-3257. Benda, B. (2004). Life-course theory of readmission of substance abusers among homeless veterans. 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