Tag: disorders

Note 1- I wrote this college essay in December of 2011. All links and references may not be relevant.

Note 2- (I had misplace my original copy of my research project. Page numbers are not included in citation).

A lot of people attribute homelessness to the current economic hardships. A majority of people and families are homeless because of the decline of the job market. Homelessness is a sad reality in our current society. There are resources out there that can help homeless people like Section 8 housing or Welfare. Congress last year implemented a plan called “Opening Doors: Federal Strategic Plan to End Homelessness,” which is a 5 year plan to end homelessness (United States). Programs designed to help homelessness have significantly improved over the years, some of which have started to yield results by addressing the root causes of homelessness. However, there are still people who stay homeless despite public assistance. In a brief Q and A section in a college English class, the students listed their opinions on the topic of homelessness. Most of the students wrote theory reports about the people begging on the streets having to do with job loss; some reports were inquiring about why housing isn’t better; a few people wrote reports theorizing about the work ethic of those on the streets. Some people are not able emotionally, physically, nor mentally to handle traumatic situations in their life, such as physical or sexual abuse or schizophrenia. Research shows that there are some people who are homeless because it is a self-destructive symptom of a much deeper issue. Most homelessness is linked to a poor economy, but there are other people who are on the streets due to a myriad of mental and physical issues beyond their control. It is important to find key groups of homeless people and the issues that the homeless face which may prevent the ability to fully address homelessness.

The first type of homeless, which makes up about 20 percent of the overall homeless population, is people who are chronically homeless. People who experience chronic homelessness are usually middle aged men and they typically live on the streets or in places unfit for human habitation. Due to different federal programs and initiatives, the rate of people who are chronically homeless have declined by 28 percent since 2005. However, despite the increase in programs and initiatives, there are still 124,000 people who qualify as chronically homeless (National).

The chronically homeless suffer from different mental issues such as schizophrenia, major depression, and bipolar disorders. Mental issues are intensified by co-occurring substance abuse. At least 38% of the chronically homeless abuse alcohol, 26% abuse drugs, and an extra 30% abuse both types of substances. Because the chronically homeless have both disabling mental issues and drug abuse, they may not qualify for housing and services that will give proper care to homelessness (Rickards). Programs that provide housing and care should address substance abuse and dependency before addressing mental issues so that the disabled chronically homeless person can qualify for services.

Individuals experiencing chronic homelessness may suffer from chronic and acute medical conditions that are exasperated by living on the street. Besides the common medical issues like colds, flu, and muscle aches, there are different disorders like lung diseases, cardiovascular issues, and even sexually transmitted diseases such as AIDS/HIV. It was found that 43% of the mentally disabled homeless have co-occurring devastating medical issues [lung, heart, brain and STDs] as well (Rickards).

Paradoxes exist to those who are chronically homeless. Some may carve out an income by panhandling in locations that may “tolerate” their presence. A person who has found a safe location to panhandle may develop a sense of attachment or ownership (Farrell). By claiming stake to key locations, a panhandler has a place that remains constant. Some of the chronically homeless may receive disability checks, which could be used to buy drugs, alcohol, sex, or even gamble, then afterwards, people receiving the checks wait in anticipation for the new check (Farrell). These attachment and cycles create a sense of familiarity. Living in a state of constant upheaval, people seek a form of structure in a chaotic environment. The cycles may, at times, prove difficult to break for both the chronic homeless person and services who seek to help the needy. Panhandling or collection of welfare checks are used to fuel a habit, but the habit is a co-dependency on a negative lifestyle (Farrell). The co-dependency is similar to abused people depending on their abusers and choosing not to leave abusive situations.

The chronically homeless typically use more charitable resources than other types of homelessness. In a journal by the National Alliance to End Homelessness, a study in one shelter found that “chronically homeless people account for about 10 percent of shelter users but consumed about 50 percent of shelter resources (National).” However, studies further show that permanent supportive housing with supportive services emphasizing health, mental, and substance abuse care have proven effective in recovery of the chronically homeless and decreases resources funded by the public.

People who are homeless for over a year or have had four episodes of homelessness during 3 years is classed as chronically homeless (Rickards). There are other groups of people that fall under the umbrella of chronically homeless, highest statistically being Veterans, Juveniles, and Women.

Veterans make up 26% of the homeless population. Nearly 200,000 veterans do not have places to go. The veterans who are at most high risk for homelessness are usually those who lived in poverty are either of Hispanic or African-American heritages. Homeless veterans are usually single men who are between the ages of 31 to 50. A small number of homeless veteran are younger minority women who are not disabled. Veterans from poor areas that do not have family or friends, and do not have a homestead end up on the streets. Additionally, homeless veterans who are alone are more socially isolated than the rest of the homeless (National Center). Veterans who have disabilities may not be able to enter into the workforce and a stipend from the Government is not enough to cover the cost of rent or housing. Combat or high stress crisis can create mental issues such as Post Traumatic Stress Disorder, which disables a person’s ability to cope with past traumatic events (Appelt). Not every veteran with PTSD becomes homeless, but it is a factor that contributes to a person’s mental well-being in relation to being homeless.

Much like the chronically homeless, vets are susceptible to the same pitfalls like substance abuse and mental issues. However, homeless veterans were more likely to use shelter-based clinics or outreach programs than community clinics or other publicly supported resources (O’Toole). Because veterans are not using publically supported program, it becomes difficult to track or follow up with additional care. The other issue that separates the chronically homeless from homeless veterans is that veterans may receive help from Veterans Affairs, but VA services might not be enough to care for Veterans. In a brief report by Dr. Thomas P. O’Toole titled “Health Care of the Homeless Veterans: Why are some people failing though the safety net,” Dr. O’Toole theorized that VA services may need to expand and coordinate its efforts to maximize their effect in reducing the number of homeless vets.

Veterans face the additional issue of Post-Traumatic Stress Disorder. Post-Traumatic Stress Disorder (or PTSD) is an anxiety disorder where a psychological trauma to a person’s physical, sexual, or psychological self has exceeded their ability to cope. In an article titled “Comorbidity between Psychiatric and General Medical Disorders in Homeless Veterans,” the study pointed out that there is “a relatively large proportion of people with combat related disorders, and numerous individuals having PTSD.” The people that have co-occurring issues combined with PTSD disables the homeless veteran’s ability to function. Sometimes, veterans who had medical and mental issues often sought self-medication in the form of narcotics, although substance addiction is much higher in younger veterans than older veterans. (Appelt). Much like the chronically homeless, veterans are susceptible to the same mental and medical issues with physically traumatizing events such as brain injuries or loss of appendages; in fact, the Veteran Affairs report that many of the returning soldiers from the Iraq and Afghanistan conflicts are suffering from Post-Traumatic Stress Disorders and traumatic brain injuries. (Vogal).

Similar to veterans, another group who has the same type of issues is older inmates now released. Older prisoners who are released have to finance their own medical and mental care. This puts older prisoners at high risk for homelessness. Much like veterans, older prisoners need medical and psychiatric services for their issues. And prisoners, due to their record, may have trouble with applying for housing or even employment (Kushel). Veterans and prisoners may share the same struggles with reintegration into society, but there are more resources for vets than there are for former inmates (Kushel). Much like the chronically homeless, studies has shown that mental help and substance addiction recovery is an effective way of dealing with homeless vets and inmates.

Unlike chronically homeless adults or veterans, homeless youth’s upbringing, or “foundation,” are skewed because of the dangers and issues that come with life on the streets. It has been difficult to measure youth homelessness, but researchers estimate over 1 million to 1.6 million of the youth in America has experienced homelessness. Youth homelessness has many causes, but the underlining theme to the causes tend to revolve around social issues such as a dysfunctional family dynamic (including sexual or physical abuse), a breakdown in social services (such as foster care), and at times, social rejection. Unaccompanied youth are at higher risk for different illnesses as well as anxiety and other mental disorders. Furthermore, homeless youth are more likely to choose dangerous activities such as prostitution or drug abuse and distribution (National Alliance). Veterans may not be as much drawn to illegal activities to supplement income as would homeless juveniles.

A factor that separates homeless youth from veterans or the chronically homeless is the lack of self-sustainability. Homeless Youth haven’t had a history of living independently and may not have the skills needed for survival. Homeless youth may not have marketable legal skills and the jobs available for homeless youth that do exist may not cover necessities such as housing, food, clothing, or even health care. In many communities, resources for homeless outreach are designed for adults, but youths may not qualify for the same resources due to their age (Corliss). It becomes important for programs to understand that teaching self-sustaining skills is as important as mental and physical care for homeless youth.

Much like veterans and the chronically homeless, the homeless juveniles are susceptible to abusing drugs and alcohol to self-medicate. Homeless youth suffer from anxiety as well as anger and may seek negative methods to manage the distress they feel. Homeless youth are a higher suicide risk and tend to have trust issues in relationships (Corliss).Homeless juveniles, as studies show, stay on the streets to become homeless adults. The longer a homeless youth is on the streets, the more likely the person will develop “deep-seated social and personal realities” (Corliss).

About 20,000 to 25,000 sixteen and older youths transition from foster care to age out or qualify for legal emancipation. The young adults enter into a system with fewer resources and a limited job market. In addition, homeless youth are arrested for “status offenses” such as breaking curfew or running away. Reentry into society, at times, proves difficult without the resources like a family support system or work opportunities (Coats and McHkenzie).

Another factor that affect youth is physical or sexual abuse. In a journal article titled “Out of the Fraying Pan, Into the Fire: Trauma in the Lives of Homeless Youth Prior to and During Homelessness”, one of the major reasons for youths to become homeless is to escape physical or sexual assault. The study reported that a higher amount of young girls ran away due to sexual and physical abuse by a non-family member than a family member. However, young men who were sexually abused by a family member are more likely to run away. The study points out that young adults escaping an abusive home believe that the homeless youth felt safer on the streets than at home. However, the study reports that the physical and psychological risk and trauma exceeded that of the trauma in the home. The study theorizes that with youths escaping an abusive homestead, it “more correctly is understood as a coping strategy (Coats and McHkenzie).” Youths on the street compound their traumatic abuse issues with risk factors like poverty, further physical and sexual abuse, crime, and violence.

Domestic violence happens at many social economic levels, but studies show that the trend is more severe in women in poor areas. In a research project by Deden Rukamana titled “Gender Differences in the Residential Origins of the Homeless: Identification of Areas with High Risk of Homeless,” Dr. Rukamana researched the difference between homelessness among men and women. Women are also more likely to cite domestic issues for homelessness as oppose to men who might attribute homelessness to job loss and occurrence of mental or substance abuse issues. The study recorded a sample of 110 Atlanta women who are victims of domestic violence. 50% of the women left the home after separating from their partners. 78% of those women became homeless afterwards. The housing problem for women were not related to if they stayed or left; rather the factors for women being homeless were money, credit, job, community resource access or even the ability to get housing in their name. Women have more social contacts (and theoretically more resources) than the other types of homelessness, but women struggle with the same issues of self-sustainment similar to homeless juveniles (Rukmana).

The issues that affect homeless youth are issues that have affected women who are homeless. Homeless women are a classification on their own because of the rise of the demographic in the United States. A study featured in the Journal of Mental Health titled “The Health Circumstances of Homeless Women in the United States,” recorded that on a national level “60 percent of homeless women had minor children with 39 percent that had at least one of those children living with them.” As similar to other types of homelessness, women are prone to mental, physical, and substance abuse issues. Similar to homeless juveniles, sexual and physical abuse is a cited reason for living on the streets. Also similar to the homeless youth, domestic violence seems is a larger factor in homelessness. Assistance needed for homeless women is similar to assistance that should be provided to homeless youth. Homeless abused women need additional training to obtain job skills. If an abused, homeless woman has children, then care and resources should be provided for the kids too, including psychological care for all (Arangua).

For some women, homelessness is a downward spiral that starts at childhood. Young girls whose lifestyles included substance abuse, parental mental issues, neglect, and physical or sexual abuse may adapt those living patterns. At times, assuming the negative habits or behavior of adults can lead and sustain homelessness. Although homeless women come from dysfunctional families, many have a history of being supported by or living with family or friends. When the situation becomes unsafe or non-adaptive, homeless women will leave because the women do not want to be a burden or involve themselves in other people’s problems. However, with the circumstantial landslide to homelessness, the event is often abrupt and the women who chose a life on the streets cannot easily reverse their decision (Finfgeld). Homeless women may differ from other types of homelessness because the symptom of being homeless may come from a lifelong habit or a learned behavior.

Homeless women, due to a lifetime of abuse and neglect, have abandonment and rejection issues. Oftentimes, feelings of resentment, anger, and fear become common and may lead to a self-destructive behavior [3]. Much like other groups of homelessness, homeless women are susceptible to the dangers of drug and alcohol abuse. Like most groups of homeless people, women have the same issues with mental and physical health. However, in women, a form of false self-confidence or independence is a type of a coping mechanism to deal with life on the streets. “They may deny their homelessness, reject help, and be extremely self-reliant and highly vigilant (Finfgeld).” At times, women would continue this sense of hyper vigilance about people and places they believe “dangerous.” Unfortunately, these behaviors might be perceived as characteristic paranoia or schizophrenia, but more often than not, the sense of hyper vigilance is because of a counterproductive defense mechanism developed for street survival.

Homelessness is one of many serious issues in America. 3.5 million Adults and children experience homelessness every year. On the surface, homeless people are stereotyped as drug addicts or drunks who were lazy and irresponsible in their lives, but people on the street abusing drugs or alcohol may be using because of other issues outside their control. Some homeless have deeper issues which contributed to their inability to take care of themselves. It is important to become educated about the real issues of homelessness because people can make better choices in their decisions about welfare and social programs. Furthermore, by understanding why some people stay homeless, we can develop better outreach programs to reduce and one-day end homelessness in America. By serving the needs of our fellow American citizens and creating self-sufficient, productive members of society, we as a country will be in a better place to serve the needs of the rest of the world.

Reference

Appelt, Cathleen, et al. “Comorbidity between Psychiatric and General Medical Disorders in Homeless Veterans.” Psychiatric Quarterly 80.4 (2009): 199–212. Academic Search Premier. Web. 20 Nov. 2011.

Arangua, Lisa, Ronald Andersen, and Lillian Gelberg. “The Health Circumstances of Homeless Women in the United States.” International Journal 0f Mental Health 34.2 (2005): 62–92. Academic Search Premier. Web. 20 Nov. 2011.

Coats, John, and Sue McKenzie-Mohr. “Out Of The Frying Pan, Into The Fire: Trauma in the Lives of Homeless Youth Prior To and During Homelessness.” Journal of Sociology & Social Welfare 37.4 (2010): 65–96. Academic Search Premier. Web. 20 Nov. 2011.

Corliss, Heather. et al, “High Burden of Homelessness Among Sexual-Minority Adolescents: Findings From a Representative Massachusetts High School Sample.” American Journal of Public Health 101.9 (2011): 1683–1689.

Farrell, Daniel C. “The Paradox Of Chronic Homelessness: The Conscious Desire To Leave Homelessness And The Unconscious Familiarity Of The Street Life.” Journal of Human Behavior in the Social Environment 20.2 (2010): 239–254. Academic Search Premier. Web. 20 Nov. 2011.

Finfgeld-Connett, Deborah. “Becoming Homeless, Being Homeless, And Resolving Homelessness Among Women.” Issues In Mental Health Nursing 31.7 (2010): 461–469. Academic Search Premier. Web. 8 Nov. 2011.

Kushel, Margot, et al. “Coming Home: Health Status and Homelessness Risk Of Older Pre-Release Prisoners.” JGIM: Journal of General Internal Medicine 25.10 (2010): 1038–1044. Academic Search Premier. Web. 20 Nov. 2011.

National Alliance to End Homelessness. “Chronic Homelessness.” Chronic Homeless Brief. National Alliance to End Homelessness , March 2010. Web. 20 November 2011 http://www.endhomelessness.org/content/article/detail/1623

National Alliance to End Homelessness. “Fundamental Issues to Prevent and End Youth Homelessness.” Youth Homelessness Series. National Alliance to End Homelessness, May 2006. Web. 20 November. http://www.endhomelessness.org/content/article/detail/1058

O’Toole, Thomas P., et al. “BRIEF REPORTS Health Care Of Homeless Veterans Why Are Some Individuals Falling Through the Safety Net?” JGIM: Journal of General Internal Medicine 18.11 (2003): 929–933. Academic Search Premier. Web. 20 Nov. 2011

Rickards, L, McGraw, S, Araki, L, Casey, R, High, C, Hombs, M, & Raysor, R, ‘Collaborative Initiative to Help End Chronic Homelessness: Introduction’, Journal Of Behavioral Health Services & Research, 37. 2 (2010)149–166, Academic Search Premier, Web. 20 November 2011.

Rukmana, Deden. “Gender Differences in the Residential Origins of the Homeless: Identification of Areas with High Risk of Homelessness.” Planning Practice & Research 25.1 (2010): 95–116. Academic Search Premier. Web. 8 Nov. 2011.

The National Center on Homelessness Among Veterans. “Veteran Homelessness: A Supplemental Report to the 2009 Annual Homeless Assessment Report to Congress” (2009).

United States Interagency Council on Homelessness. “Opening Doors: Federal Strategic Plan to Prevent and End homelessness. (2010).

Vogal, Steve. “Face of homelessness is often vet’s.” Seattle Times. The Seattle Times. 9 Nov. 2007. Web. 2o November 2011. http://seattletimes.nwsource.com/html/nationworld/2004003475_homeless09.html