Clinical and Medical Social Work Commons^™

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Drivers Of Being Unhoused And The Prevalence Of Health Conditions Among Unhoused Individuals In Asheville, Nc, Andrea K. Yontz, Amber Beane, Tessa Frank, Amy Upham, Dustin V. Patil, Dan Pizzo, Steve Buie, Jacqueline R. Halladay

HCA Healthcare Journal of Medicine

Background

During the COVID-19 pandemic, there was an increase in the number of unhoused individuals in Asheville, North Carolina resulting in more tent encampments.

Understanding the physical, mental, and socially determined health characteristics associated with being unhoused can help guide stakeholders with policy development, healthcare program planning, and funding decisions to support unhoused individuals.

Methods

In this study, we used an observational cross-section methodology. Using a convenience sample approach, we interviewed 101 participants who were receiving services from 2 emergency hotel shelters, a day center, and a resource center. Data were analyzed using descriptive statistics, and open-ended responses were collected …

Salud Integral De Las Personas En Situación De Calle Abordada Desde Los Distintos Programas Sociales De La Ciudad De Arica, Chile, Maya Trujillo

Independent Study Project (ISP) Collection

Homelessness as a public health phenomenon is a humanitarian crisis present across nations around the world. Instances of homelessness are rooted in public social and economic failures. Complex challenges like this require multifaceted and holistic initiatives such as those proposed by the Integrative Family Health Model in Chile. This project describes current interdisciplinary programs (social services) and how they collaborate to provide integrated services to people experiencing homelessness. We also consider the patient perspective on how these interventions affect their well-being. Through observational data, interviews, and surveys, we describe the physical, social, and cultural aspects of homelessness in Arica, Chile …

Design Guidelines For Homeless Shelter And Resource Center Site Plans, Samuel Johnson

All Graduate Reports and Creative Projects, Fall 2023 to Present

Homelessness is one of the most pressing humanitarian issues facing the country today. Lack of affordable housing, among many other complicating factors, have led to many cities scrambling to find both short-, middle-, and long-term solutions to the issue. The Covid-19 pandemic added a disruption in services, critical record-keeping, and data-gathering, which has further confounded experts looking for an effective path forward. As it stands, there is a significant gap in academic research addressing best practices for shelter site design, particularly as it relates to landscape. The role of landscape and greenspace within and around a shelter is not well …

The Role Of Social Work In Health Care For Veterans In The United States Of America (Praca Socjalna W Lecznictwie Weteranów Służby Wojskowej W Usa), Jaroslaw Richard Romaniuk

Faculty Scholarship

Clinical social work in the American system of health care and its specific features in the Veterans Affairs (VA) of veterans are described in this paper. VA hospitals are the largest employers of social work worldwide. Because health care for veterans is paid for from government funds, VA hospitals are subject to regulations developed on the basis of research into the system’s effectiveness and efficiency. Clinical social workers cooperate with physicians and nurses to comprise an integral part of the health care team. Social workers fulfill the usual tasks related to social well‑being but also act as health educators and …

Changes In Hospital Utilization By Individuals Experiencing Homelessness After Engaging With Interdisciplinary, Low-Barrier Healthcare Services In Portland, Maine, Sarah Hemphill Ba, Adam Normandin Md, Ms, Debra Rothenberg Md, Phd

Journal of Maine Medical Center

Introduction: The Maine Medical Center Preble Street Learning Collaborative (PSLC) aims to couple medical education with addressing the unmet healthcare needs of those experiencing homelessness in Portland, Maine. The PSLC provides low-barrier medical, psychiatric, dental, and case management services to all-comers and is co-located near many of the city’s social services. The purpose of this study was to evaluate the impact of the PSLC in its first 19 months by describing demographic characteristics and patterns in hospital utilization of patients served by the PSLC.

Methods: We performed a retrospective chart review of 888 patients with one or more …

Out Of The Frying Pan, Into The Fire: Trauma In The Lives Of Homeless Youth Prior To And During Homelessness, John Coates, Sue Mckenzie-Mohr

The Journal of Sociology & Social Welfare

Anecdotal evidence from those who work with homeless youth indicates that trauma permeates these young people's lives. This paper presents the findings from a study of 100 homeless youth regarding the presence of trauma in their lives, both before and during homelessness. Participants living in the Maritime Provinces volunteered to take part in a semi-structured interview lasting one to two hours. The interview questionnaire was conducted by a trained interviewer, and was composed of standardized and adapted survey instruments, as well as questions regarding demographics, experiences prior to becoming homeless, assistance received while dealing with stressors, and current needs. The …

Housing For People With Serious Mental Illness: Approaches, Evidence, And Transformative Change, Geoffrey Nelson

The Journal of Sociology & Social Welfare

The evolution of housing approaches for people with serious mental illness is described and analyzed. A distinction is made between three different approaches to housing: (a) custodial, (b) supportive, and (c) supported. Research evidence is reviewed that suggests the promise of supported housing, but more research is needed that compares supported housing with different supportive housing approaches. It is argued that the current move to a supported housing approach represents a fundamental shift or transformative change in mental health policy and practice. Strategies to facilitate this shift are discussed.

Influences On Job Retention Among Homeless Persons With Substance Abuse Or Psychiatric Disabilities, Russell K. Schutt, Norman C. Hursh

The Journal of Sociology & Social Welfare

Job retention is an important psychosocial rehabilitation goal, but one that is not often achieved. We investigate facilitators of and barriers to employment retention among homeless individuals with psychiatric and substance abuse diagnoses who were re-interviewed eight or more years after participating in a traditional vocational rehabilitation program. Most program graduates who maintained employment had secured social support from a variety of sources; personal motivation was also a critical element in job retention and compensated in some cases for an absence of social support. Both the availability of social support contacts and personal motivation influenced likelihood of maintaining sobriety. Physical …