Psychiatric and Mental Health Commons^™

The Impact Of The Deinstitutionalization Policies On Homelessness, Henrique Krigner

Helm's School of Government Conference - 2021-2024

Homelessness is a growing issue in America. In 2019 there were 567,715 homeless individuals in the United States, distributed in emergency shelters (63%) or residing unsheltered on streets (27%). In 2021, even though specialists argue that the Covid-19 restrictions greatly harmed an accurate counting, the total number of unsheltered homeless in America increased in 20%. Such increase became a central discussion not only to regular citizens and neighborhood associations, but it also became a great concern within the federal government which has been appropriating billions of dollars each year to “end homeless”.

Specialists point out that the growth of the …

Challenges In Discharge Planning For Adults Transitioning From An Inpatient Psychiatric Level Of Care Experiencing Homelessness, Deanna` R. Mccaskill

Walden Dissertations and Doctoral Studies

Mental illness and the homeless population are a growing concern in the United States. Homeless individuals utilize emergency rooms and acute inpatient stays more than those with housing. Social workers play a vital role in discharge planning, starting on the first day of admission. This action research study explored the challenges of social workers developing discharge plans for adults transitioning from an inpatient psychiatric level of care experiencing homeless. The theoretical framework implemented in this study was systems theory. Data were collected from 12 purposively selected master’s level social workers in the format of individual and focus group interviews. Eight …

Challenges In Discharge Planning For Adults Transitioning From An Inpatient Psychiatric Level Of Care Experiencing Homelessness, Deanna` R. Mccaskill

Walden Dissertations and Doctoral Studies

Mental illness and the homeless population are a growing concern in the United States. Homeless individuals utilize emergency rooms and acute inpatient stays more than those with housing. Social workers play a vital role in discharge planning, starting on the first day of admission. This action research study explored the challenges of social workers developing discharge plans for adults transitioning from an inpatient psychiatric level of care experiencing homeless. The theoretical framework implemented in this study was systems theory. Data were collected from 12 purposively selected master’s level social workers in the format of individual and focus group interviews. Eight …

Through The Cracks: The Disposition Of Patients With Schizophrenia Spectrum Disorders In The Post-Asylum Era, Briana Tillman, Erin Smith, Alicia Cho, Colt Kennington, Alexandra Kreis

HCA Healthcare Journal of Medicine

This paper aims to explore current disposition options for patients with psychosis in light of shifts toward community care and changes in mental healthcare funding in the post-asylum era and to propose systemic-level improvements based upon local successes. It evaluates critiques of long-term psychiatric care programs, claims of transinstitutionalization to incarceration, shelters, and emergency rooms, and programs initiated to address deinstitutionalization. The authors conclude that while Assertive Community Treatment, Partial Hospitalization Programs, intermediate-level care, and housing interventions can improve outcomes for many persons with psychotic illness, a significant portion of these patients would still be best served in long-term psychiatric …

Generational Homelessness In New York City Family Homeless Shelters, Deborah Johnson

Walden Dissertations and Doctoral Studies

Homelessness has been a problem in New York City (NYC) for decades. Part of the problem is children who grew up in the shelter system and then returned as adults, a phenomenon known as 2nd-generation homelessness. Literature indicates that no researchers have interviewed second-generation homeless adults about their experiences. The purpose of this study was to explore the experience of 2nd-generation homelessness from the perspective of homeless adults returning to the shelter system. The sample included 1 second-generation homeless adult and 10 case managers at Tier II homeless shelters. Interviews were conducted and data were analyzed using hand coding to …

The Perennial Purple Heart, Anonymous

SURGE

Let’s talk about Veterans’ sacrifices. I must admit that I didn’t know much myself about veterans until one of my siblings entered the Navy. I’m very proud of his service, sacrifice, and dedication to protecting the United States. It’s probably not a common thought to all of us, but I think often of what it is like to be away during wartime serving our country. Military folks sacrifice a ton – whether it be lower pay, moving around a lot, being away from family for a long time, going into risky military operations, etc. These men and women sacrifice comparatively …

Mentally Ill Persons In Emergency And Specialized Shelters: Satisfaction And Distress, Russell K. Schutt, Stephen M. Goldfinger

Russell K. Schutt

Emergency and specialized mental health shelters represent different service philosophies and are meant to appeal to different segments of the homeless and homeless mentally ill population. This article describes the different characteristics and needs of users of emergency and specialized mental health shelters for homeless persons in Boston. Service satisfaction is described in relation to these characteristics and needs as well as in terms of shelter type. Implications are identified for social and mental health service policies for the homeless.

Research Brief: "Impact Of The Seeking Safety Program On Clinical Outcomes Among Homeless Female Veterans With Psychiatric Disorders", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the effect of the Seeking Safety program's services on improvement in PTSD, psychiatric symptoms, and social support among homeless female veterans. In policy and practice, clinicians should be trained on how to use the program to better serve homeless female veterans, and policymakers should push for clinician training for those who work with homeless veterans. Suggestions for future research include applying this study and the Seeking Safety program to non-VA healthcare systems, assessing substance use within the program, and assessing the long-term effects of the Seeking Safety program.

Gender And Empowerment In Supported Housing : A Consumer-Oriented Empowerment Model For Adults With Psychiatric Disabilities And Histories Of Homelessness, Eleanor M. Jaffee

Legacy Theses & Dissertations (2009 - 2024)

Using data from an evaluation of a supported housing program for adults with psychiatric disabilities and histories of homelessness (n = 59), the relationships of gender and the presence of children with subjective measures of mental health, personal mastery, personal empowerment, social support, and quality of life were explored, and the results informed the development of a revised consumer-oriented empowerment model. Key findings include a significant relationship between gender and personal mastery and empowerment with women scoring significantly lower than men on measures of this construct, and the role of personal mastery and empowerment as a mediator between psychiatric symptoms …

Shelter Program For Homeless Males With Substance Use And Mental Illness: A Strength And Effectiveness Based Approach, Kotatee Tamba

All Graduate Theses, Dissertations, and Other Capstone Projects

Homelessness represents one of the United States most pressing and complex problems. Approximately, nine percent of the nation’s homeless are considered to be rural. Locally, homelessness in Steele County continues to be a problem. A one night survey of homeless individuals in southeastern Minnesota revealed that there are 217 people experiencing homelessness on any given night. Homeless males have been found to be at greater risk of becoming homeless and tend to remain homeless for longer periods of time. The high risks associated with substance use, lack of adequate shelters and limited access to health care services in rural communities …

Housing With Support Marketing Study Tool, Gary M. Travis

All Graduate Theses, Dissertations, and Other Capstone Projects

Housing for persons with serious mental illness (SMI) that is permanent, affordable, and supportive is very limited because the availability of these resources is inadequate and subject to significant demand by persons that are disabled or on a limited income. The limited access to housing for persons with SMI is contributing to homelessness and Minnesota has seen a steady rise since 1994 in the rate and number of people that are homeless and coping with mental illness (Wilder Research, 2010a). While some of the impact of disability, homelessness, and limited affordable housing access is known, what remains uncertain is a …

Mentally Ill Persons In Emergency And Specialized Shelters: Satisfaction And Distress, Russell K. Schutt, Stephen M. Goldfinger

New England Journal of Public Policy

Emergency and specialized mental health shelters represent different service philosophies and are meant to appeal to different segments of the homeless and homeless mentally ill population. This article describes the different characteristics and needs of users of emergency and specialized mental health shelters for homeless persons in Boston. Service satisfaction is described in relation to these characteristics and needs as well as in terms of shelter type. Implications are identified for social and mental health service policies for the homeless.

Aggressive Outreach To Homeless Mentally Ill People, Ellen Nasper, Melissa Curry, Elizabeth Omara-Otunnu

New England Journal of Public Policy

Historically, people with chronic mental illnesses have been particularly at risk for homelessness. In 1984, the Connecticut Department of Mental Health (DMH) articulated policy to insure housing for mentally ill persons. One facet of that policy is to increase mental health services to homeless people. The Greater Bridgeport Community Mental Health Center has addressed this need through the formation of the Homeless Outreach Team (HOT). This article describes the development, organization, clinical work, and future of HOT. The team is run jointly by the Mental Health Center (funded through DMH) and Family Service-Woodfield, a United Way-funded agency that provides case …

The Needs Of Hartford's Homeless Mentally Ill, Steven Kessler

New England Journal of Public Policy

A state budget deficit in Connecticut threatens the closing of state mental hospitals and holds the potential of displacing chronically mentally ill patients into homelessness. This article explores the historical association between deinstitutionalization of patients from mental hospitals and subsequent homelessness. One third to two thirds of homeless individuals are mentally ill and require intensive, specific, and targeted responses by the community to end their homelessness. Trends in the care of the chronically mentally ill and the conditions of those who are homeless in Connecticut are explored. Model treatment programs are discussed to suggest possible actions, and recommendations that would …

The Kindred Bonds Of Mentally Ill Homeless Persons, Richard C. Tessler, Gail M. Gamache, Peter H. Rossi, Anthony F. Lehman, Howard H. Goldman

New England Journal of Public Policy

While the unraveling of the kinship bond has long been suspected to play a role in the epidemiology of homelessness, the connection between kinship and homelessness has been little studied. Based on a normative analysis of the role of family structure in response to adversity, this article explores the impact of the amount and quality of kinship ties on episodes of homelessness experienced by discharged psychiatric patients in Ohio. Survey data derived from personal interviews with both former patients and their kin indicate more strain in relations with kin of the homeless than the nonhomeless. The strain in the kinship …

Housing, Community Support, And Homelessness: Emerging Policy In Mental Health Systems, Paul J. Carling

New England Journal of Public Policy

This article summarizes the dramatic changes in public policy through which public mental health systems are attempting to meet the housing and community support needs of persons with severe and persistent mental illnesses, including those who are homeless. It traces the historical approach to meeting these needs through defining people principally as patients and providing some combination of psychotropic medications, outpatient therapy, and structured, supervised quasi-institutional settings such as group homes, shelters, and segregated single-room-occupancy, or board-and-care facilities. A transition phase in public policy has emphasized defining these individuals essentially as service recipients who need greater or lesser amounts of …

Victimization And Homelessness: Cause And Effect, Pamela J. Fischer

New England Journal of Public Policy

The literature on the contemporary homeless population is reviewed to examine the association of victimization with homelessness. Although few studies have specifically focused on victimization, findings derived from studies investigating pathways to homelessness, prevalence of health, mental health, and substance-use disorders, and demographic profiles and life histories suggest that victimization both causes homelessness and is an outcome of losing housing. Causal sequences ending in homelessness most frequently involve domestic violence, which mainly affects women, although other types of abuse may extrude individuals from their established housing. Once they become homeless, the risk of violence escalates for people living on the …

The New England Shelter For Homeless Veterans: A Unique Approach, Ken Smith, James M. Yates

New England Journal of Public Policy

It has been estimated that veterans comprise one third of the homeless population. To combat this national disgrace, many small veterans' groups have been formed nationwide to serve their homeless "brothers" in such settings as shelters, group homes, and outreach centers.

A Boston group, the Vietnam Veterans Workshop, based its New England Shelter for Homeless Veterans on the simple but powerful concept of veteran helping veteran. The shelter created a program to accomplish three important functions: providing the basic necessities of a bed, a meal, clothing, and a hot shower; rehabilitating the veterans by offering various activities to comfort and …

The Pendulum Swings: How Changes In Federal And State Policy Have Affected The Status Of Homeless People With Mental Illness In Ohio, Kim Bryant

New England Journal of Public Policy

Public policy in the problem areas of homelessness and mental illness has been reactive, rather than proactive, for the past thirty to forty years. As a result of this approach, federal and state policies have swung, like a pendulum, from one extreme to the other, taking the homeless mentally ill population on a most difficult ride. Public policies concerning these issues must become proactive, even if it means a complete overhauling of federal and state social service systems. Only with proactive policies will mentally ill individuals, and all people, have the housing, food, and health care they need, and the …

Ending Homelessness Among Mentally Disabled People, Steven A. Hitov

New England Journal of Public Policy

This article examines some of the many shortcomings of the mental health system operated by the Massachusetts Department of Mental Health (DMH) and explores the impact of that system on single homeless individuals who suffer from some form of serious or long-term mental disability. To afford that discussion context, however, the article first briefly examines those forces which have, and have not, significantly contributed to the large number of mentally disabled homeless persons. It suggests certain changes, including a shift in departmental focus from hospitals to community services and the creation of a housing subsidy system exclusively for DMH clients, …