Homelessness and Schizophrenia

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Table of Contents

Introduction
Research background
Purpose of the study
Research questions
Prevalence of homelessness among schizophrenic
Prevalence of schizophrenia among the homeless
Barriers for schizophrenia care
Solutions to treatment barriers
Conclusion
References

Introduction

Schizophrenia is commonly known as a mental disease or disorder. However, the ailment is chronic and affects the brain. There are several factors that are known to contribute to schizophrenia. One such factor is genes and environment of an individuals upbringing. Another major factor is brain damage that causes an imbalance in brain functions. Individuals suffering from schizophrenia are known to experience symptoms such as acute anxiety, hallucinations and weird thoughts.

Some people are known to exhibit signs of agitation and aggressiveness. Therefore, schizophrenics find it difficult to make important decisions in life. Moreover, it is also difficult for such a person to live a normal life. The probability of such an individual to lack basic needs such as food, clothing and shelter is high. In this respect, most schizophrenics are unable to access shelter and ultimately become homeless.

Homelessness is a condition where people are deprived basic needs and lacks a place to call home. Homelessness can be described from different dimensions. For example, total lack of a shelter or home to live can be termed as homelessness. In addition, lack of a safe dwelling place with adequate amenities can be described as homelessness. Individuals who do not have a regular place to live with other family members are termed as homeless.

For many years, poverty and diseases have been termed as the main causes of homelessness. In this respect, a direct relation between schizophrenia and homelessness can be evidenced. It is difficult for mentally insane individuals to make correct life decisions that can be provide in a home. A safe home with adequate facilities can only prosper if an individual living in such a place is mentally sane.

Research background

Schizophrenia is an illness with multiple limitations in life. Among these limitations is the lack of capacity to live a normal life. This is evidenced where the social setting does not allow a schizophrenic person to live in a safe home. An unsafe place is devastating to a person suffering from schizophrenia. In fact, this worsens and makes the recovery process for such a person difficult. A proper home plays a critical role in ensuring that home-based care solutions are met without much difficult.

The deprivation and lack of safe and adequate living conditions are prevalent among schizophrenic individuals. It is important to note that schizophrenic people tend to isolate themselves. This is one aspect of homelessness. Sometimes homelessness is forced on people with mental disorder by acts of isolation and seclusion from the mainstream society. The mere fact that social ties lacks in lives of people living with mental disorders exemplifies the relationship between schizophrenia and homelessness.

The defragmentation of a normal family life can always be the main cause of homelessness. This happens to schizophrenic individuals who are unable to live their normal lives. On the other hand, environmental factors such as poor families, poor neighborhoods can always contribute to schizophrenia cases. For example, people who live in poverty stricken societies tend to engage in activities that are destructive. This is mostly evidenced among people who engage in the use of alcohol and drugs.

From a medical point of view, abuse of drugs like marijuana, alcohol and other ecstasy drugs have been tipped to cause schizophrenia. Eventually, people who engage in such destructive lifestyles become homeless. They leave their families, engage in crime or become mentally ill. Considering that such people come from poverty stricken communities, it is obvious that homelessness among schizophrenic individuals becomes prevalent. It is even difficult to access care for poor individuals who are mentally ill.

Purpose of the study

This research paper seeks to examine the relationship between homelessness and schizophrenia. The research paper reviews the prevalence of homelessness among schizophrenic individuals. Moreover, the research also focuses on the prevalence of schizophrenia among the homeless. As a matter of prudence, the research seeks to know the barriers toward achieving care for schizophrenic individuals and the various solutions that have previously been executed.

Research questions

The following are some of the research questions to be addressed in this research paper.

What is the prevalence of homelessness among the schizophrenic individuals?
What is the prevalence of the schizophrenic individuals among the homeless?
What are the barriers for care towards schizophrenic individuals?
What are the previous solutions for the care of schizophrenic individuals?

Prevalence of homelessness among schizophrenic

According to a survey done between 1197 and 2010 by the Department of Health and Human Services, the number of homeless among the schizophrenia cases was approximately 200,000. In a study conducted by Folsom et al. (2005) on more than 10,000 mental ill patients in San Diego, a high prevalence of homelessness in mentally ill was established.

According to Folsom et al. (2005), the sample population of the study included patients with schizophrenia, bipolar disorder and major depression. From the study, it was established that the prevalence of homelessness among the mentally ill patients was 15%. However, it was established that other variables such as age, ethnicity, substance abuse and Medicaid were major factors in patients homelessness.

From the study, the researchers concluded that homelessness is one critical concern for mental health. The researchers agree that the prevalence of homelessness among the ill patients can be associated with the poor quality of life and other life-endangering elements.

For example, homelessness can be a mental burden to an individual. A homeless person is vulnerable to physical and mental assault, compared to an individual living in a well secured home. A homeless person is less likely to access medical care than a person living in a home.

In fact, the prevalence of death cases is more evidenced among homeless individuals. According to Folsom et al. (2005), a critical analysis on a psychiatric ward at the Department of Veterans Affairs show that most of individuals accessing care are homeless before admission. A further analysis on the same records shows that at least 7.5% of cases reported at the facility, comprise of individuals who shared public shelter for at least 3 years.

Among the mentally ill patients, a large number of homeless people are men. On the same note, more African-Americans are found to be homeless compared to other ethnic groups. Another important aspect that contributes to a higher prevalence of homelessness among the mentally-ill is substance abuse. According to Folsom et al. (2005), the prevalence of homelessness among schizophrenic patients was higher than in other mental illnesses.

For example, the prevalence of homelessness among patients with bipolar disorder and depression was 17% and 9% respectively. On the other hand, a 20% percent of schizophrenic patients were found to be homeless. In fact, this was supplemented by the fact that schizophrenic patients prefer the in-patient mode of hospitalization, compared to home-based schizophrenics. In addition, the homeless schizophrenics were found to be hospitalized in emergency psychiatric units.

This shows how their mental condition was worse than home-based schizophrenics. A further revelation from the study shows that homelessness among schizophrenia patients was due to the extreme nature of their mental conditions. This had been contributed by lack of earlier access to medical attention. In this case, the higher-cost of living and outpatient-type mental treatments had resulted to hospitalization of schizophrenia patients.

The fact that schizophrenia patients admitted at the hospital facility had earlier lived in same conditions, especially in a public shelter for more than 3 years was evidenced in most cases. According to Folsom et al. (2005), the research concludes by asserting that lack of Medicaid insurance and substance abuse were major contributors to homelessness among schizophrenic patients. Further results indicate that co-morbid substance use disorders are likely to contribute to homelessness among mentally-ill patients.

Prevalence of schizophrenia among the homeless

In a research conducted by Fazel, Khosla, Doll & Geddes (2008), it is evident that people with mental disorders are more likely to be homeless than mentally sane individuals. The research was based on population from western countries in Europe and North America. From a general perspective taken by the researchers, it is estimated that a majority of people who are homeless worldwide are mentally sick. It is general knowledge that at least 1 million people are poor and do not have an access to mental health worldwide.

The researchers conducted a research on other surveys done on the same in the United States, United Kingdom and Australia. According to Fazel, Khosla & Geddes (2008), more than 380,000 people in the United States are homeless. This number doubles in the United Kingdom at any time of the year. An estimated 40% of this number lives in the streets or live in public shelters like emergency hostels and temporary make-shifts.

In a number of researches analyzed by the researchers, it has been estimated that psychological disorders among the homeless, in the mentioned countries range from 2% to 31%. This can be compared to other major mental health issues such as depression and personality disorders. The increase and prevalence of psychiatric morbidity among the homeless has been contributed by lack of low-cost houses and support programs that help the ill patients.

The findings of the research conducted on 29 surveys, and from a total of 5,684 homeless individuals show that prevalence rates of psychotic issues were high. Schizophrenia is among some of the mental problems mentioned among the homeless individuals. It estimated that 37.9% of the homeless individuals suffered from mental disorders, compared to 24.4% of cases found among individuals abusing alcohol and drugs.

It is evident from the two researches that there exists a connection between homelessness and schizophrenia. It is evident that schizophrenia cases are hard to tackle especially if the patient cannot afford basic needs in life. While homelessness can be a leading factor towards extreme cases of schizophrenia, schizophrenia can also be a cause of homelessness.

It is essential to consider that lack of a proper home can exert pressure in an individual, to the extent of mental burdening. However, poor living conditions are an example of environments that breed schizophrenic cases. It is also important to consider the fact that genetic factors are also major causes of schizophrenia.

Barriers for schizophrenia care

As indicated earlier, schizophrenia is chronic and can start to develop in an individual at an early stage. In such cases, the symptoms aligned to schizophrenia are ignored, and early detection of the disease is not executed (Forbes, 2010). This makes the intervention to the disease difficult at later stages.

An access to the disease treatment is sometimes costly to poor individuals, especially to those perceived as homeless. Some studies show that lack of proper equipments in health facilities has become a treatment barrier to schizophrenia. For patients with multiple ailments like diabetes and obesity, it becomes difficult to treat schizophrenia. According to Cochrane (2006), a combination of multiple disorders in a schizophrenic patient is dangerous and requires critical care.

For most patients that visit health centers, the ignorance of their mental health is evidenced by their concern for general health issues. The recent studies on the schizophrenia medications indicate that anti-psychotics medicines have negative side-effects. For example, patients who take anti-psychotics are usually at higher risks of having other complications such as diabetes and obesity. In addition, it has also been noted that schizophrenia patients do not stick to prescribed medications.

This is due to lack of proper follow-ups by physicians. Considering that some patients are homeless, they have no one to take care of them and remind them of their medication. It is common knowledge that schizophrenic patient do not comply with treatment, due to their mental status.

There are concerns that lack of clinical records for schizophrenic patients, may be a hindrance to accessing important patients health records. Another barrier to proper schizophrenia care is hindered by lack of medical consultation time.

Medical practitioners are always wary of the impairment of both cognitive and social abilities that are difficult to repair during the treatment process. Moreover, the stigma that is associated with mentally insane individuals is overwhelming to schizophrenic individuals. Such individuals feel insecure and isolated in the society. This hinders the treatment and recovery process in such individuals.

Solutions to treatment barriers

In order to ensure that barriers to schizophrenia treatment and care are resolved, various measures require to me made. According to Baker (2005), such measures include having a plan to provide adequate homes for patients who are homeless. This requires government and non-government involvement in building stable shelters for the patients. A low-cost schizophrenia treatment program can be critical in ensuring that access to schizophrenia is made available to the poor.

Community-based support programs are essential in identifying schizophrenia cases and offering basic home-based care to such individuals. Proper training to medics and physicians in handling schizophrenia cases in every health facility within the society is essential. The use of electronic health records is imperative in tracking the medical and health history of a schizophrenia patient. Proper medication and follow-up programs for nurses and medic consultants are critical.

Conclusion

It is important to understand that schizophrenia is one of the most dreaded public health issues. As indicated earlier, the disorder is most prevalent among individuals who are less privileged in the society. There is a positive co-relation between homelessness and schizophrenia.

Therefore, schizophrenia intervention should be directed towards providing adequate home facilities. Such interventions should ensure that a schizophrenic patient lives under safe and secure means. Considering that relapse of the disorder is common among schizophrenia patients, proper follow-up programs require to be implemented by nurses.

References

Baker, A. (2005). Palliative and end-of-life care in the serious and persistently mentally ill population. Journal of the American Psychiatric Nurses Association, 11(5), 298-303.

Cochrane, E., M. (2006). Medical co-morbidity risk factors and barriers to care for people with schizophrenia. Journal of Psychiatric and Mental Health Nursing, 13(4), 447-452.

Fazel, S., Khosla, V., Doll, H. & Geddes, J. (2008). The prevalence of mental disorders among the homeless in western countries: Systematic review and meta-regression analysis. PloS Med 5(12), 225. doi:10.1371/journal.pmed.0050225.

Folsom, D., P., Hawthorne, W., Lindamer, L., Gilmer, T., Bailey, A., Golshan, S.&.Jeste, D., V. (2005). Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. The American Journal of Psychiatry, 162(2), 370-376.

Forbes, V., J. (2010). Unawareness as a barrier to treatment in patients with schizophrenia: A conceptual analysis. Journal of Psychosocial Nursing and Mental Health, 48(3), 30-36.

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