Homelessness is one of the major issues affecting the modern US society. It is described as the condition of lacking a fixed, regular, and adequate residence to spend the night. The problem first emerged in the 1870s where a large part of the population moved to the emerging urban cities. It was further increased in the 20th Century during the occurrence of the Great Depression in the 1930s. Deinstitutionalization in the 1970s and increased housing and social service cuts in 1980s rapidly increased the number of homeless people. The Great Recession in the US led to the significant rise in this population. Despite the high number of homeless people in the country, little has been done to accommodate their significant needs. Only the McKinney-Vento Homeless Assistance Act enacted in 1987 has allocated federal funding to provide direct service to this population. The occurrence of mental illness, post traumatic stress disorder, substance abuse, and unemployment cause homelessness and further heighten the suffering of these individuals. It is evident that the homeless people experience co-occurring disorders an issue that has been present for quite some time. The following report provides a better understanding of this health issue and ways of treating them.
Prevalence of Co-Occurring Disorders
Following the significant improvement of research methods and availability of technology, the quality of data has also gotten considerably better. The occurrence of mental illness has been one of the integral reasons for becoming homeless over the past few decades. Such illnesses are closely linked with substance abuse and in various cases may occur simultaneously (Somers, Moniruzzaman, Rezansoff, Brink, & Russolillo, 2016). The government along with the American society as a whole has employed a capitalistic attitude in the handling of the population. They are considered a bane of the society as they do not provide considerable improvement to the economy of the country. Scholars and a section of policy makers agree that these co-occurring illnesses should be treated concurrently (Somers et al., 2016). It is evident that the US has various medical, psychiatric, and counseling services available for addressing these concerns. However, the homeless people are unable to afford them as there is no universal health-care plan to effectively serve the needs of these individuals.
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A recent research sought to prove the high incidence of co-occurring disorders among women who were homeless in three major cities in the US. The study intended to focus on borderline personality disorder, Axis I Psychiatric and substance use disorders. The sample of the study incorporated 156 women where 79 were from Omaha, Nebraska, 39 from Pittsburgh, Pennsylvania, and 38 from Portland, Oregon (Whitbeck, Armenta, & Welch-Lazoritz, 2015). In the same sample 140 women were from shelters while the other 16 were from meal locations. The vast majority of this population demonstrated to have had at least one psychiatric disorder in their lifetime (84.6%), approximately ¾ (73.1%) had experienced it in the past year, while 39.7% had experienced the same in the past year (Whitbeck, Armenta, & Welch-Lazoritz, 2015). The results were disturbing when looking into the co-occurring disorder as 73.7% had experienced at least two disorders in their lifetime, 53.9% had at least three, while 39.1% had four or more (Whitbeck, Armenta, & Welch-Lazoritz, 2015). This is a clear indicator of the high prevalence of the issue as it affects the society. The findings also showed that 16.7% and 19.9% had low and high self-harm BPD (Whitbeck, Armenta, & Welch-Lazoritz, 2015). The results of the study identify the importance of developing measures to treat co-occurring disorders among homeless communities.
Treatment Options for Homeless People
The government over the past decade has actively sought to improve medical coverage of the American citizens as it attempts to achieve universal care. During this period, the availability of psychiatric, counseling, and mental care services have been vastly increased particularly to increase accessibility in rural areas. However, the most concerning issue at hand is the lack of effective eradication of the public health problem. It is evident that the lack of a stable night residence makes the interventions ineffective. According to a a study conducted by Kozloff and colleagues (2013) there are three broad categorical factors that are essential for ensuring homeless youth participate in services provided by local, state, and federal governments. They include individual, program, and systemic factors.
The individual aspect incorporates motivation, therapeutic relationships, and support to prompt the homeless persons from reverting to a life of drug abuse. The programming factor encompasses the flexibility and comprehensiveness of services and availability of harm reduction services. In this case, the programs should directly alleviate the primary causes of drug addiction and homelessness. Under the systemic process of influencing service use, stigma and accessibility significantly prevent the appropriate participation of the population. Research conducted by Roy, Crocker, Nicholls, Latimer, and Ayllon (2014) shows that high prevalence of victimization was a common trait associated with female homeless persons with a history of child abuse and incidence of depression (Roy et al., 2014). The members of society have also developed a negative perspective of the population resulting in ineffective treatment of the co-occurring disorders.
Conclusion
The above research shows that co-occurring disorders among homeless people is an issue of critical concern. Experts in the field emphasize that this issue is not an exception rather should be an expectation of patients and clients in behavioral health settings. The research revealed that mental illness and drug abuse are caused by common risk factors. Therefore, in providing treatment for the homeless population, it is essential that the programs ensure support of the individual throughout the therapeutic process while providing them with stable residents and employment that will help guarantee long-term achievement of the goals. The stressful nature of living in the streets makes it difficult to cope without the use of alcohol and other drug consumption. The high prevalence of the public health issue highlights the need to address the issue as soon as possible.
References
Kozloff, N., Cheung, A. H., Ross, L. E., Winer, H., Ierfino, D., Bullock, H., & Bennett, K. J. (2013). Factors influencing service use among homeless youths with co-occurring disorders. Psychiatric Services, 64 (9), 925-928.
Roy, L., Crocker, A. G., Nicholls, T. L., Latimer, E. A., & Ayllon, A. R. (2014). Criminal behavior and victimization among homeless individuals with severe mental illness: a systematic review. Psychiatric Services, 65 (6), 739-750.
Somers, J. M., Moniruzzaman, A., Rezansoff, S. N., Brink, J., & Russolillo, A. (2016). The prevalence and geographic distribution of complex co-occurring disorders: a population study. Epidemiology and Psychiatric Sciences, 25 (3), 267-277.
Whitbeck, L. B., Armenta, B. E., & Welch-Lazoritz, M. L. (2015). Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities. Social Psychiatry and Psychiatric Epidemiology, 50 (8), 1285-1291.
