Presentation on theme: "The Institute for Human Services, Inc. Definition & Diversity of Homeless Persons Homeless definition has 4 categories: Literally homeless individuals/families."— Presentation transcript:
Definition & Diversity of Homeless Persons Homeless definition has 4 categories: Literally homeless individuals/families Imminently at risk for homelessness Unaccompanied youth or families with children/youth who meet the homeless defintion under another federal statute and 3 additional criteria Imminently at risk for homelessness
Homelessness = A person or family who lacks fixed, regular, and adequate housing nighttime residence, meaning: Sleeping in a place not designed for or ordinarily used for as a regular sleeping accommodation: car, park, abandoned building,bus/train station, airport, camping ground Living in a shelter
Chronically Homeless = Homeless for 365 days or 4 episodes in the last 3 years AND Have a disability that is expected to persist indefinitely
Just imagine… You haven’t had a safe place to sleep in over a year. So your sleep is probably not very deep. How might your mood and ability to think be affected? Would you remember how to take your medication as prescribed? Might you be showing signs of grumpiness, distractability and forgetfulness?
You don‘t have a home…. How do you keep medications like insulin refrigerated ? How do you secure your pain medications prescribed for chronic back pain that you’ve developed because you’re sleeping on the hard cement all the time? How do you stay warm and dry in the pouring rain?
Imagine… You barely have enough resources to pay for food, transportation and maintaining your hygiene… How would you do laundry? How do you avoid getting an infection or allowing a small one to fester?
IHS and Chronically Homeless Individuals SAMHSA grant focused on helping chronically homeless individuals access needed treatment AND housing. Systematically identifying and prioritizing those who are chronically homeless or vulnerable for intervention because… Housing IS treatment.
In 1st Year… We served 367 chronically homeless persons through outreach (116) and inreach (251) We placed 115 of them into housing 57% of unsheltered outreached had health insurance benefits 62% of sheltered had medical benefits at intake 28 accessed substance abuse treatment 88 accessed psychiatric evaluation or treatment
Psychiatry-Assisted IHS Outreach Project sought to demonstrate the impact of psychiatry assisted outreach Compared homeless people who are geographically in the urban area (Downtown Honolulu, China town, Kalihi) and those how are in a rural area (North Shore - Wahiawa) Triaging very ill persons and finding help for them
Challenges to Serving Chronically Homeless People Approach to Healthcare: Accessibility Affordability Appropriateness Ability to engage in tx
Confidentiality: Protection or Obstacle Other current Health care providers Past healthcare providers Family Homeless providers Case managers Neighbors & others concerned
Medical Acuity of Homeless Persons Increasing numbers coming to IHS with more serious medical problems In calendar year Jan-Dec 2012, IHS fielded 434 referrals from hospitals 109 New from hospital 222 were returning guests 13 were turned down due to their acuity required
Who’s coming through the door? Post surgery Discharged from Psychiatric unit -SI Post detox Dying Post partum Cardiac conditions Diabetes Major infections
What we do… Making Connections Emergency Room Clinics Mobile medical care Screening to prevent TB, Hansens Disease Physical: Diabetes, hypertension, asthma, skin infections etc. Onsite treatment or triage Provide transportation – bus fare, taxi vouchers
What do you do? When you know a person is homeless, do you ask about their environment and resources? Are you screening for behavioral health issues? Do you ask about their practical support network? When you give Rx, do you assess if the person has ability to fill it and follow through? Do you take time to access information on the persons past success with treatment? Or to assess motivation for treatment