1. Copyright © 2008 Delmar. All rights reserved. Chapter 27 The Homeless Population

2. Copyright © 2008 Delmar. All rights reserved. 2 Homelessness Homeless Assistance Act of 1987 refers to someone: –Who lacks a fixed residence –Lives in shelters –Lacks regular sleeping accommodations –Living in a home and has been asked to leave within the next month

3. Copyright © 2008 Delmar. All rights reserved. 3 Homelessness Social condition and usually the result of several factors such as: –Severe and chronic health conditions –Mental illness, substance abuse –Chronic unemployment –Domestic violence –Poverty, war, disease, forces of nature

4. Copyright © 2008 Delmar. All rights reserved. 4 Homelessness Population is younger, often employed, and involves children Vulnerable populations are subgroups sensitive to risk factors because of: –Economic, social, physical, environmental, biological and lifestyle, chronic disease, health care disparities

5. Copyright © 2008 Delmar. All rights reserved. 5 Key Factors in Contributing to Homelessness Poverty Eroding work opportunities Decline in public assistance and government supported housing Lack of affordable health care Domestic violence, mental illness, addiction

6. Copyright © 2008 Delmar. All rights reserved. 6 Health of the Homeless Higher rates of substance abuse Higher rate of peripheral vascular disease Hypertension Liver disease Communicable disease Limited access to health care

7. Copyright © 2008 Delmar. All rights reserved. 7 Health of the Homeless Chronic versus acute health problems –Diabetes –Tuberculosis Policy recommendations for health care of homeless –Universal access, accessible health care –Increase funding

8. Copyright © 2008 Delmar. All rights reserved. 8 Health of the Homeless Better tracking systems for hate crimes Promotion of police training about hate crimes Homelessness speakers’ bureaus End homelessness

9. Copyright © 2008 Delmar. All rights reserved. 9 Mental Illness Policy recommendations –Ensure access to accountability of addiction and health care services –Require health plans

10. Copyright © 2008 Delmar. All rights reserved. 10 Mental Illness Policy recommendations –Strengthen existing mental and addiction services –End criminalization of homelessness –Establish policies and programs that are consistent with evidenced-based practices

11. Copyright © 2008 Delmar. All rights reserved. 11 Mental Illness Special populations –Homeless youth Family, economic, and residential problems Gay, lesbian, bisexual, transgender Accessibility of education –Risk of STDs, depression, substance abuse, suicide attempts

12. Copyright © 2008 Delmar. All rights reserved. 12 Mental Illness Policy and program recommendations for homeless youth –Substance abuse services –Provide drug free safe place to socialize –Group training in conflict resolution –Anger management, stress reduction, coping skills

13. Copyright © 2008 Delmar. All rights reserved. 13 Homeless Elderly Individual over age 50 Primarily due to: –Lack of affordable housing –Increased poverty –Decreased wages –Lack of adequate retirement

14. Copyright © 2008 Delmar. All rights reserved. 14 Homeless Elderly Often suffer from the following: –Neurological disorders Epilepsy, peripheral neuropathies Cognitive disorders –Gastrointestinal problems –Musculoskeletal disorders –Pneumonia, COPD, TB

15. Copyright © 2008 Delmar. All rights reserved. 15 Characteristics of Homeless Elderly Men African American Low levels of education Significant psychiatric problems Suffer chronic diseases Suffer higher rate of social isolation Often never employed full time

16. Copyright © 2008 Delmar. All rights reserved. 16 Characteristics of Homeless Elderly Women Vulnerable to homelessness after death of spouse Caucasian Receive public assistance Suffer psychiatric illnesses Chronic health problems

17. Copyright © 2008 Delmar. All rights reserved. 17 Characteristics of Homeless Elderly Growing number are veterans –Low income, post-traumatic stress disorder –Poor physical health Policy and program recommendations –McKinney-Vento Homeless Assistance Act –Federal Education Rights and Privacy Act –Strong support system, advocacy

18. Copyright © 2008 Delmar. All rights reserved. 18 Homeless Veterans Lack of affordable housing and poverty Decreasing veterans’ benefits Post-traumatic stress disorder –Alcohol and substance abuse –Lack of family and social support

19. Copyright © 2008 Delmar. All rights reserved. 19 Programs for Homeless Veterans VA’s Health Care for the Homeless Veterans Program VA’s Domiciliary Care for Homeless Veterans Special Outreach and Benefits Assistance Veterans Benefits Assistance

20. Copyright © 2008 Delmar. All rights reserved. 20 Programs for Homeless Veterans Acquired Property Sales for Homeless Providers Programs Readjustment Counseling Service Vet Center Drop-in centers

21. Copyright © 2008 Delmar. All rights reserved. 21 Overall Prevention and Policy Recommendations Title V (1983) Homeless Persons’ Survival Act (1986) Urgent Relief for the Homeless Act (1987) –McKinney-Vento Homeless Assistance Act Community Involvement –Resources –Self-improvement

22. Copyright © 2008 Delmar. All rights reserved. 22 Overall Prevention and Policy Recommendations Ending chronic homelessness Strategies for action –Enhance access to services –Foster state and local response Geographic Information System Community Based Homelessness Prevention Program

23. Copyright © 2008 Delmar. All rights reserved. 23 Overall Prevention and Policy Recommendations National Coalition for the Homeless –Housing justice –Economic justice –Health care justice –Civil rights