Identification of a Social Problem and Identification of a Policy
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HomelessnessandMentalhealthProblemanditsPolicies.edited.docxRunning head: SOCIAL WORK 1
SOCIAL WORK 7
Homelessness and Mental health Problem, and its Policies
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Description of Homelessness and Mental Health and its incongruence with social work values/ethics.
There are over 144,000 people across the United States who are homeless and have a mental illness. This social problem, which is defined as a lack of adequate housing, leads to stress and isolation. Moreover, homeless is associated with poor mental health, which negatively affects physical health. This social problem creates more issues such as chronic unemployment and substance abuse. As a result, a social worker trying to control mental illness, residential instability, and poverty has a hard time providing the fundamental services. Social work values define that they must connect homeless individuals with mental illness with basic services.
Consequently, the social workers serve in shelters, emergency rooms, jails, and libraries (Mental Illness & Homelessness How Social Workers Help, 2020). Hence, a social worker working with homeless individuals who have mental illness must have specialized skills; Which is necessary for developing therapeutic relationships, evaluate and solving underlying problems.
Background and the actions that are taken to address homelessness and mental health
A 2017 survey of the homeless population in the United States provides that approximately half a million Americans are homeless daily. This trend show to increase over the previous seven years from an annual survey that was conducted. At the same time, individuals with untreated severe mental illness are estimated to be one-third of the total homeless population of the cases in the United States. Among this population, many do not realize that their conditions are severe. Moreover, some do not have access to services that may help them. It is discovered that New York and California account for a total of forty percent of the homeless cases in the United States.
One of the actions taken to address this issue is direct housing; Which means that homeless individuals are provided with safe, sustainable access to housing without precondition for mental health. Also, they are provided with supportive services for mental and medical health. The second action is documented approach, which involves documenting efforts to help the homeless population. Through documentation, the chances of some individuals being overlooked are minimized (Institute of Medicine (US) Committee on Health Care for Homeless People, 1988c). The final action is by collaborating with non-traditional partners such as prisons and hospitals to target individuals to prevent them from experiencing housing insecurity.
How have the groups affected by this concern changed over time?
Alcohol disorder prevalent mostly in men who are homeless show to have increased a little over two decades since 1980. On the other hand, women with comparatively less prevalence have substantially increased over the two decades since 1980. However, for those two decades, the drug use disorder show to have increased significantly for the past two decades; women had a higher increase. Therefore, 59% of women and 85% of men had an alcohol or drug use disorder by 2000. Substance abuse resulted in many psychopathology cases; for instance, 87% of men and 68% of women recorded a psychiatric disorder by 2000. Men who are also homeless recorded an increase in the cases of bipolar disorder after 1990 (Institute of Medicine (US) Committee on Health Care for Homeless People, 1988a). Moreover, men showed a major depression while alcohol and drug use, especially cannabis, recorded a decline. However, women recorded a decrease in the age of onset of schizophrenia while cocaine use disorder increased from 1980.
Policy area related to this social problem.
In recent years, there is evidence of congressional actions to develop an act to address homelessness more broadly and the homeless people's health less broadly. Hence, the policy developed was under the Health Professionals Training Acts of 1985. This act gave the secretary of the Department of Health and Human Service the mandate to request the Institute of Medicine of the National Academy of Science to research the quality of healthcare delivery to homeless individuals. The study committee comprised experts in the social science, medicine and nursing fields. The study committee to help define the term a homeless person adopted the nationwide McKinney Homeless Assistance Act of 1987. This act defined a homeless person as one who lacks a fixed and permanent nighttime residence. Also, a person whose nighttime residence is a temporary shelter fits the description.
How long has the current policy been in place and the different aspects?
Many current policies such as Health Professional Training Acts developed programs such as the Johnson-Pew projects roughly between 1984 and 1987. The projects had staff who provided services with a single set of policies and procedures. Some of the programs had relied on contracts with the existing provider to offer specialized services to a specific geographic area. Staff acted as employees of the contracting agency and are subject to federal policies and laws. The services offered were a mixture of contracted and direct services. The salaried staff would provide certain services such as case management while the contractor provided services such as clinic operations.
Who supports and opposes the policy?
Many physicians, nurse practitioners, and assistants found it extremely hard and professionally isolating to practice healthcare outside a healthcare facility. Moreover, healthcare services in a social service agency can be time-consuming due to negotiations of specialty clinic appointments (Institute of Medicine (US) Committee on Health Care for Homeless People, 1988b). Sometimes, the contracted staff experience divided loyalty between their employer and the homeless program when a major healthcare agency employs them. The contract agencies may have different personnel policies such as the pay scales, holidays, and staff development programs. The policies however has gained a lot of support from the federal government.
Changes/amendments made to the policy.
The federal policies and laws provided for developing the Johnson-Pew project program for homeless people with mental health issues. These projects comprised elements defining the care the homeless people receive from a social worker. For example, stakeholders adopted a holistic approach instead of treating an isolated health problem; This meant that a person's environmental and social situation is considered. This program recognizes the importance of the interaction between the state of being homeless and mental illness. The second element is bringing healthcare where homeless people are available. This targeted service serves as a conduit for other services such as application and advocacy of entitlement benefits. Another major change is the multidisciplinary approach which meant that teams working with the homeless are inclusive of various disciplines such as nurse practitioners, social workers, and physicians.
How this policy affects clients and the importance of advocating for change?
The federal laws and policies requiring the development of methods to provide for a no need in permanent addresses impose unrealistic requirements on homeless individuals (North et al., 2004). The system is ineffective due to the lack of funding, intrinsic challenges of responding to a group with special needs, and excessive demands of the services. More importantly, the state of homelessness is entwined with the individual's well-being, compromised due to the failed systems. Therefore, it is imperative to advocate for change since a decline in the number of affordable housing units is deeply associated with unemployment among the United States population. Consequently, this has a major impact on the economy. Therefore, addressing this issue by reducing the unemployment rate with a focus on the mental health system will improve an individual's living standards. Hence, improving the country's economy.
References
Institute of Medicine (US) Committee on Health Care for Homeless People. (1988a). Dynamics of Homelessness. National Academies Press (US).
Institute of Medicine (US) Committee on Health Care for Homeless People. (1988c). Summary and Recommendations. National Academies Press (US).
Mental illness & homelessness how social workers help. (2020, January 22). https://onlinemasters.ohio.edu/blog/mental-illness-and-homelessness-how-social-workers-help/
North, C. S., Eyrich, K. M., Pollio, D. E., & Spitznagel, E. L. (2004). Are rates of psychiatric disorders in the homeless population changing? American Journal of Public Health, 94(1), 103–108.
