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* '''Hotels''': Gaining temporary shelter by staying in hotels is common among the houseless. Though many lack the money to rent a room so they do not literally "stay" in a hotel, they rather sleep in the lobby. * '''Hotels''': Gaining temporary shelter by staying in hotels is common among the houseless. Though many lack the money to rent a room so they do not literally "stay" in a hotel, they rather sleep in the lobby.


==Services==
], ].]]
]s operated by government, churches, or charities work to provide temporary housing to the homeless.


Types of shelters include ]s, ]s, ]s, and ].<ref>Coalition on Homelessness and Housing in Ohio. . Retrieved ].</ref>
There are also day shelters which give basic services during the daytime hours when many of the overnight shelters for sleeping are closed.

In the United Kingdom, the majority of services for single homeless people and couples are provided by the voluntary sector, usually through contracts paid for by local government through ]. Services available to homeless people include night shelters, day centres, hostels, resettlement services and floating support.

While some shelters also provide food, others require people to turn to ]s and ]s for nutrition. In the United Kingdom, these services are usually paid for by homeless people themselves in service charges in addition to the housing benefit which pays the rent.

'''Auxiliary services''' provided by some shelters include:
* '''Health ]s'''
* '''Clothing and personal items'''
* ''']'''
* '''] and other ]''': such as addiction control, trauma counseling, and depression.
* '''] Capabilities''' (], ], ])

However, there are a number of complaints about the safety and quality of homeless shelters.{{citation needed}} ] is a more expensive solution that some believe might end the cycle of homelessness. Homeless Link<ref>Homeless Link </ref> in the UK provides minimum standards and best practice advice on how agencies can best deal with their clients to ensure permanent change and solutions to homelessness.

An "outreach program" is a group that may include police officers, formerly homeless civilian outreach workers, or counselors. This team makes contact with homeless people and can provide assistance, or guide them to shelters for assistance. This can avoid unnecessary and costly arrests intended to displace the homeless.<ref>National Coalition for the Homeless. . Retrieved ].</ref>

Most homeless people have no means of communications with the outside world. Few have access to a phone to make or receive calls, get voice messages, send and receive a fax or email. Many support organisations provide some limited local phone access, voice mail, and internet computers with email. This is critical in a modern technological world for medical appointment verification, job and services searches.<ref>{{cite news | first= Sam | last= Allis | author=
| url= http://www.boston.com/news/local/articles/2006/05/14/a_port_in_the_storm/?page=full
| title= A port in the storm Center gives homeless a phone and a chance | work= The Boston Globe
| publisher= Globe Newspaper Company | pages= | page= | date= May 14, 2006 | accessdate=
}}</ref>


==Health care for the homeless== ==Health care for the homeless==

Revision as of 16:12, 22 January 2007

File:P7032101 small2.jpg
A homeless person in Paris.

Homelessness refers to the condition and societal category of people who lack housing, or live in transitional housing, or who spend most nights in a supervised public or private facility providing temporary living quarters, or in a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings.

HOMELESS PEOPLE SUCK THE BIG ONE!

Terms for Homelessness

The term most often used in the late twentieth century is "homeless". However, other terms include: vagrant, tramp, hobo (U.S.), transient, bum (U.S.), bagman/bagwoman, sturdy beggar, or the wandering poor. The term '(of) No Fixed Abode' (NFA) is used in legal circumstances.

More recently, many advocates and individuals who have experienced homelessness prefer using the term “houseless” to reflect more accurately the fact that the problem resides not with the lack of a home, which carries with it connotations including propinquity to family and other meta-physical notions, but with the more concrete problem of not having a house or apartment in which to live.

In different languages, the term for homelessness reveals the cultural and societal perception and classification of a homeless person:

  • Spanish: "persona sin hogar" (person without a home)
  • French: "Sans domicile fixe" (SDF, without a fixed domicile)
  • German: "obdachlos" (without a roof above)
  • Italian: "Senzatetto" (without a roof)
  • Portuguese: "sem-teto" (without a roof) or "Pessoa sem abrigo" (person without a shelter)

Definition of homeless

The U.S. Department of Housing and Urban Development (HUD) defines the term "homeless" or "homeless individual or homeless person" as -- (1) an individual who lacks a fixed, regular, and adequate nighttime residence; and (2) an individual who has a primary nighttime residence that is: A) supervised publicly or privately operated shelter designed to provide temporary living accommodations (including welfare hotels, congregate shelters, and transitional housing for the mentally ill); B) an institution that provides a temporary residence for individuals intended to be institutionalized; or C) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodations for human beings.

Pre-disposing factors to homelessness

Skid Row in Los Angeles, CA

Most researchers attempt to make a distinction between: 1) why homelessness exists, in general, and 2) who is at-risk of homelessness, in specific. Homelessness has always existed since urbanization and industrialization.

Factors placing an individual at high-risk of homelessness include:

  • Poverty: People living in poverty are at a higher risk of becoming homeless.
  • Drug or alcohol misuse: It is not uncommon for homeless to suffer from a substance abuse problem. Debate exists about whether drug use is a cause or consequence of homelessness. However, regardless when it arises, an untreated addiction "makes moving beyond homelessness extremely difficult."
  • Serious Mental Illness and Disability: It has been estimated that approximately one-third of all adult homeless persons have some form of mental illness and/or disability. In previous eras, these individuals were institutionalized in state mental hospitals. According to the National Alliance for the Mentally Ill (NAMI), there are 50,000 mentally ill homeless people in California alone because of deinstitutionalization between 1957 and 1988 and a lack of adequate local service systems. Various assertive outreach approaches, including a mental health treatment approach known as Assertive Community Treatment and the Path Program, have shown promise in the prevention of homelessness among people with serious mental illness.
  • Foster Care background: This population experienced rates of homelessness nearly 8 times higher than the non-foster care population.
  • Escaping domestic abuse, including sexual, physical and mental abuse: Victims who flee from abuse often find themselves without a home. Abused children also have a higher chance of succumbing to a drug addiction, which contributes to difficulties in establishing a residence. In 1990 a study found that half of homeless women and children were fleeing abuse.
  • Prison discharge: Often the formerly incarcerated are socially isolated from friends and family and have few resources. Employment is often difficult for those with a criminal record. Untreated substance abuse and mental illness also may put them at high risk for homelessness onced discharged.
  • Civilian during war: Civilians during war or any armed conflict are also are at a higher risk for homelessness, because of possible military attacks on their property, and even after the war rebuilding their homes is often costly, and most commonly the government is overthrown or defeated which is then unable to help its citzens.

Main causes of homelessness

The major reasons and causes for homelessness as documented by many reports and studies include:

  • Lack of affordable housing
  • Low paying jobs
  • Substance abuse and lack of needed services
  • Mental illness and lack of needed services
  • Domestic violence
  • Unemployment
  • Poverty
  • Prison release and re-entry into society
  • Change and cuts in public assistance

The high cost of housing is a by-product of the general distribution of wealth and income. The rate of homelessness has also been impacted by the reduction of household size witnessed in the last half of the 20th century.

Individuals who are incapable of maintaining employment and managing their lives effectively due to prolonged and severe drug and/or alcohol abuse make up a substantial percentage of the U.S. homeless population. The link between substance abuse and homelessness is partially caused by the fact that the behavioral patterns associated with addiction can alienate an addicted individual's family and friends who could otherwise provide a safety net against homelessness during difficult economic times.

Increased wealth and income inequality have caused distortions in the housing market that push rent burdens higher, thereby decreasing the availability of affordable housing.

Some homeless individuals choose not to have a permanent residence, including travelers and those who have personal spiritual/religious convictions (as yogis in India). Most researchers feel the population of individuals who choose not to have a permanent residence is negligible. Many people who respond that they "prefer" the homeless lifestyle suffer from mental illness, trauma or have adapted to the lifestyle and the response reflects a socially-desirable response or justification rather than having no real desire for stable shelter.

Refuges for the Homeless

There are many places where a homeless person might seek refuge.

  • The Outdoors: Exposed or in a tent
  • Vehicles: such as a car or a motorhome. Some people who live nomadically in a motorhome or trailer are people of means who do so by choice and do not think of themselves as "homeless" in the sense it is usually used. For others a vehicle might serve as a temporary living refuge, for example those recently evicted from a home.
  • Public places: parks, bus or train stations, airports
  • Derelict structures: abandoned buildings, ruined cars, beached boats
  • Shelters
  • Boarding houses, or more specifically, flophouses which offer cheap temporary lodging and are often used by those trying to pull themselves out of homelessness or who are one step above homelessness.
  • Friends or family: This is distinguished from living with friends or family in that it is temporary. This is occasionally referred to as "couch surfing".
  • Hobo jungles: Ad hoc campsites usually near rail yards.
  • Hotels: Gaining temporary shelter by staying in hotels is common among the houseless. Though many lack the money to rent a room so they do not literally "stay" in a hotel, they rather sleep in the lobby.


Health care for the homeless

In general, health care for the homeless is a very important charitable issue and a public health issue.

The homeless are under-served for medical problems. State medical insurance is one possibility, but many homeless can't get access to it. Free-care clinics, especially for the homeless, exist and are usually over-burdened with patients.

The actual medical conditions affecting the homeless are somewhat specialized and has opened a newer area of medicine catering to this population. Skin diseases and conditions abound, as well as dental, personal hygiene and the like. Specialized medical textbooks have been written to address this for providers.

The effects of poor nutrition, substance abuse, and unmitigated exposure to the severe elements of weather are important considerations.

There are many organizations providing free care all over the world for the homeless, but the services are in great demand given the limited number of medical practitioners helping. For example, it might take months to get a minimal dental appointment in a free-care clinic.

Communicable diseases are of great concern, especially Tuberculosis in high density urban populations.

Income opportunities

Many non-profit organizations such as Goodwill Industries maintain a mission to "provide skill development and work opportunities to people with barriers to employment", though most of these organizations are not primarily geared toward homeless individuals. Many cities also have street newspapers or magazines: publications designed to provide employment opportunity to homeless people or others in need by their sale on the streets of their respective cities.

While some homeless have paying jobs, some must seek other methods to make money. Begging or panhandling is one option, but is becoming increasingly illegal in many cities. Despite the stereotype, not all homeless people panhandle, and not all panhandlers are homeless. Another option is busking: performing tricks, playing music, drawing on the sidewalk, or offering some other form of entertainment in exchange for donations. In cities where pharmaceutical companies still collect paid blood plasma, homeless people may generate income through frequent visits to these centers.

Homeless people have been known to commit crimes just to be sent to jail or prison for food and shelter. In police lingo, this is called "three hots and a cot." Similarly a homeless person may approach a hospital's emergency department and fake a mental illness in order to receive food and shelter.

Statistics for developed countries

The following statistics indicate the approximate average number of homeless people at any one time. Each country has a different approach to counting homeless people, and estimates of homelessness made by different organisations vary wildly, so comparisons should be made with caution.

European Union: 3,000,000 (UN-HABITAT 2004)
England: 10,459 rough sleepers, 98,750 households in temporary accommodation (Department for Communities and Local Government 2005)
Canada: 150,000 (National Homelessness Initiative - Government of Canada)
Australia: 99,000 (ABS: 2001 Census)
United States: Chronically homeless people (those with repeated episodes or who have been homeless for long periods) 150,000-200,000 (some sources say 847,000-3,470,000) though a report in January 2007 said 744,000.
Japan: 20,000-100,000 (some figures put it at 200,000-400,000)

Developing and undeveloped countries

The number of homeless people worldwide has grown steadily in recent years. In some Third World nations such as Brazil, India, Nigeria, and South Africa, homelessness is rampant, with millions of children living and working on the streets. Homelessness has become a problem in the cities of China, Thailand, Indonesia, and the Philippines despite their growing prosperity, mainly due to migrant workers who have trouble finding permanent homes and to rising income inequality between social classes.

Homelessness in the popular media

Popular films

Documentary films

TV documentaries

Homelessness in specific countries

Main article: Homelessness in the United States Main article: Homelessness in Canada Main article: Homelessness in Australia Main article: Homelessness in the United Kingdom

Voluntary Homelessness

Voluntary Homelessness is also known as Nomadism. Some choose Homelessness as a lifestyle, preferring it to a settlement with society's norms. Nomads have existed throughout history.

See also

References

  1. Office of Applied Studies, United States Department of Health and Human Services,"Terminology"
  2. United States Code, Title 42, Chapter 119, Subchapter I, § 11302. United States Code: General definition of a homeless individual.
  3. Coalition on Homelessness and Housing in Ohio (2006-09-17). Homelessness: The Causes and Facts. Retrieved 2006-05-10.
  4. http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.212/DC1
  5. Robert A. Rosenheck, MD; Deborah Dennis, MA, "Time-Limited Assertive Community Treatment for Homeless Persons With Severe Mental Illness", Archives of General Psychiatry. 2001;58:1073-1080.
  6. Dixon L, Weiden P, Torres M, Lehman A., "Assertive community treatment and medication compliance in the homeless mentally ill", American Journal of Psychiatry. 1997 Sep;154(9):1302-4.
  7. Meisler N, Blankertz L, Santos AB, McKay C., "Impact of assertive community treatment on homeless persons with co-occurring severe psychiatric and substance use disorders", Community Mental Health Journal, 1997 Apr;33(2):113-22.
  8. Homeless Agency. Facts about Homelessness: Causes of Homelessness. Retrieved 2006-05-10.
  9. National Coalition for the Homeless (June 2005). Often, more local resources are available to fleeing women and children as this group is easier to identify and improve their situation. Domestic Violence and Homelessness. Retrieved 2006-05-11.
  10. Chicago Coalition for the Homeless. Homelessness—Causes and Facts. Retrieved 2006-05-10.
  11. http://www.chicagohomeless.org/factsfigures/war.pdf#search=%22War%20and%20homelessness%22
  12. United States Conference of Mayors, "A Status Report on Hunger and Homelessness in America's Cities: a 27-city survey", December 2001.
  13. United States Conference of Mayors, "US Conference of Mayors/Sodexho Hunger and Homelessness Survey: 2005", December 2005, "Main Causes of Homelessness", p.63-64.
  14. Coalition on Homelessness and Housing in Ohio (2006-09-17). Homelessness: The Causes and Facts. Retrieved 2006-05-10.
  15. "Homeless advocates urge council to remember 'couch surfers'", Susan O'Neill, Inside Toronto, Canada, 7 July 2006
  16. Aday, Lu Ann , "Health status of vulnerable populations", Annual Review of Public Health, 1994;15:487-509.
  17. Bibliography on Healthcare for the Homeless
  18. United States Department of Health and Human Services, "Healthcare for the Homeless".
  19. Ferguson, M., "Shelter for the Homeless", American Journal of Nursing, 1989, pp.1061-2.
  20. Lenehan, G., McInnis, B., O'Donnell, and M. Hennessey, "A Nurses' Clinic for the Homeless", American Journal of Nursing, 1985, pp.1237-40.
  21. Martin-Ashley, J., "In Celebration of Thirty Years of Caring: Pine Street Inn Nurses Clinic", Unpublished.
  22. Homeless Health Concerns - National Library of Medicine
  23. Wood, David, (editor), "Delivering Health Care to Homeless Persons: The Diagnosis and Management of Medical and Mental Health Conditions", Springer Publishing Company, March 1992, ISBN 0-8261-7780-8
  24. "No Angels Here: The Closing of the Pine Street Inn Nurses Clinic, 1972–2003", by Grace Elizabeth Moore, Harvard Divinity School, Center for the Study of World Religions
  25. O'Connell, James, J, M.D., editor, et al. "The Health Care of Homeless Persons: a Manual of Communicable Diseases & Common Problems in Shelters & On the Streets", Boston Health Care for the Homeless Program, 2004.
  26. Government of Canada, "National Homelessness Initiative: Working Together"
  27. Australian Bureau of Statistics, "Housing Arrangements: Homelessness", 2004.
  28. National Alliance to End Homelessness
  29. "Study: 744,000 homeless people in U.S.". Associated Press. Jan. 10, 2006. Article is here, too.
  30. "In pictures: Japan's homeless", BBC News.

Bibliography

External links

Historical

International

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