“For many patients, a prescription for housing or food is the most powerful one that a physician could write, with health effects far exceeding those of most medications.”
– from Housing as Health Care — New York’s Boundary-Crossing Experiment
Image by nouspique via flickr.
Housing First is a health care strategy based on the idea that secure, affordable housing is a necessary first step to care effectively for homeless people with chronic mental health and substance abuse problems. There is some evidence that this approach may, in some circumstances, even save taxpayers money (but probably not as much as is often claimed).
In a much-cited 2009 study in Seattle, researchers analyzed medical and law enforcement costs for 91 people given supportive housing and found that costs dropped to about half the level seen among 35 comparable homeless people on a waiting list.
Cities from coast to coast are ramping up efforts to provide housing as a health care solution. Reporters who keep an eye on this trend won’t be lacking for stories to pursue. There’s a lot of money at stake, for one thing. And, despite all the potential for helping people, it’s questionable whether all these projects will really save money, especially if they house more than just the heaviest repeat users of emergency rooms and jail cells. Other aspects of the Housing First model are bound to stir controversy (more on this below). Continue reading
With much of the country feeling the “polar vortex” and some of the coldest temperatures seen in 20 years in some places, reporters may be called upon to write about health – and death – in cold weather.
Hypothermia is the unintentional lowering of the body’s core temperature below 95º F. According to the Centers for Disease Control and Prevention, common risk factors for hypothermia include exposure to cold while under the influence of alcohol or drugs, altered mental status and immersion in cold water. Other factors can include advanced age, chronic medical conditions, substance abuse and homelessness.
The CDC has some winter weather health and safety tips to help people protect themselves from frostbite, hypothermia, carbon monoxide poisoning, chainsaw mishaps and more. Here are some other general resources: Continue reading
Photo by Desiree RobinsonLarry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program, addresses visiting AHCJ members.
“I’ve been locked up in mental institutions and prison. If it hadn’t been for the team here, I wouldn’t be talking to you right now. When I’m feeling depressed, I pick up the phone and I call my psychiatrist and talk.”
These are the heartfelt sentiments of Larry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program (BHCHP). First of its kind in the nation, BHCHP serves 12,000 patients through over 60,000 visits a year in more than 80 locations. For more than 25 years their mission has been to provide or assure access to the highest quality health care for all homeless men, women, transgender and children in the greater Boston area.
As part of one of the field trips offered at Health Journalism 2013, journalists toured the bright and warm facility where health care teams mobilize to serve the most underserved of Boston’s residents. Continue reading
In the first of a series of articles, Kim Horner of The Dallas Morning News looks at the struggle of helping the chronically homeless. The series will look at the costs of inadequate treatment for mental illness and addiction, as well as possible solutions. The project received support from The Carter Center.
Though chronic homelessness is a nationwide problem, Texas falls behind most states in providing care at psychiatric hospitals and mental health clinics. That lack of commitment results in overflowing facilities and poor follow-up care that can set up the most vulnerable patients for failure.
Horner reports that the system of psychiatric hospitals, drug and alcohol treatment centers, mental health clinics and housing programs isn’t working for most of the chronically homeless. “That failure not only perpetuates homelessness but ends up costing taxpayers millions for law enforcement, emergency care and other expenses that could be avoided.”
Chronically homeless people often do not follow through with their care and cannot properly care for themselves, leading them to return to treatment repeatedly. A hospital superintendent says failure to take medications is the top reason people are readmitted to his hospital.
The article does look at proposed solutions to the problem of homelessness. One answer – supported by experts nationwide – is to establish special apartments coupled with intensive mental health services to keep people stable.
Urban Workshop keynoter Steve Lopez puts focus on mental health [Listen to Lopez’ speech]
Jill Maddox, psychiatrist at the Center for Urban Community Services and the Project for Psychiatric Outreach to the Homeless, speaks about mental health issues in urban areas at the 2007 Urban Health Journalism Workshop.
The National Center on Family Homelessness has released a report card on child homelessness, with an estimate that more than 1.5 million children in the United States are homeless.
The report points out that:
“Children without homes are twice as likely to experience hunger as other children. Two-thirds worry they won’t have enough to eat. More than one-third of homeless children report being forced to skip meals. Homelessness makes children sick. Children who experience homelessness
are more than twice as likely as middle class children to have moderate to severe acute and chronic health problems.”
Health is one measure taken into account for the report’s child well-being score and the report has sections that deal with the health of children as well as policy initiatives, such as Medicaid and SCHIP.
The report has a state-by-state breakdown that shows the percentage of uninsured children, Medicaid expenditures and eligibility and other measures. It also includes rankings and an evaluation of each state’s policy and planning for homelessness.