PHIL2070 Healthcare Ethics

Question: Today we will be addressing the issue of homelessness within Australia, and how their mental health is affected by being homeless. Shortly I will be joined by two people who will be sharing their lived experience of being homeless, and mental health obstacles. But what is homelessness? Well, the Australian Beauro of Statistics defines homelessness a situation in which a person fulfils the following criteria (2012). Firstly, they are in a dwelling that is inadequate, or secondly, there is no tenure, or if their tenure is short and non-extendable, or does not allow them to have control of, and access to space for social reasons. This definition was updated in 2012 as we have come to better understand homelessness to refer to be without a home, rather than without a roof. Mallet (2004) identified elements such as security, privacy, safety, stability, and the ability to control the living space as contributors to what substitutes as a home. Within Australia it is estimated that approximately 5 people for every 1 000 are homeless as per the 2016 census data (ABS, 2018), which is a 4.6% increase from five years ago. Of the twenty-three and a half million people living in Australia on the 2016 census, over 116,000 were homeless.Homelessness and mental illness are quite interlinked (WayAhead Mental Health Association NSW 2016). People who have experienced homelessness have attributed it to being isolating, traumatic and disempowering, affecting their quality of life and self-esteem (Williams & Stickley 2010).So it is correlated that people without mental health issues before becoming homeless, will develop mental distress that can become quite serious in the experience of homelessness (Williams & Stickley 2010).And just as homelessness has been found to contribute to the development of mental illness, mental illness can contribute to homelessness, and the two can interlink and cause and affect the other (WayAhead Mental Health Association NSW 2016). Answer: Mental illness is considered as the huge range of mental health condition which includes behaviour and disorders that affect the mood of individual. As an example of mental health issue or mental illness depression, eating disorder, anxiety, addictive behaviour and schizophrenia could be considered, however, there are various mental illnesses that affect both the physical and mental health of individual, thus create difficulties in living life meaningfully. Relationship between the homelessness and development of mental health issue gas been observed by various public health workers, agencies that provide service and social justice bodies. It has been found that the condition of homelessness influence the development of mental illness at a higher rate as compare to other population. It has been estimated that the incidence of mental illness among the homeless people ranges from 2 to 90 %. A study in Sydney has identified that 75% people that are homeless suffer from at least one mental disorder where as the prevalence is 20% in other population. As the diagnosis of mental illness become more advance the diversity of disorders are become clear and effective approaches for recovery have been developed to cope up with the situation. The major approach for providing effective care to such people is the psychosocial approach. Association between the substance abuse and mental illness has been found in case of homeless people. Study has identified that psychosocial intervention such as motivational interview, cognitive behavioural therapy, strategies for preventing relapse and interpersonal and supportive therapies. In addition, trauma informed therapy is also effective as it helps to recover from the traumatic events that influence the symptoms of mental illness. Furthermore, housing is another important requirement of homeless people, thus it is important to provide safe place with the opportunity to communicate with others to recover them from isolation. The family members could be educated regarding the management of people with mental illness in order to enhance the community knowledge. It would help to create awareness. It is required to ensure the access to adequate mental health service and support for the family and carers. Improve the resilience and well-being. References AIHW. 2018. Exploring drug treatment and homelessness in Australia: 1 July 2011 to 30 June 2014 [Online]. Available: https://www.aihw.gov.au/getmedia/088123dd-a9f2-40f8-b92e-1386f965ed9a/19940.pdf.aspx?inline=true [Accessed October 13. 2018]. Australia, H. 2018. Are you experiencing homelessness? [Online]. Available: https://www.homelessnessaustralia.org.au/are-you-experiencing-homelessness [Accessed October 13. 2018]. Drake, R.E. and Whitley, R., 2014. Recovery and severe mental illness: description and analysis. The Canadian Journal of Psychiatry, 59(5), pp.236-242. Henwood, B.F., Derejko, K.S., Couture, J. and Padgett, D.K., 2015. Maslow and mental health recovery: A comparative study of homeless programs for adults with serious mental illness. Administration and Policy in Mental Health and Mental Health Services Research, 42(2), pp.220-228. Homelessnessnsw.org.au. (2018). Mental illness and homelessness | Homelessness NSW Inc.. [online] Available at: https://www.homelessnessnsw.org.au/resources/mental-illness-and-homelessness [Accessed 13 Oct. 2018]. Kirst, M., Zerger, S., Misir, V., Hwang, S. and Stergiopoulos, V., 2015. The impact of a Housing First randomized controlled trial on substance use problems among homeless individuals with mental illness. Drug and alcohol dependence, 146, pp.24-29. Petros, R., Solomon, P., Linz, S., DeCesaris, M. and Hanrahan, N.P., 2016. Autovideography: The lived experience of recovery for adults with serious mental illness. Psychiatric Quarterly, 87(3), pp.417-426. Sydney, T. C. O. 2018. Homelessness [Online]. Available: https://www.cityofsydney.nsw.gov.au/community/community-support/homelessness [Accessed October 13. 2018]. Vigo, D., Thornicroft, G. and Atun, R., 2016. Estimating the true global burden of mental illness. The Lancet Psychiatry, 3(2), pp.171-178. Yfoundations. (2018). Link2home – Yfoundations. [online] Available at: https://yfoundations.org.au/need-help/yconnect/ [Accessed 13 Oct. 2018].

PHIL2070 Healthcare Ethics

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