Custom essays on Analysis of the services that relate to Homelessness

Homelessness is a complex concept that includes the situation when people are left without living place, do not have permanent housing, live in unsafe areas or in poor conditions.
Homeless people include virtually people sleeping on the street, newly arrived immigrants and victims of fires, floods or severe harassment or violence; those without permanent housing, including those who sleep in casual or temporary premises such as night shelters, hostels or refuge and those who are discharged from institutions such prolonged detention, as psychiatric hospitals, prisons, detention facilities are temporarily deprived of their liberty, local or other institutional care, and who have nowhere to go after them.
In one study, after controlling for potential confounding factors, homeless children had more frequent emergency department visits in the past year and were significantly more likely to be hospitalized in the past year compared with housed children. Thus, it is even more important to be aware of the health conditions that homeless children face in order to help these people be healthy. (Crosson-Tower 2009)
About one third of medical problems treated at Health Care for the Homeless locations are chronic physical conditions. The most common (excluding substance abuse) are hypertension, gastrointestinal problems, neurological disorders, arthritis and other musculoskeletal disorders, etc. (Sachs-Ericsson et all 1999)
Common illnesses (such as colds or the flu) that are easily treated in the general population often escalate to more severe problems in the homeless population, and chronic health problems common among the housed population are made much worse by the stress and exposure of homelessness, as well as lack of access to ongoing treatment. (Sachs-Ericsson et all 1999)
Other health issues, such as stress and nutrition, affect the lives of homeless children more negatively than other people. It has been suggested that homeless people may use drugs or alcohol, and lack of appropriate health care and stressful living conditions may lead to increased substance abuse.
So Homeless children face severe barriers to health care, and more research is needed to understand the barriers to treatment that are specific to this population.
The first steps in providing health services to homeless are:
– identification of homeless in specific area;
– using homelessness status as markers for increased health risk;
– development of specific quality assurance activities and outcome measures focusing on homeless enrollees, in collaboration with advocates and experienced homeless service providers.
The most common medical services needs of homeless children are associated with (also with common diseases) drug dependence, alcohol dependence or mental disorders, and often dual diagnosis. Additional causes include injuries (due to accident or violence), poor condition of feet or teeth due to lack of care, infections and complaints of skin diseases. Other infections among homeless children include diphtheria (usually skin) or hepatitis A, and in intravenous drug use also include hepatitis B and C, HIV, septicemia, encephalitis, endocarditis, and many more complications. (Sachs-Ericsson et all 1999)
Many homeless children do not participate in the health insurance system. There are examples from different countries, demonstrating that with respect to health care, they are dependent on doctors, nurses and social workers, hospitals. Cross-sectional studies conducted in the United States of homeless groups in urban regions, show that between 41% to 81% of them have no health insurance (Sachs-Ericsson et all 1999)
This figure is lower for homeless families. However, 26% of homeless families had no health insurance.
Availability of health insurance, of course, correlates with greater use of both outpatient and inpatient health services, treatment compliance, and lower levels of obstacles to the demand for care. The frequency of calls about accidents in the emergency service and ambulance services are not dependent on the presence or absence of health insurance.
Some of the obstacles to achieving health care for homeless children are: discrimination, inconvenient schedule health-care facilities, procedures for the appointment time and receive no financial incentives for medical practitioners.
To overcome these difficulties, there are various structures to ensure health care for the homeless children in particular states. In the first case it is an ordinary general medical service, which assumes the additional role in terms of providing primary health care for the homeless children.
The second is a “special” general practice, which deals with only the homeless people. The task lies in the provision of primary health care for the homeless children in the hospitals of second level support. The most important factor in the success of such programs seems to support from social workers , however, primary care program for the homeless led to a reduction in the number of hospitalizations.
Providing primary care for homeless children requires the organization, policies and operating procedures regarding the possible threatening behavior of patients, convenient time for the reception and organization of multidisciplinary teams. Services must be responsive to those groups of homeless people, who may have special needs.
There are good examples of how primary health care services with multidisciplinary teams can provide effective health care and prevention for the homeless children. Measures for common health, drug or alcohol addiction or sexual risk behavior can provide real opportunities for the homeless children to avoid all the difficulties of homeless life, and help them to continue treatment.
It is unclear how many homeless people are receiving assistance under each type of practice, and this may be the subject of further research. Specialized general practice is usually observed only in large cities and is therefore are not an effective way to address homelessness in rural areas.

The services policy recommendations
Access to primary health care – is the basic prerequisite for effective treatment and elimination of health problems among the homeless. This would include actions to address the problems associated with obtaining medical care, such as lack of health insurance.
Cultural barriers associated with stigma or lack of relevant knowledge among health workers, can be eliminated through appropriate learning activities. It is also necessary to take measures to eliminate obstacles to effective cooperation of the set of institutions of different profiles, in order to help homeless people access to health care and counseling, financial support.
My personal philosophy of helping homeless children is associated with measures to ensure a healthy housing for the homeless children. The approach recognizes the need for healthy living in health and social support, and support for shelter, and entails a shift from large-scale treatment measures in hospitals to smaller, individualized care.
In fact it is not important what type of service (primary or special) is held at the place of residence of homeless, the most important is the fact that the services are surely provided!
References
Crosson-Tower,C. (2009). Exploring Child Welfare. A Practice Perspective. Pearson Education, Inc
Frost JJ, Bolzan M. (1997). The provision of public-sector services by family planning agencies in. Fam Plann Perspect 29(1), pp. 6-14.
Sachs-Ericsson N, Wise E, Debrody C, Paniucki H. (1999). Health problems and service utilization in the homeless. Journal of Health Care for the Poor and Underserved 10(4), pp. 443-452.
Ferenchick G. ( 1992). The medical problems of homeless clinic patients: A comparative study. Journal of General Internal Medicine 7(3), pp. 294-297.