Involvement in an outreach and residential treatment program for homeless mentally ill veterans

Article Abstract:

As many as half the homeless people in the United States are mentally ill or are abusing drugs or alcohol. The homeless are clearly underserved in terms of medical and social services, but because of their sense of distrust and alienation, they often do not take advantage of the services that are available. Outreach programs have been designed to bring services to the homeless mentally ill, but the success of these efforts has not been studied. One such program is the Homeless Chronically Mentally Ill Veterans program, established in 1987 at 43 sites around the nation. Both outpatient and residential psychiatric services are offered. For this study, clinicians at nine sites documented the services delivered to and participation by 1,684 veterans, during the first three months after these individuals were first screened for the program. The results indicate that almost all the homeless mentally ill were initially interested in a wide range of services, but their rate of continued involvement in the program was modest, at 24 percent after three months. Only 16 percent of the individuals screened went on to have more than 10 contacts with the veterans' program. Individuals who had previous contacts with mental health institutions had a higher rate of entry into residential treatment than other individuals. The factor that was most strongly linked to ongoing participation in the program was receiving residential treatment; 48 percent of those treated as inpatients were still involved in the program after three months, compared with 15 percent of those treated as outpatients. These findings suggest that residential treatment is essential to the care of the homeless mentally ill, despite its cost. (Consumer Summary produced by Reliance Medical Information, Inc.)

Services, Mentally ill persons, Mentally ill, Homeless persons, Veterans

---

Experiences of a paraplegic psychiatry resident on an inpatient psychiatric unit

Article Abstract:

It is estimated that there are between 18,000 and 80,000 physically disabled physicians in practice in the United States, but little has been written about their experiences in practice. Dr. Beryl B. Lawn, a paraplegic medical doctor, discusses her experiences working in a hospital psychiatric unit. During training she encountered few comments about her disability, but it was frequently brought up by hospitalized psychiatric patients during residency. During Lawn's training period and 12 years of internal medicine practice, very few people commented on her disability. In general, people assumed she was retarded, unemployed, poor, asexual, and unhappy. When she began her psychiatry residency at an inner-city teaching hospital, she was unprepared for the responses from hospitalized psychiatric patients. Within 15 minutes of Lawn's arrival, a schizophrenic woman approached her and inquired pleasantly, "Are you crippled?". She continued to receive the same question from almost every patient she saw, and her responses were consistently affirmative, but patient reactions varied markedly. Many patients told her that they prayed daily for her healing; several wanted to push her around the ward in her wheelchair. Often the most withdrawn and hostile patients vied most earnestly for the job. A positive effect of the disability resulted from the decreased emotional distance patients felt towards her because she was hurt or less than perfect. By being "defective, too", she could empathize with her patient's pain and powerlessness. Helping them heal their hurts has aided her in healing wounds of her own. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Personal narratives, Medical students, Physically disabled persons, Paraplegics, Paraplegia

---

Similar abstracts:

• Abstracts: Regional variation in patterns of inpatient psychiatric care. Partial hospitalization: an update
• Abstracts: Media distortion of the public's perception of recidivism and psychiatric rehabilitation. Assessing symptom change in Southeast Asian refugee survivors of mass violence and torture
• Abstracts: Transfers of hospitalized psychiatric patients under Medicare's prospective payment system. Managed health care and the Massachusetts experience
• Abstracts: Witch doctors and mental illness in mainland China: a preliminary study. Neuroleptic malignant syndrome in 12 of 9,792 Chinese inpatients exposed to neuroleptics: a prospective study

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.