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Community Needs Assessment

of the Mentally Ill Homeless Individual
Cynthia Diane Hancock
Excelsior College
Nursing 541
Judith Treschuk Ph.D
Abstract
The purpose of this paper is to describe the vulnerable homeless population, while focusing on the specific health related problem of mental illness, and the resources available for an effective care program in Kerr County Texas. The vulnerable population of the homeless and the specific health related problem of mental illness is a dilemma that requires improving social and economic resources with which to manage their care. Kerr County Texas has many individuals who are homeless with mental illness and in need of assistance with finding the minimal resources available. Persons who are homeless and mentally ill are generally recognized as the most difficult people to engage and provide with affordable permanent housing.
The visibility of the homeless mentally ill persons on street corners, in parks, or under bridges here in America serves as a poignant sign that communities are not meeting the needs of these vulnerable citizens. There is much Kerr County Texas can do to help the homeless persons who are mentally ill. This dilemma calls for improving social and economic resources with which to manage their care. The homeless are in need of advocates to lobby for change on their behalf and provide essential elements of support. The purpose of this paper is to describe the vulnerable homeless population, while focusing on the specific health related problem of mental illness, and the resources available for an effective care program in Kerr County Texas.

Description of Aggregate
The vulnerable population of homeless people with the existing health related problem of mental illness is a social group which has limited social and economic resources that separates them from mainstream society (Di Martile Bolla, 2008, p. 784). The homeless mentally ill are more disadvantaged than others because health planning focuses on the majority and not this vulnerable group that is disenfranchised in that they are from a low income group with the highest levels of unmet needs for housing assistance and health care. SSI income and housing costs has resulted in an increased number of people with mental illness who either cannot afford housing, and have lost it or hold onto their housing by foregoing other essentials such as food, health care, and clothing (Herb, Miller & O?Hara, 2010). According to the US Surgeon General, as many as one-third of individuals who experience homelessness has a mental illness. Persons who are homeless and mentally ill are generally recognized as the most difficult people to ?engage? and provide with affordable, permanent housing that they can maintain. It is often said that these individuals are ?system resistant.? The system in place doesn?t adequately address their needs and desires (Schwartz, 2005).

Several commonalities exist amongst the homeless mentally ill individuals who are often treated with disdain and/or scorned which makes it much easier to ignore their needs. This type of stigmatization frequently causes the mentally ill to avoid seeking the very help that they need. This is a very serious issue because they frequently have multiple health issues in addition to their mental health problems. Another important factor in this area is the fact that many health care professionals have condescending attitudes toward this vulnerable group. Often these caregivers possess some of the same prejudices and misguided ideas about the homeless as those of the society at large (Clark, 2008).

These types of attitudes often create communication barriers at the point of first patient provider encounters, thus greatly reducing the likelihood of an effective resolution of the medical issues presented by the homeless individual (Buck, Clark, Kneuper, Melillo Monteiro, Rochon, & Volk, 2005). Frequently the mentally ill homeless resort to various modes of self medication which often lead to use of alcohol or other elicit drugs in an effort to deal with their problems. The use of injectable street drugs presents an array of potential negative outcomes including addiction as well as a high probability of exposure to serious transmissible diseases. This in turn tends to create a self perpetuating cycle involving the elements of mental illness, drug abuse and poor health care seeking behavior. Taken together these conditions also make stable employment and residency problematic. Also, they have