homelessness and mental healh

As complex as the co-incidence of homelessness and mental illness is, the difficulty posed in its treatment is indicative of the limitations of conventional models of health and community service delivery. The issue demands a radical adaptation of conventional services, from a curative or palliative model to a new public health model, with an emphasis on prevention and health promotion. Many innovative policies and programs are in place in Australia, Britain, America and elsewhere which reflect an awareness of the special needs of the homeless mentally ill and the importance of services that integrate them. However, the need for holistic and tightly integrated approaches is still largely unmet. In A Long Road to Recovery, Robinson (2001) highlights the limited care and support services available in NSW to people with mental health problems and asks “Why are there so many people wandering our streets lost and confused, if our mental health system is truly working?”

I think australias mental health system is failing in all states, theres not enough services in general not enough beds in psych wards people being turned away who really are unwell or in danger of harming themselves or others...as the numbers increase of new diagnosis's the services stay limited and generic, theres a lack of dual services for youing people and drug addictions and mental health etc..we are not really prepared for this new wave of amphetamine/meth addicitons and psychosis that in time is going to keep growing, this is where people will fall between the cracks and end up homeless living on the streets, we need more specialised supported accomodation and community services to allow people to maintain as much independance as possible....hmm this issue just frustrates me it needs a definate overhaul and review by state and federal parliament and relevant MH services.

lol...thought you two were talking about America's problem at first glance.

Two years while homeless with my family, I attempted to get psych help. The only assistance I found was due to searching myself. The doctor's that DO help the homeless with psych problems CANNOT do so for those receiving Medicaid (our subsidized medical program for children and families in Florida, USA).

Hence, if you're rebuilding your life and already made the effort to get medical coverage...you cannot receive psych services that are available to other homeless on the streets...who are so far gone or choose NOT to deal with their medical issues.

In other words, there IS help for the majority of those who are in denial and will never benefit from psych help due to not accepting it. There is NO help for those who are proactive in their personal medical care, and are covered under government medical assistance.

The hell of this...when I and my wife went to a local County run mental resource center, we were told they accept Medicaid coverage. We were told to leave though...because since we lived in a homeless shelter, we had services available there.

On three different occassions. We were given the nasty looks, the stereotyping, etc etc...from the place we trusted enough to go for help.

Not that place again...they're hypocrites, flat out. It's not what they said...it was the look in their eye's when they said it.

welcome to homlessness HIJ,
anything I can do to encourage you, ask........
first where are you.....
I know the job seen.....wherever you are
maybe we should go off screen........decide

Dude you did it before, by your self. You are the same person. Rely on your resources. YOUR resoureces. YOU CAN DO IT. Bring it back together. Don't give up, don't rely on the sytstem, except for food. You CAN do it, get it on.
GO, GO, GO. Don't fucking give up.

Theres not enough services in general not enough beds in psych wards


I actually have the figures for this in one of my lectures on the subject, IIRC we have about 5-10% of the mental health beds now, that we had in the 70's. We also have about twice the population. Not hard to do the math.

Regards,
Konstantìn

I think australias mental health system is failing in all states, theres not enough services in general not enough beds in psych wards people being turned away who really are unwell or in danger of harming themselves or others...as the numbers increase of new diagnosis's the services stay limited and generic, theres a lack of dual services for youing people and drug addictions and mental health etc..we are not really prepared for this new wave of amphetamine/meth addicitons and psychosis that in time is going to keep growing, this is where people will fall between the cracks and end up homeless living on the streets, we need more specialised supported accomodation and community services to allow people to maintain as much independance as possible....hmm this issue just frustrates me it needs a definate overhaul and review by state and federal parliament and relevant MH services.
It is 22 years since the Richmond report recommended moving people out of psychiatric wards to be cared for in the community.Known as deinstitutionalisation, the process began in the 1960s and was well under way before the report was released in 1983.It recommended that the NSW government fund a system of community-based networks, backed up by specialist hospital and accommodation services. Mental hospitals were to be progressively reduced in size, and their services provided by general hospitals, supported accommodation and hostels.But David Richmond's idea of a new system of caring for people with mental illness was never properly supported by successive governments, which have used it as a blunt instrument to cut costs by closing beds.Proper community support remains little more than a utopian dream for most people with psychotic disorders. Chronic poor funding means services are always struggling and supported accommodation is rarely available.

I think australias mental health system is failing in all states, theres not enough services in general not enough beds in psych wards people being turned away who really are unwell or in danger of harming themselves or others...as the numbers increase of new diagnosis's the services stay limited and generic, theres a lack of dual services for youing people and drug addictions and mental health etc..we are not really prepared for this new wave of amphetamine/meth addicitons and psychosis that in time is going to keep growing, this is where people will fall between the cracks and end up homeless living on the streets, we need more specialised supported accomodation and community services to allow people to maintain as much independance as possible....hmm this issue just frustrates me it needs a definate overhaul and review by state and federal parliament and relevant MH services.
It is 22 years since the Richmond report recommended moving people out of psychiatric wards to be cared for in the community.Known as deinstitutionalisation, the process began in the 1960s and was well under way before the report was released in 1983.It recommended that the NSW government fund a system of community-based networks, backed up by specialist hospital and accommodation services. Mental hospitals were to be progressively reduced in size, and their services provided by general hospitals, supported accommodation and hostels.But David Richmond's idea of a new system of caring for people with mental illness was never properly supported by successive governments, which have used it as a blunt instrument to cut costs by closing beds.Proper community support remains little more than a utopian dream for most people with psychotic disorders. Chronic poor funding means services are always struggling and supported accommodation is rarely available.

The problem is we have an acute shortage of psych staff. Nurses, Doctors, etc...

Now I understand the ideal of deinstitutionalisation, but there were never the staff to do it, it takes many more people to run 25 little mental health wards than 3 big ones.

Secondly it moves mental health triage effectively into casualty.
That is the client at their most accute. So what does Joe public see? Crazy = violent, volatile and agressive. Not accurate but it is now a not infrequent public experiance at hospitals. Because they don't get to see them at other times, they think they are always like that and the misconception stays.

Regards,
Konstantìn

Exactly!! Im all for deinstitutionalisation, my view on the lack of beds was just my experience working in mental health that the consumers i worked with were refused and rejected when they really needed hospitalisation due to very acute symptoms and suicidal and self harm behaviour as all beds were full. Theres also the recent case of a GP up in our north WA that referred a patient who was severely depressed and suicidal down to perth to be assessed and admitted as he had had a breakdown and had lost his wife, home, job, children everything..on arrival he was assessed and sent away and told to come back in a day or 2 if he still felt that way that night he hung himself in a hostel..the Dr up north is currently attempting to sue the mental health hospital for ignoring and refusing his referral that was labelled an urgent assist.
More patients who are seen as 'regulars' should be given the opportunity and support to stay in the community instead of being locked up every couple of months for weeks at a time it affects their accomodation, stability, social and emotional wellbeing.

Theres also the recent case of a GP up in our north WA that referred a patient who was severely depressed and suicidal down to perth to be assessed and admitted as he had had a breakdown and had lost his wife, home, job, children everything..on arrival he was assessed and sent away and told to come back in a day or 2 if he still felt that way that night he hung himself in a hostel..the Dr up north is currently attempting to sue the mental health hospital for ignoring and refusing his referral that was labelled an urgent assist.


Oddly I have personally seen that exact same thing happen, almost to the letter. Makes you wonder how common it is?

Sadly he was one of my favourite patients. He was always going around trying to help people even when suicidal he was still thinking of others. A really lovely chap.

I sort of hope the doctor wins, but then I realise that if they had taken him, the only way to do that would have probably been to throw one of the others out. :(

Konstantìn

In a lot of cases there is a disparity when clients present at hospitals with mental health issues. Scenario; upon presenting at hospital and explaining that I am too sick to stay at home, response you are not sick enough to be in hospital. It is ok to say the current norm; ethos is based on home-based treatment. If you are homeless you are treated with suspicion and vacillation when presenting.

Konstantin, yes makes you realise how common this actually is and how degrading it is also to the families who have lost the battle with a loved one and spend a lifetime grieving their memory..not too mention the ever increasing black crosses against out mental health system that gives off a rather negative and incompetent image to the public and the media and other community services. You just need to look into the prisons too how many deaths in custody have occured which coulc have been prevented with more assessment, observation and support of new 'young' first time prisoners and prisoners with a mental health history..ever seen 'Who killed Malcolm Smith' a rather sad documentary on an aboriginal prisoner who was unwell.
Ian i agree homelessness can often be seen as an easy means to accomodation. As well as consumers presenting with drug/alcohol histories. So what will happen to the increasing number of people using pot and meth and the effects it can have on ones mental wellbeing. So will the gaps just keep on widening in our mental health system or will new services and treatments be introduced that can cater for specific poly drug use issues etc??