Living With Dual Diagnosis and Homelessness: Marginalized Within a Marginalized Group

Schütz, Christian; Choi, Fiona; Song, Michael Jae; Wesarg, Christiane; Li, Kathy; Krausz, Michael

doi:10.1080/15504263.2019.1579948

Cited by 20 publications

(17 citation statements)

References 23 publications

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“…Finally, aspects like malnourishment, depression and lack of sleep lead to an enfeeblement of the immune system, which could make these people prone to more severe symptoms of the illness ( Lima et al, 2020 ) suffering from higher rates of chronic illnesses ( Wood et al, 2020 ). Those who suffer from dual disorders and smoke also frequently suffer from lung diseases and are more vulnerable, with more complex necessities ( Schütz et al, 2019 ). Because of all these reasons, HP younger than 65 have a mortality rate between 5 and 10 times higher than general population ( Baggett et al, 2013 ) and the disease caused by COVID19 can make such mortality rates rise ( Tsai & Wilson, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Martin

Andrés

Bullón

et al. 2020

Int J Soc Psychiatry

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Background: Homeless population has been severely affected by the COVID-19 pandemic. Their living conditions, comorbidity with different pathologies and a greater frequency of mental disorders, make this population vulnerable. Method: We implemented a program of serial visits in a hostel for confined homeless of the city council social services, for the monitoring and treatment of mental disorders and substance abuse problems. Accompanied by serial phone and email contacts. Results: A highly significant percentage (63%) had mental disorders or substance abuse, requiring pharmacological intervention, and 37% began follow-up in resources of the Mental Health and Addiction network of the Psychiatric Service at the end of the program. Hospital emergency service visits were drastically reduced. None of them were infected with COVID-19. An individualized Social plan was drawn up in order to reintegrate them with support in the community. Conclusions: The Results have been really positive, meeting all the objectives and opening up developing new programs in the future, in the pandemic outbreak and out of it.

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Section: Introductionmentioning

confidence: 99%

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Martin

Andrés

Bullón

et al. 2020

Int J Soc Psychiatry

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“…(WHO, 2020) Patients with dual diagnoses had a higher risk of nonadherence than those with a single disorder (Carrà et al , 2015; Herbeck et al , 2005). Therefore, the already compromised treatment availability during the pandemic could have a more significant negative impact on patients with co-occurring disorders. Social and public health concerns: patients with dual diagnosis are at a greater risk of unemployment, homelessness and incarceration (Carrà et al , 2015; Schütz et al , 2019). COVID-19 has resulted in record unemployment and consequent financial difficulties (Cuellar et al , 2020).…”

Section: Introductionmentioning

confidence: 99%

How did the COVID-19 lockdown impact patients with dual diagnoses?

Ghosh

Subodh

Sharma

et al. 2022

ADD

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Purpose Individuals with dual diagnoses might experience significant clinical and social vulnerabilities during the pandemic and lockdown. This study aims to compare medication adherence, substance use, clinical stability and overall functioning before and during lockdown periods. Design/methodology/approach This was a cross-sectional survey among patients registered in dual diagnosis clinic of an addiction psychiatry center in Northern India between March 2019 and February 2020. This study approached 250 patients for telephonic interviews. This study assessed adherence to medications with the brief adherence rating scale (BARS). Global functioning was measured by global assessment of functioning. Clinical interviews assessed substance use and the clinical status of psychiatric disorders. Findings One hundred fifty patients were recruited. The mean age of the sample was 35.8 years. The sample had a slight preponderance of alcohol dependence. Depressive disorder was the largest category of psychiatric diagnosis. Compared to prelockdown period, during the lockdown, there were an increased number of days of nonadherence (X2 17.61, p < 0.05), proportion of patients underdosing (X2 8.96, p = 0.003) and lower BARS scores (t = 10.52, df = 144, p < 0.0001). More patients were abstinent from substances during the lockdown (X2 49.02, p < 0.0001). Clinical stability of psychiatric disorders did not differ during the two-time points, but overall functioning decreased during the lockdown (t = 2.118, p = 0.036). This study observed a small positive correlation (r = 0.2, p = 0.02) between functioning and adherence levels. Originality/value Lockdown was associated with poor medication adherence, change in substance use patterns and functional impairment. In the future, treatment programs and policies must take preemptive steps to minimize the effects of restrictions.

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“…Research has shown that individuals with TBI and MHSU report poorer psychological and physical health and greater unmet care needs than individuals without co-occurring conditions [17,18]. Certain barriers to providing optimal services for those with TBI and MHSU who are experiencing homelessness have been proposed, including: (1) limited evidence for interventions (i.e., how to support individuals with concurrent TBI and MHSU with housing); (2) a lack of knowledge of TBI among professionals in housing or mental health services; and (3) having multiple concurrent conditions (i.e., TBI and MHSU) affecting eligibility for services [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Critical Characteristics of Housing and Housing Supports for Individuals with Concurrent Traumatic Brain Injury and Mental Health and/or Substance Use Challenges: A Qualitative Study

Estrella

Kirsh

Kontos

et al. 2021

IJERPH

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Traumatic brain injury (TBI) and mental health and/or substance use challenges (MHSU) are commonly co-occurring and prevalent in individuals experiencing homelessness; however, evidence suggests that systems of care are siloed and organized around clinical diagnoses. Research is needed to understand how housing and housing supports are provided to this complex and understudied group in the context of siloed service systems. This study aimed to describe critical characteristics of housing and housing supports for individuals with concurrent TBI and MHSU from the perspectives of service users with TBI and MHSU and housing service providers. Using basic qualitative description, in-depth interviews were conducted with 16 service users and 15 service providers. Data were analyzed using thematic analysis techniques. Themes capture core processes in finding and maintaining housing and the critical housing supports that enabled them: (1) overcoming structural barriers through service coordination, education and awareness raising, and partnerships and collaborations; and (2) enabling engagement in meaningful activity and social connection through creating opportunities, training and skills development, and design of home and neighborhood environments. Implications for practice, including the urgent need for formalized TBI and MHSU education, support for service providers, and potential interventions to further enable core housing processes are discussed.

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Living With Dual Diagnosis and Homelessness: Marginalized Within a Marginalized Group

Cited by 20 publications

References 23 publications

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

How did the COVID-19 lockdown impact patients with dual diagnoses?

Critical Characteristics of Housing and Housing Supports for Individuals with Concurrent Traumatic Brain Injury and Mental Health and/or Substance Use Challenges: A Qualitative Study

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