Health and Homelessness Flashcards
Maslow’s Hierarchy of needs
TOP to BOTTOM
Self-actualisation
Esteem
Love/Belonging
Safety
Physiological
State the main determinants of health
Individual lifestyle factors
Social and Community networks
General socio-economic, cultural and environmental conditions
Key determinant of health
Housing
Health-care services
ECG of wellbeing
5Rs
- Rafters (firm foundations)
- Relationships (firm foundations)
- Resources
- Restoration
- Resilience
Rafters
Shelter, Security and Continuity
Resources
Income, Wealth, Education, Employment, Opportunity
What is homelessness ?
EXAM TYPE Q
Has no accommodation in the UK or elsewhere that they can reasonably occupy.
Cannot gain access to their accommodation or risk domestic violence by living there.
Accommodation which is unreasonable, overcrowded or risk to health.
‘Likely to become homeless’ - within 2 months
State some forms of temporary accommodation
Council Housing
Voluntary Sector Hostels
Women’s Refuge
Supported Flats
Bed and Breakfast
Why do people become homeless ?
Social issues
Personal factors/ vulnerabilities
Housing Factors
State some social issues
Lack of affordable housing
Lack of Jobs
Inadequate levels of welfare & disability payment
Ethical & Racial Discrimination
Economic Downturn / Welfare Reform
State some personal factors (family related)
Adverse Childhood experiences
Childhood family environment
History of Institutional living
Relationship breakdowns
Social Isolation
Life-coping skills are overwhelmed
Bereavement
State some personal factors (illness related)
Mental illness
Substance misuse
Domestic/ Sexual Abuse
Learning Disabilities
History of anti-social behaviour/ offending
State some personal factors (financial related)
Poverty and Debt
Household with no recourse to pubic funds (NRPF)
NRPF
No recourse to public funds
State some housing factors
Rent or Mortgage arrears
Impending eviction/ repossession
Tenure insecurity - tied tenancy
History of neighbour complaints
Previous homelessness
House unable to be adapted to needs
State some people who are at high risk of homelessness (younger generation)
Single young males
Young adults 18-25
Family breakups
State some people who are at a high risk of homelessness (people serving time)
Those leaving the HM forces
Leaving prison
Refugees / Those with NRPF
State some people who are at a high risk of homelessness (medical)
Victims of domestic abuse
Hospital Discharge
People with addictions/ mental health issues
Looked after young people
Describe some health consequences of homelessness
Impact on life expectancy (lowered)
Mental Illness and Substance abuse
Physical Ill health
State the life expectancy for rough sleepers
Average life expectancy of 41 years, compared with the national average of 79 for men and 83 for women.
State the top causes of death amongst the homeless
Drugs (20x)
Intentional Self Harm (8x)
Assault (7x)
Chest (6x)
Infections (6x)
Alcohol (5x)
What is ‘Housing First’ ?
A wrap around support to rebuild connection and wean off support, once a previously homeless individual moves into their new accommodation.
Dual Diagnosis
Mental Illness
Substance Abuse
SII
Slope Index of Inequality
What is the Slope Index of Inequality ?
Epidemiological measure of the difference in life expectancy between the most and least deprived sections of the local population.
SMR
Standardised Mortality Ratio
Cross-Cutting issues of homelessness
- 3rd sector dental care
- Nutrition
- Social work
- Podiatry
- Substance use
- Emergency Departments
- Primary Care
- Alcohol abuse
- Mental Health
- Skin care
Why is Emergency department a cross cutting issue of homelessness ?
Since some homeless people are not registered with a GP/ have issues trying to access the GP, the ER may tend to be the front door for these people.
Why is Nutrition a cross-cutting issue of homelessness ?
Malnourished due to not getting enough food.
Diet may not be the best, as donated food may not be the healthiest food choices / they may buy the cheapest food.
Barriers to accessing healthcare
NHS administration
Staff attitudes
Aggressive behaviour
Location and timing of appointments
Problem of ‘Dual Diagnosis’ referral patients
Temporary accommodation
NHS administration barrier
Need for a permanent address to register
Staff attitudes barrier
Hostile reception staff
Aggressive behaviour barrier
Substance misuse (from the homeless) may cause aggressive behaviour.
Temporary accommodation barrier
Loss of contact
Methods of service delivery
Dedicated GP / Dental Practices
Dedicated Health Visitors for homeless families
Specialised mental health, drug and alcohol staff
Mainstreamed service
One-Stop Shop arrangements
Mainstreamed Service
With bespoke access arrangements (in reach, out reach)
One stop shop arrangements
At homeless venues with voluntary organisations
Range of needs for homeless
Physical ill-health
Increased mortality
Increased multiple morbidity
Long term conditions
Recovery for homeless
Relationships and Resilience
Quality and Quantity
What are resilience factors ?
Hope generators
State some resilience factors (network related)
Supportive family / friends
Strong social networks
Appropriate support services
Available advice and advocacy
State some resilience factors (work related)
In a stable employment
Personal empowerment
Savings or access to financial help
Inverse Care Law
Those who need healthcare the least, use the services more and more effectively.
Those with the greatest need and those people in the worst healthcare receive the least services.
What is the purpose of homelessness prevention ?
Rebuild hope, purpose and self-respect
State some homelessness prevention strategies (conflict / issue resolution)
Family/ relationship conflict resolution
Alcohol and Drug Partnerships
Personal resilience skills
Employment support
Income maximisation
State some homelessness prevention strategies (social help)
Health outreach services
Education and Skills
Housing support
Social work
Homelessness Services function
Homelessness is about supportive relationships and communities.
Services need to build networks of supportive relationships
Relationships thrive in strong communities.
