in the Houston, Texas Area
The Homeless and Indigent in the Houston, Texas Area
Homelessness is a very significant problem that exists in any city. Houston, Texas has such a large population that it comes as no wonder that there is an increasing number of homeless people around (Dixon & Osher, 1995). Almost 150,000 people in this city are living without the basic necessities. Even though Texas experiences mild temperatures during most of the year, winter can still be very harsh. Living without a home or the right nutritious food can be very tough, especially for those who have no other choice. Even though this is seen as a rampant social problem, it continues to grow despite the efforts of those who are trying to make a difference – i.e. homeless shelters. No matter how many shelters there are that exist in the area, they are still not enough to house all the homeless (Emergency Shelter Grant Program, 1998). There are a number of shelters across the city that aim at providing the best care and support for those who are needy. However, the programs that are being offered are not sufficient enough to meet the needs of those without a home.
A very common problem among the homeless and the indigent is substance abuse. There are shelters that might provide residence and food for those who are struggling, but not all allow intoxicated or drug dependent individuals in (Lomas, 1992). This is not because of prejudice or discrimination, but because of the safety of others who might want to find refuge in the shelter. There are many shelters which offer refuge for women who want to get their children off the streets and are struggling to find food enough to feed their family. However, most of these shelters that are exclusively for women do not allow men inside, more so homeless men who may have addiction issues. There has been a rapid increase of homeless males with a substance abuse problem. Without the right help and support, these people would not have anywhere to turn to and could just end up being a mortality statistic. The sad truth is that no one really pays any mind to these people unless they are moved by a touching television commercial or billboard. You don’t ever think of helping a homeless person in need unless it is Christmas. The right care for those who might be less fortunate is needed. In order to provide sufficient service, the needs have to be assessed (Lomas, 1992).
There are many reasons why the homeless exist. Many people who like to think in stereotypes always assume that they do not work hard enough to get a job, or that they were lazy therefore they lost their home. However, there are a number of reasons why people end up in the street. Because these reasons are so varied and diverse, there is really no one way to stop it from happening (Farriello & Scheidt, 1989). If there is no prevention for homelessness, and there is no cure, there should be a remedy. The problem really starts to begin when the rate of youth who end up in the street increases. This is a problem in the upcoming generation because children are more vulnerable when separated from their family. The rate of runaways who end up homeless is alarming and should not be tolerated. The number one reason for this is because of domestic violence, physical abuse or substance abuse within the home. Children think that the solution to their problems is by running away and finding a life on their own. They do not know any better and have no idea how rough the world outside really is. There are programs that can help children stay off the street permanently. Many shelters aim at giving these kids an education, counseling, medical care and so much more (Scott, 1993). However, the number of children who are ending up on the street is still increasing. It comes as a wonder if these methods will do any good when the necessary resources or willing volunteers run short. Outreach programs designed to help children find their own way are great. But, many question if it is a good way to reenter children who are homeless back into society. Many people criticize these charitable efforts and believe that these children will just turn to illegal or illicit means to survive. This might involve stealing, drug dealing or even prostitution. In the social strain theory, all of this is possible without the proper guidance and counseling. It still cannot be determined if the efforts of charity and non-profit organizations are enough.
Many people who are on the streets have mental conditions or substance abuse problems that are not being treated (Scott, 1993). As many as 50% of those who are homeless have a mental illness, out of that percentage a large 70-80% have spent a lifetime not being diagnosed (Dixon & Osher, 1995). It cannot be determine if these conditions were due to homelessness or was the cause of their homelessness. Studies have not gotten far enough to determine this. However, it is clear that the conditions and symptoms of illnesses do worsen due to the living conditions each homeless person has to face. Those who are involved in substance abuse face an even greater problem that plagues the lives of the homeless. Many of the people who are seen to have this problem find it as a last resort, in order to escape reality or divert their hunger (Farriello & Scheidt, 1989). The motivation for change seen in homeless people who have a mental condition or are facing substance abuse is not getting any better.
This is mostly because they do not think that there is any hope left for them. Many people who are in the street feel as if they are alone and have no other choice. They live their lives trying to get by with the little that they have. Many of these people feel that they have become invisible to society, no longer wanted and not at all needed. Homeless shelters can only offer refuge to a small percentage of the homeless. Many do not make the cut as shelters can only take in a certain number each day. There are a lot of agencies that have tried to implement programs that help those with substance abuse problems. Unfortunately, these programs are difficult to find and homeless people with violent cases are also difficult to treat. More so if there are a number of intoxicated individuals in the room who are aggravated and are feeling targeted. Nevertheless, these efforts are still to be pursued for the good of humanity and to restore life. It may be difficult to implement programs for those who suffer from a mental illness and those who have a history of drug abuse, but it does not mean that all efforts are in vain.
There is a complexity in needs when it comes to those who have substance abuse problems. When considering a treatment program for these types of individuals, a lot of things have to be put in place. This comes a big challenge for those who want to provide treatment. There are a number of things that have to be settled before something like this is pursued. The budget for the facility, the target or goal, the manpower and the equipment/resources need to be ready even before patients or the homeless are chosen. For those who are mentally ill or have a history of substance abuse, it might be difficult to get them to attend the program. It should be a proactive effort of the city to target and identify those who are most in need. It should be an ongoing effort for the city to let civilians know that there is such a program, in any case that they see someone who might be in need of the help. Those who are running the facility need to be in constant care for their safety as well as the safety of their co-workers. Those who might have a serious history of drug or alcohol abuse might become aggravated if they are not approached in a manner which they think is appropriate. It is best to study different methods in learning how to talk to those who are in need of this kind of help. Those who might suffer from mental illnesses also need to be studied further. Those who have potentially violent demeanors should not be allowed with other patients as trouble might start. It is not uncommon for those who feel they are being attacked to act in such a way that they believe is an acceptable way of self defense. Volunteers and those who are most capable of dealing with patients of this nature should be found and briefed of something like this. The needs and treatment for those who are homeless and have a mental illness or a history of drug abuse cannot make it in regular shelters as they will only cause a disruption. It should be part of the initiative of the city to provide the right kind of care for people who are in this situation.
There are certain things that need to be determine before an initiative like this is to be implemented. Instruments in finding those who are in need of this kind of service should be developed in order to find those who are most in need. Children, the elderly and those who are suffering from severe mental illnesses should be prioritized diagnosed (Dixon & Osher, 1995). There should be a checklist in order to determine the category of the patients who will be entered into the care facility. For those who are considered mentally ill:
- Months/years on the street
- Age
- Health conditions
- Diagnosis
- Hostility level
Many people who are experiencing any kind of mental illness are in distress (Miller, et. Al, 1991). Most people found on the street who have a mental condition are suffering from some sort of paranoia. This might be the result of drugs or alcohol abuse, or it might be a growing mental condition. Those with high levels of distress need to be tended to in a separate facility before allowing them to mingle with others who might be suffering the same condition. This would prevent trouble within the facility. It is imperative that those who are handling homeless individuals who are suffering from a mental disease know different approaches in order not to trigger a violent reaction. Different methods of speech and actions should be taken into consideration when dealing with patients like these. Communication, psychology and social skill should be developed when handling patients within a facility like this (Miller, et. Al, 1991). It is an ongoing study and all patients will show different reactions.
Those who are suffering from a history of alcohol and substance abuse need to also be assessed mentally for any condition. There should be a checklist that will determine the level of the substance abuse and how the problem should be approached (Emergency Shelter Grant Program, 1998). Not all patients who suffer from a substance abuse problem will react in the same way. It is best that the history of the problem is determined and the amount of time spent on the street is analyzed. The checklist for those who are suffering from a substance abuse problem should be as follows:
- Length of time spent on the street
- Drugs found in system
- Disposition
- Health conditions
- Hostility level
It usually follows that someone who has spent some time on the street would be suffering from other infectious diseases. Those who are involved in drug use usually contract some form of disease including HIV (Dixon & Osher, 1995). The awareness for this kind of disease should be increased and a form of guidance counseling should be implemented. Those who are suffering from substance abuse usually have problems with their health, which may include mental problems. It is best that before a solution is found, that the proper diagnosis is done (Farriello & Scheidt, 1989). It is also possible that a patient is not entirely truthful about their drug abuse history. A series of tests should be done in order to find out what is really in their system. This is very important in order to get the right cure. Those who are suffering from substance abuse problems are also most likely to experience withdrawal symptoms. The treatment and easing of this kind of condition needs to be handled with care in order not to start anything within the facility.
The treatment in those who are within the facility should be focused on. It is best that the facility starts out small and learns from the patients who are receiving care. The situation of the patients within the facility cannot be treated like any other mental institute. Rehabilitation facilities usually have people funding them, and patients usually have money to pay for the care. With this kind of homeless shelter and rehabilitation center, the care of patients should not be compromised (Miller, et. Al, 1991). The right care should still be administered to those who are in need.
Not a lot of people notice the homeless people who fade away in the background. There are hundreds and thousands of homeless individuals lining up for shelters each day (Lomas, 1992). ‘Unfortunately, not all of them can get access or make the cut. Homeless shelters can only take a certain number of individuals each day. Those who are suffering from a mental illness or are battling a substance abuse problem are sometimes left out on the street because of the potential danger they might be for those with children or single women. An initiative by the city should be focused on helping those who have mental conditions get the help that they need. This goes beyond healthcare and a job, it goes deeper than that. The facility should help give this people a chance at life by giving them the support and guidance that they need.
References
Dixon, L., & Osher, F. (1995). Housing for persons with chronic mental illness and substance
abuse disorders. In A. F. Lehman, & L. B. Dixon (Eds.), Double jeopardy: chronic mental
illness and substance use disorders. Australia: Hardwood Academic Publishers.
Emergency Shelter Grant Program (1998). Report to U.S. Department of Housing and Urban
Development.
Farriello, D. F., & Scheidt, S. (1989). Clinical case management of the dually diagnosed patient.
Hospital and Community Psychiatry, 40 (10), 1065 - 1067.
Lomas, E. (1992). Skid - row - based services for people who are homeless and mentally ill. In
R. I. Jahiel (Ed.), Homelessness: a prevention - oriented approach ( pp. 193 ± 206).
Baltimore, MD: Johns Hopkins University Press.
Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: preparing people for change.
New York: Guilford Press.
Scott, J. (1993). Homelessness and mental illness. British Journal of Psychiatry, 162, 314 - 324.
