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Vulnerable PopulationDiana VanRheeFerris State UniversityAbstractThis paper discusses the vulnerable population of homeless individuals who suffer from mental health conditions. It encompasses health disparities, health equity and defines vulnerable populations. Statistics regarding the homeless, along with percentages of the individuals who are homeless and are mentally ill will be discussed. Personal and professional biases of nurses will be addressed along with how the nurses and individuals can make a change in this vulnerable population.Keywords: health disparities, homelessness, mental health, mental illness, vulnerable populationVulnerable populationVulnerable populations cover a broad spectrum of people and they are at an increased risk to develop health problems. Ethnicity, elderly, the mentally and physically disabled, substance abusers, recent immigrants or refugees, homeless individuals and gay/lesbians are groups of people who are vulnerable (Harkness and DeMarco, 2012). These vulnerable populations face health disparities which is defined as “gaps in healthcare experienced by one population compared with another” (Harkness and DeMarco, 2012, p. 3). Often individuals fall into more than one population, such as the homeless who suffer from mental illness, which makes them especially vulnerable. Mental Illness and HomelessnessMental illness can be defined as “health conditions that are characterized by alterations in thinking, mood, or behaviors” (Centers for Disease Control, 2013). Anxiety, depression, bipolar disorders, schizophrenia and Alzheimer’s are some of the mental illness that can play a part in someone being homeless (Centers for Disease Control, 2013). Each year about one third of the world’s population has a severe mental illness, sadly only two thirds are able to receive any mental health treatment (Harkness and DeMarco, 2012, p. 412). There is a stigma attached to the homeless and the mentally ill in which society views them in a negative light. They may be considered dangerous, dirty or unintelligent. Any one of us can face an episode of anxiety or depression, but if we were homeless, it can greatly compound the issue. Being homeless is a devastating situation that no one would want to be in. Often when a person is homeless, they need to face today’s important problems because tomorrow may never come (Wilson, 2009). I often would think of the homeless as people I see living on the streets or stay in the homeless shelters, but they include individuals and families who reside with other households because they have no place of their own. According to the National Coalition for the Homeless, 2009, a person is “homeless who lacks a fixed, regular, and adequate night time residence” (National Coalition for the Homeless, 2009). There are many reasons for being homeless, including, unemployment, mental and physical disabilities, immigration, substance abuse, domestic violence or abandonment (Harkness and DeMarco, 2012). In the 1960’s, there was a large effort to have the mentally ill deinstitutionalized and have them mainstreamed into society (Harkness and DeMarco, 2012). Regrettably that was a disservice to them, because they were without adequate access to their medication and treatment. Unfortunately, 20-25% of the homeless suffer from mental illness which can disrupt their ability to care for themselves and maintain a household (National Coalition for the Homeless, 2009). It appears there is a vicious cycle going on between the homeless and the mentally ill that needs immediate attention.Personal AwarenessI struggled with my own negative image of mentally ill people and the homeless in general prior to researching this paper. While I have given food to the homeless, I have never handed out money because I would stereotype them as wanting the cash for alcohol or cigarettes. It seemed easier to look the other way and go about my life, which I feel guilty about. This vulnerable population hit a personal note for me and I realize I had personal biases toward the homeless and the mentally ill.DemographicsWhile 6% of Americans suffer from a severe mental illness, 20-25% of the homeless population in the United States suffer from a severe mental illness (National Coalition for the Homeless, 2009). For families who are homeless, mental illness was mention as “being one of the top three causes for their situation and mental illness was cited as being the third largest cause for single homeless adults (National Coalition for the Homeless, 2009). This does not just include people living on the streets. Individuals may qualify as homeless if they are literally homeless, are at an imminent risk to be homeless and fleeing or attempting to flee from domestic violence (National Coalition for the Homeless, 2009).In the United States, 610,042 people were homeless on any given night, while more than one million people were served in a supported housing program such as emergency, transitional or permanent housing program each year (U.S. Department of Housing and Urban Development, 2013). Michigan has 100,176 people that were considered homeless in 2010 (Michigan State Housing Development Authority, 2010). Barry County has 102 individuals (64 children under age 18) who are homeless, whereas 162 individuals sought out Homeless Prevention Assistance (Campaign to End Homelessness, 2006). These statistics are overwhelming and clearly a wakeup call for health care professionals to make a change.Self-ReflectionAfter reflecting on the vulnerable population of homeless individuals with mental illness, my attitude has softened and my compassion for them increased greatly. Equity to quality healthcare and mental support needs to be aggressively addressed. The Centers for Disease Control, 2013, states that “there are social determinates of mental health as there are social determinates of general health that need to be in place to support mental health” (Centers for Disease, 2013). I will strive to look them in the eye, gain their trust and to treat them with the dignity and respect they deserve, remembering there is a story behind every face. KnowledgeBeing educated on homelessness and mental illness is where change begins. As health care professionals, “nurses need to be aware of their biases and discuss them with peers, instructors, and professional role models…failure to do so may adversely affect the nursing care provided” (Black, 2014, p. 119). Increasing awareness to the plight of homeless people and mental illness is only the beginning. I can be a patient advocate and an advocate for policy change in the community where I live. Donating time and money to clinics and shelters for this vulnerable population is something I can get my family involved in.ConclusionIn conclusion, health disparities exist and vulnerable populations often do not receive the mental and physical healthcare they deserve. Homeless individuals who suffer from mental illness are very vulnerable to increase health risks. Nurses need to be supportive in the development for prevention and treatment of mental health and support professional education (Pearson et al., 2014). There may always be some mentally ill homeless people, however, if the mental health needs were addressed sooner and proper treatment given, the homeless population would potentially decrease.ReferencesBlack, B. P. (2014). Professional nursing: Concepts and challenges (7th ed.). St. Louis, Missouri: Elsevier SaundersCampaign to End Homelessness. (2006). 10 year plan to end homelessness in Barry County. Retrieved from htpp://Portals/0/pdfs/10YrPln_Reg6_BarryCo.pdfCenters for Disease Control and Prevention. (2013). Burden of mental illness. Retrieved from for Disease Control and Prevention. (2013). Mental health basics. Retrieved from for Disease Control and Prevention. (2013). Minority health. Retrieved from http//minority/OMHHE-htmlHarkness, G. A., & DeMarco, R. F. (2012). Community and public health nursing: Evidence for practice. Philadelphia, PA: Wolters Kluwer Health-Lippincott Williams & Wilkins.Michigan State Housing Development Authority. (2010). Retrieved from .gov/mshda/National Coalition for the Homeless. (2009). Mental illness and homelessness. Retrieved from Coalition for the Homeless. (2009). Who is home homeless? Retrieved from , G.S., et al., (2014). Addressing gaps in mental health needs of diverse, at-risk, underserved, and disenfranchised populations: A call for nursing action. Archives of Psychiatric Nursing. Retrieved from States Department of Housing and Urban Development. (2013). Retrieved from , C. R. (2009). Nurse-managed free clinic fosters care connection for homeless population. Rehabilitation Nursing, 34 (3), 105-109 ................
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