Single individuals that experience long-term homelessness have high rates of mental illness and/or substance abuse disorders. Chronic homelessness is also associated with severe symptoms of alcohol abuse, schizophrenia, and personality disorder. Homeless adults have not been effectively engaged or retained in outpatient treatment and show increasingly high rates of chronic, disabling, and/or life-threatening health conditions (hypertension, asthma, HIV/AIDS, liver disease). They are disproportionately hospitalized, and on average stayed in the hospital longer.
Geographic barriers and resource limitations impede homeless adults' ability to travel to fixed site health centers. Additionally, the homeless person is likely to have been separated from his or her neighborhood of origin, and thus any former medical care provider. These factors suggest that health services should be taken to homeless people where they live and congregate. Care for the Homeless provides care on-site and at regularly scheduled times, building a trusting relationship that enables them to provide more comprehensive care.
Homelessness can prove to be a stigma for homeless people who seek medical attention. Those with active mental illness or substance abuse problems also are likely to have experienced problems with hospital security or law enforcement when they seek to access care. Long waits at public hospitals and safety net health centers can exacerbate the medical conditions with which the person presents and lead them to ignore their symptoms or wait too long before attempting to access primary care. Care for the Homeless bridges the gap by reaffirming that the lack of a permanent address is not a reason for unmet primary, mental and behaviorial health needs.
Mike Gilhooly, Health Information Manager, talks about the work Care for the Homeless does at the New York City Rescue Mission, one of our over 35 sites in New York City.