Homelessness, Ageing and Dying 15 more recent findings of the 2010 and 2011 Simon Health Snapshot Studies28 which found that 56% of respondents in 2010 and 65% of respondents in 2011 had been diagnosed with at least one physical health condition, while Simon staff reported that 36% in 2010 and 29% respondents in 2011 had at least one undiagnosed health condition. Multi-drug resistant TB is becoming a particular problem associated with rough sleeping given that it is difficult to follow the rigorous daily treatment regime for the six months as required if a person is homeless. Certain severe and contagious diseases are found to a higher degree among the homeless population than among the general population, for reasons related to inadequate access to healthcare, malnutrition, unsanitary conditions and lifestyle factors such as drug and /or alcohol use. These include hepatitis B and C, HIV, and diabetes. Smoking is also common among people who are homeless and along with poor conditions in hostels and poor nutrition, serves to predispose many people who are homeless to pneumonia, influenza and minor upper respiratory infections29. It is interesting to note that many of the studies on the physical health of people who are homeless have concentrated on people living in hostel type situations, with significantly less known about the physical health of individuals who (using the ETHOS typology) are living in houseless, insecure and inadequate accommodation. Mental Health Issues Worry over possible housing loss and lack of control over one’s accommodation situation can lead to mental health issues including depression, stress, insomnia and anxiety. Housing that is overcrowded and of bad quality can also impact on mental health30. As indeed can housing that is located in areas that are perceived to be undesirable and which lead to feelings of low self-esteem and/or insecurity, loneliness and depression. Feeney et al (2000) found that 37% of the people who were homeless had no close friends and 47% had no close relatives they could approach when they need support. For some individuals homelessness can be a major contributory factor in relation to mental health issues, while for others mental health issues can be a route into homelessness. It is not surprising therefore to find that rates of mental ill-health are higher among the homeless population than among the population in general (Hourigan & Evans, 2003). Researchers31 estimate that between 25% and 50% of people who are homeless in Ireland experience mental health problems. These estimates are confirmed by a variety of more local studies including a study32 of hostel dwellers in inner city Dublin, which found that 52% suffered from depression, 50% from anxiety and 4% from other mental health problems. This survey also found that 72% of homeless men in hostels, who met criteria for serious mental health problems, were not in receipt of care. The 2011 Simon National Health Snapshot found that over 47% respondents had been diagnosed with at least one mental health condition (the 2010 Simon National Health Snapshot identified 52% respondents with at least one diagnosed mental health condition). Again depression was the most commonly occurring diagnosed mental health condition. Symptoms of poor mental health experienced include stress, anxiety and feelings of isolation, along with incidences of depression and a higher risk of suicide. Cleary and Prizeman (1998)33 found that 68% of people who were homeless and attending a day centre had attempted suicide. Mental health and homelessness often relate to each other in a negative cycle with mental health problems contributing to 28 The 2010 and 2011 Simon Snapshot studies are point in time surveys that provide details of the health status of a sample of Simon Service Users. 29 WHO-Europe Health Evidence Network: How can health care systems effectively deal with the major health care needs of homeless people 30 World Health Organisation 2004: “Review of Evidence on Housing and Health” Fourth Ministerial Conference on Housing and Health, background document, pg 4. 31 Amnesty International (2003) Mental Illness-The Neglected Quarter-Homelessness. Amnesty International All Ireland Section. McKeown, K (1999) Mentally Ill and Homeless in Ireland: Facing the Reality, Finding the Solutions. Disability Federation of Ireland. Homeless Agency (2004) Making it Home: An Action Plan on Homelessness in Dublin 2004-2006. Homeless 32 ERHA & RCSI (2000) The Health of Hostel-Dwelling Men in Dublin: perceived health status, lifestyle and healthcare utilisation of homeless men in south inner city Dublin hostels. 33 Cleary, A & G. Prizeman (1998) Homelessness and Mental Health. Social Science Research Centre
Homelessness, Ageing and Dying
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