The purpose of this post is to discuss if I agree or disagree with my pier and why. Also, an additional online resource that can be utilized by families struggling with mental illness will be provided at the end.
I agree with you Melinda that suicide is concerning and has risen to one of the top causes of death in The United States. According to the Centers for Disease Control and Prevention (CDC), suicide is the tenth leading cause of death overall. Most concerning, however, is that suicide is the fourth leading cause of death amongst Americans between the ages of 35-54. They add that adverse childhood experiences (ACE) score of higher than 7 increased the suicide rate risk by more than 30 times in adults (National Health Care for the Homeless Council, 2018).
Some suicide risk factors are depression, substance use/dependence, homelessness, hopelessness, stress, family conflict, domestic or sexual abuse, unemployment, adverse childhood experiences (ACEs) amongst others (Seidler et al., 2020). John meets criteria for high suicide risk, but he has been receiving poor quality healthcare that has missed some of this not so subtle aspects in his life. Without adequate mental health treatment, John will continue to engage in substance abuse and overall high-risk behavior that may include suicide.
Mental and medical health access barriers that John faced include a lack of insurance, lack of funds, and poor health literacy. Additionally, men have been reported to have more feelings of shame, greater isolation when dealing with mental illness. Seidler et al. (2020) found that men were hesitant to acknowledge the loss of control and admit to requiring assistance as it opposed their innate masculine tendencies. This they argued may account for higher rates of substance abuse and overdoses in men than women.
Trauma has long-lasting effects and clinicians should be cognizant of this fact and always perform trauma screening. Early detection has been shown to prevent re-traumatization and begin the process of healing (Chesnay & Anderson, 2020). In Johnâ€™s case, he requires treatment for his past trauma and current mental illness and substance abuse problems. Additionally, social, and financial support for housing and possible employment in the future should be part of his healthcare plan.
National Alliance on Mental Illness NAMI), is dedicated to improving the lives of individuals and families affected by mental illness.
Chesnay, M. D., & Anderson, B. A. (2020). Caring for the vulnerable: perspectives in nursing theory, practice, and research. Burlington, MA: Jones & Bartlett Learning.
National Health Care for the Homeless Council. (2018, May). Suicide and homelessness: Data trends in suicide and mental health among homeless populations. https://nhchc.org/wp-content/uploads/2019/08/suicide-fact-sheet.pdf
National Alliance on Mental Illness (NAMI). (n.d). https://www.nami.org/Your-Journey/Family-Members-and-Caregivers
Seidler, Z. E., Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S. (2020). What gets in the way? Menâ€™s perspectives of barriers to mental health services. International Journal of Social Psychiatry, 66(2), 105â€“110. https://doi.org/10.1177/0020764019886336
I chose one of the same questions as you, but I did not address a personal encounter of homelessness. Although we both chose the question related to the â€œdownward spiralâ€ that John encountered, I agree with many of the points that you made about the related factors to his current situation. John had many things that impaired his ability to have a roof over his head. Trauma impacts a person and their stressors in their life and John encountered numerous stressors from his childhood and for a majority of his life. Primarily the loss of his job led John down a â€œdownward spiralâ€ and I agree with you on the statement that most homeless individuals are often looked down on by society. This means that they need a significant amount of help and additional resources from health care professionals to assist them in achieving the goals that they strive for.At one point in my career, I encountered a handful of homeless individuals in a stand-alone emergency department that was often treated as a walk-in med-express clinic by people in the town. There were frequent fliers that received that stereotype due to their continuous visits without diagnosis. Many times, these individuals were homeless and were trying to get out of the cold in the dead of winter. My first interactions with homeless individuals were like the experience that you explained. I was uneasy and unsure about interacting with these individuals, but I learned a significant amount about their lifestyles and what impacted their life. Last weeks discussion about trauma informed care plays s role in this mindset. What is Trauma-Informed Care (2020) shifts focus from what is wrong with you to what happened to you to make you the way that you are. This is the mindset that is needed for those that are homeless. Removing bias and generalizations and stereotypes is essential to treat this vulnerable population and I agree with you that â€œeveryone has a storyâ€. Backman (2012) discusses that health educational programs are important to include in health care plans for patients, but often do not have a significant impact on health behaviors or the long-term health benefits alone. Interventions associated with individual and population health are often more beneficial when they are paired together with health care plans. Mixed Medi-Cal managed care plans assist in inventory health interventions and impact their members the best in the community. Through these care plans, members are offered various programs that promote various community activities.ReferencesBackman, D., Kohatsu, N., Paciotti, B., Byrne, J., and Kizer, K. (2012). Health promotion interventions for low-income californians through medi-cal managed care plans. Prev Chronic Dis. 2015;12:150269. DOI: http://dx.doi.org/10.5888/pcd12.150269externalicon.Pender, N., Murdaugh, C., Parsons, M., (2015). Health Promotion and Nursing Practice (7th edition). Pearson Education.What is Trauma-Informed Care? (2020). Retrieved from https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/