Wednesday, January 18, 2006

Homelessness, Mental Illness, HIV: Missing links

A post in the Burnt Orange Report (BOR) caught my eye last Friday, partly because it touched on a topic of interest (homelessness) but also because there was an active discussion of the issue, which allowed for the airing of some interesting perspectives. I was particularly pleased to see the acknowledgement that homelessness is all too often linked with mental illness and the self-medication that leads to substance abuse. One link that was missing in the discussion was the role of HIV.

According to SAMSHA:

Epidemiological estimates indicate that about one-third of all homeless, single adults have severe and persistent mental illness and have marked neuropsychological impairments in attention, executive functioning, verbal memory, and general intellectual functioning. Substance use and abuse estimates are extremely high for homeless adolescents and adults, including alcohol and injection drug use (ranging from 20-80%). Available data suggest that in major urban areas, 10-20% of homeless persons who suffer from chronic mental illnesses are infected with HIV.
AIDS Housing of Washington explains why:

People with serious mental illnesses may be at increased risk for HIV infection. Reasons include higher rates of drug and alcohol use associated with high risk behaviors, a lack of safer sex education designed for people with major mental illnesses, and the increased vulnerability of people with mental illnesses to sexual assault and abuse, including in institutional settings. A study released in 2001 found that nearly half of people receiving care for HIV had a psychiatric disorder. Studies have also shown that depression is two to three times more common in people receiving HIV care than in the general population, affecting 22% to 32% of the total.
BOR points out that the National Coalition for the Homeless ranks Houston and Dallas among the top 10 meanest cities in the country if you're homeless. (Go read it.) Sounds like some city fathers (and mothers) are also missing the link. Dallas bulldozes homeless "housing" when it's too visible; Houston has a thing about BO (the smelly kind, not BOR) and bans sitting on the sidewalk. Meh.

1 comment:

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