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Wang Y, Hua L, Zou S, Deng T, Chen Y, Cao W, Wu C, Zhou Y, Zou H. The Homeless People in China During the COVID-19 Pandemic: Victims of the Strict Pandemic Control Measures of the Government. Front Public Health 2021; 9:679429. [PMID: 34458220 PMCID: PMC8387877 DOI: 10.3389/fpubh.2021.679429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background: By implementing aggressive control measures, China has rapidly and effectively controlled the Coronavirus disease 2019 (COVID-19) pandemic. However, the neglected homeless population may become victims of that perceived success. Due to political sensitivity, we know little about them. Aims: This study aimed to investigate how the pandemic and the pandemic control strategies of the government affected the lives of the homeless people in mainland China. Methods: A total of 103 eligible participants experiencing absolute homelessness were recruited from Guangzhou City during July and August 2020. Surveys measured demographic characteristics including health status, changes in daily living, and actions of the government toward the homeless during the pandemic. Sankey diagrams and ordered logit regression models were used to examine the impact on the homeless of inhumane government efforts to drive the homeless away. Qualitative materials were analyzed by using an inductive approach to provide more details. Results: First, the homeless people in Guangzhou tended to be male, aged 40 to 64 years, less well-educated, and they originated from outside Guangdong although they were living in the city center. Most had little connection with their families. After a long period of homelessness, almost half of the participants were in poor health with various conditions, which made them extremely vulnerable to COVID-19. Second, the pandemic caused a substantial decline in incomes of homeless people, had less of a negative impact on their food intake, and affected sleep time in different ways. Third, during the COVID-19 pandemic, humanitarian aid from local governments of China decreased, whereas inhumane efforts to drive the homeless away intensified. Fourth, quantitative models and qualitative materials demonstrate the devastating effect of the strict pandemic control strategy of the government on the lives of homeless people, which may further cause their health problems. Conclusion: This study for the first time illustrated the characteristic features of the street homeless population in mainland China and their living situation during the COVID-19 pandemic, and most importantly demonstrated the devastating effect of the strict pandemic control of the government, which has been considered a great success in previous studies, on lives of homeless people. Urgent measures should be taken to ensure the protection of the homeless population and prevent an impending humanitarian crisis.
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Affiliation(s)
- Ying Wang
- School of Public Policy and Administration, Chongqing University, Chongqing, China
| | - Lei Hua
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
- College of Attainment, Nanfang College of Sun Yat-sen University, Guangzhou, China
- School of Government, Sun Yat-sen University, Guangzhou, China
| | - Shuyun Zou
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
- College of Attainment, Nanfang College of Sun Yat-sen University, Guangzhou, China
| | - Taofeng Deng
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
- College of Attainment, Nanfang College of Sun Yat-sen University, Guangzhou, China
| | - Yongqi Chen
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
- College of Attainment, Nanfang College of Sun Yat-sen University, Guangzhou, China
| | - Wanying Cao
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
- College of Attainment, Nanfang College of Sun Yat-sen University, Guangzhou, China
| | - Chuhan Wu
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
| | - Yujie Zhou
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
| | - Hua Zou
- School of Public Administration, Nanfang College of Sun Yat-sen University, Guangzhou, China
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Smartt C, Prince M, Frissa S, Eaton J, Fekadu A, Hanlon C. Homelessness and severe mental illness in low- and middle-income countries: scoping review. BJPsych Open 2019; 5:e57. [PMID: 31530300 PMCID: PMC6611071 DOI: 10.1192/bjo.2019.32] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite being a global problem, little is known about the relationship between severe mental illness (SMI) and homelessness in low- and middle-income countries (LMICs). Homeless people with SMI are an especially vulnerable population and face myriad health and social problems. In LMICs, low rates of treatment for mental illness, as well as differing family support systems and cultural responses to mental illness, may affect the causes and consequences of homelessness in people with SMI. AIMS To conduct a systematic, scoping review addressing the question: what is known about the co-occurrence of homelessness and SMI among adults living in LMICs? METHOD We conducted an electronic search, a manual search and we consulted with experts. Two reviewers screened titles and abstracts, assessed publications for eligibility and appraised study quality. RESULTS Of the 49 included publications, quality was generally low: they were characterised by poor or unclear methodology and reporting of results. A total of 7 publications presented the prevalence of SMI among homeless people; 12 presented the prevalence of homelessness among those with SMI. Only five publications described interventions for this population; only one included an evaluation component. CONCLUSIONS Evidence shows an association between homelessness and SMI in LMICs, however there is little information on the complex relationship and direction of causality between the phenomena. Existing programmes should undergo rigorous evaluation to identify key aspects required for individuals to achieve sustainable recovery. Respect for human rights should be paramount when conducting research with this population. DECLARATION OF INTEREST None.
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Affiliation(s)
- Caroline Smartt
- PhD Student, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Martin Prince
- Professor of Epidemiological Psychiatry and Assistant Principal for Global Health, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Souci Frissa
- NIHR ASSET Programme Coordinator, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Julian Eaton
- Co-Director, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine; and CBM International, London, UK
| | - Abebaw Fekadu
- Associate Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University; Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia; and Professor of Global Mental Health, Global Health and Infection Department, Brighton and Sussex Medical School, UK
| | - Charlotte Hanlon
- Reader in Global Mental Health, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Adjunct Associate Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University; and Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia
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Fu YN, Cao XL, Hou CL, Ng CH, Ungvari GS, Chiu HFK, Lin YQ, Wang L, Zheng X, Jia FJ, Xiang YT. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China. Psychiatry Res 2017; 255:13-16. [PMID: 28505468 DOI: 10.1016/j.psychres.2017.04.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/23/2017] [Accepted: 04/07/2017] [Indexed: 11/28/2022]
Abstract
There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight.
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Affiliation(s)
- Yan-Nan Fu
- Southern Medical University, Guangdong Province, China; Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Lihui Wang
- Huizhou Veteran Hospital, Huizhou, Guangdong, China
| | | | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Moya EM, Chavez-Baray SM, Loweree J, Mattera B, Martinez N. Adults Experiencing Homelessness in the US-Mexico Border Region: A Photovoice Project. Front Public Health 2017; 5:113. [PMID: 28580355 PMCID: PMC5437212 DOI: 10.3389/fpubh.2017.00113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/02/2017] [Indexed: 01/21/2023] Open
Abstract
Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university.
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Affiliation(s)
- Eva Margarita Moya
- Department of Social Work, College of Health Sciences, University of Texas at El Paso, El Paso, TX, USA
| | - Silvia M Chavez-Baray
- Department of Social Work, College of Health Sciences, University of Texas at El Paso, El Paso, TX, USA
| | - Jacqueline Loweree
- Department of Social Work, College of Health Sciences, University of Texas at El Paso, El Paso, TX, USA
| | - Brian Mattera
- School of Social Work, Temple University, Philadelphia, PA, USA
| | - Nahomi Martinez
- Department of Social Work, College of Health Sciences, University of Texas at El Paso, El Paso, TX, USA
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