The homeless and unhealthy: a review and analysis

Stressors and Coping Strategies of Homeless Men

1 Major stressors commonly encountered by homeless men are violence to self, theft of belongings, inability to meet basic needs, inconsistent enforcement of rules by shelter staff, and other people's dehumanization or humiliation caused by behavior toward the men. 2 Cognitive, sociocultural, and spiritual coping strategies were frequently used and found to be effective in coping with stressors by homeless men who were either in crisis or alcohol/drug dependent. 3 Severely and persistently mentally ill men had lower mean scores for both use and effectiveness of coping strategies in physical, cognitive, psychological, sociocultural, and spiritual strategies. 4 The longer the duration of homelessness, the lower the mean scores for frequency and effectiveness of use of coping strategies in any of the dimensions.

The Winner's Group: A Self-Help Group for Homeless Chemically Dependent Persons

The homeless chemically addicted person presents many unique problems that cannot be addressed in standard treatment programs. Homeless clients are difficult to track and are not consistent in follow-up care. The health and mental health conditions found in this population are straining the resources of drug treatment programs, hospitals, the criminal justice system, and social agencies that serve the homeless (Bassuck, 1991). The Winner's Group located in an inner city soup kitchen demonstrates the adaptability and flexibility of nursing practice. The nurses exhibited creativity in developing methods to meet the diverse needs of homeless chemically addicted persons. The goals and objective that were achieved were neither successes nor failures, they were reflections of efforts to make lifestyle changes. Some of those persons responded in a very positive manner, while others continued to deteriorate. An overall desire was to instill a seed of hope and knowledge that there is always a potential for change and that recovery from chemical dependency is possible. Nurses who work with the homeless must be knowledgeable and realistic about the impact and importance of substance abuse. Nontraditional programs that meet the unique needs of a particular setting and a particular population can provide an opportunity to gain access to health care providers.

Women's perspectives on homelessness

An increase in the number of individuals who are homeless since the 1980s has made homelessness a major social, economic, and political problem in the United States. The number of homeless in this country is estimated as high as 3 million, with women and children constituting the fastest growing subgroup of this population. A study of eight homeless women using a shelter in a southeastern city was conducted to explore the experience of homelessness from the women's perspectives. A modified ethnographic approach using a semistructured interview provided qualitative data. The constant comparative method of analysis identified themes of heightened awareness, guarding, identification of needs, and strategies for resolution. This study provides a new understanding of how some women experience homelessness, as well as the responses they take to solve this problem.