Mental illness encompasses perpetual issues in every day society. Homelessness, being one of them, is the most prevalent concern within this group. “In 2016, 550,000 individuals were homeless in the United States [alone]” (Tsai, Otoole, & Kearney, 2017, p. 113). Out of those 550,000 individuals, “veterans represent more than 12% of the U.S. homeless population” (Adler, Pritchett, Kauth, & Mott, 2015, p. 47). Depression, substance abuse, post-traumatic stress disorder, poverty and unemployment among other issues can all be attributed to mental health (Tsai, Otoole, & Kearney, 2017). Individuals with mental illness can be emotionally vulnerable when it comes to making a health care decision. These individuals need individualized care due to their versatile healthcare needs. Compassion, patience, with a non-biased advocate will help guide them through the right health care alternatives.
Mental illness can manifest itself in a variety of ways. Major depression, bipolar 1 & 2, schizophrenia, PTSD, and others are all classified as mental disorders (Treichler, Evans, & Spaulding, 2019). All of these disorders differ in signs and symptoms, treatments, therapies and medication. A nurse can advocate during an individuals hospital stay by individualizing the care provided. Most importantly, when stable including the patient to make health care choices and making sure their preferences are taken into consideration just like you would with any other patient. According to Greenwood & Manning (2019), “when individuals are afforded choice over treatment options, addiction and mental health services are more effective” (p. 148). For example, “cocaine users who chose their therapy reported less use than those who did not” (Manning & Greenwood, 2019, p. 148). In addition, for those mentally ill patients suffering from depression, were more likely to comply if they were included in the corresponding therapy rather than just have one assigned (Manning & Greenwood, 2019).
“Similarly, women with histories of trauma who perceived choice in their treatment reported fewer unnecessary hospitalizations, compared to those who felt they had no choice” (Manning & Greenwood, 2019, p. 148). These patients are no different than any other. They just want to be heard and given options. Another way a nurse can advocate for their patient is by introducing cognitive therapy. Problem solving therapy (PST) is a subcategory of cognitive therapy used specifically for mentally ill patients in order to help with adaptive problem-solving skills (Gabrielian, et al., 2019). PST can help with depression by working with an individual’s cognition and function, which will ultimately help with employment, social skills, and real world challenges (Gabrielian, et al., 2019). Nurses should also emphasize the importance of compliance when it comes to psychiatric drugs. Teaching the patient the benefits the medication will provide could possibly have an affect on their compliance. Ultimately, it is up to the patient whether or not they decide to stick with the medication regimen assigned. The more the patient adheres to their medication the more positive outcomes they will have. Mental illness is not easy for the patient or the nurse but together they can find a way to make things work.
Mental illness, a potential fatal disorder, can deprive any individual from basic human needs. According to Kearney, O’Toole and Tsai (2017), “homeless individuals have higher rates of visual impairment than the general population and are at greater risk for not obtaining appropriate glycemic control when diabetic, which can lead to diabetic retinopathy and visual impairment” (p. 115). These individuals are experiencing a wide range of chronic disorders aside from mental illness. It’s a never-ending cycle. These mentally ill homeless individuals cannot obtain the proper care their body physically needs until their mental illness is taken care of. The nurse can advocate immensely by providing a shelter for the patient after discharge. This alone can help the mentally ill homeless patient from relapsing into a vicious incessant cycle. Homelessness prevention should be the number one goal and priority in a care plan.
The sooner an individual struggling with homelessness is placed in a rapid rehousing program has shown to have a greater effect on permanent housing (Tsai, Otoole, & Kearney, 2017). Not everything goes as planned therefore a back up plan should always be in place. The nurse can provide the mentally ill patient with numerous addresses of homeless shelters in case of an emergency. After discharging, in order to advocate for this high-risk population nurses can provide thorough education on mental health advance directives. This way, if a homeless individual is experiencing a mental health life crisis, without reasoning capability, the health care team can identify treatment preferences through documentation. It’s crucial to obtain this information when the individual fully comprehends. Since mental illness has multiple subcategories, the nurse can determine the necessary programs the homeless individual might benefit from.
For example, if you have a mental ill homeless person suffering from alcoholism, the nurse along with a social worker can provide information on alcoholics anonymous. In addition, the nurse can provide education on Medicaid and Medicare and have the social worker help the homeless patient fill out an application. Medicaid or Medicare can financially provide the necessary medications and follow up appointments the mentally ill homeless person may need. For those suffering with depression, the nurse can have the patient sign a contract stating they will not commit suicide. Mental illness and homelessness has a strong correlation with veterans. There are many helpful programs the government has initiated for those veterans suffering from mental illness that cannot take care of themselves due to their emotional instabilities. These programs have community-based outpatient clinics that provide dental care, substance-use treatment, transportation, and job training needs (Adler, Pritchett, Kauth, & Mott, 2015). Mental illness accompanied with homelessness unleashes many problematic issues for this group of individuals but a nurse’s voice can persuade any uncertainty or incompliance with detailed education.
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