Arpita Ghosh
Bethany Yeiser, an individual who
suffers from schizophrenia, and was homeless for several years said:
“My homelessness was a direct result
of untreated schizophrenia…I found comfort in the isolation…But because of
untreated schizophrenia, my mind was broken.” (Psych Central, 2021).
Reflecting upon what schizophrenia
is will help get an insight into Yeiser’s statement. Schizophrenia is a mental
health disorder associated with impairment in daily functioning. Individuals
with this disorder may have disorganized speech and behavior, and experience
delusions and hallucinations (APA, 2022). Another sign of this disorder is
psychosis wherein there is a loss of contact with reality, and an inability to
connect with others (Hooley et al., 2021). This inability to form connections
with others may lead to feelings of isolation. Feelings of detachment and
experience of delusions and hallucinations, among patients with chronic
schizophrenia, often lead to homelessness (Eglit et al., 2018). To investigate
this, the blog first establishes the relation between chronic schizophrenia and
homelessness. Second, it elucidates why individuals with chronic schizophrenia
have a greater risk of becoming homeless and why it is especially challenging
to treat them. It then focuses on the possible measures to help such patients
from becoming homeless.
Building on this, homelessness can
be said to be a manifestation of social isolation associated with chronic
schizophrenia. Although individuals with other mental health disorders may
experience feelings of social isolation, those with chronic schizophrenia are
especially prone to it because of the severity of their symptoms (Eglit et al.,
2018). Further, there is the clinical concern of social isolation among these
patients because they are subject to intense societal discrimination.
Additionally, since these patients lack social interaction skills and
goal-directed behavior, they are often inefficient at their workplace- which
can lead to situations of unemployment and poverty, further worsening the
quality of their lives (Hooley et al., 2021; Wible, 2012). Thus, these
socio-environmental factors make them more susceptible to homelessness—making
them financially incapable of obtaining proper healthcare or housing facilities
(Eglit et al., 2018).
Moreover, their experience of social
isolation is related to cognitive biases which often make them believe that
people around them–friends and family, are motivated to harm them (Cagliostro,
2022). Their psychotic symptoms make them perceive the world differently, which
often makes them suspicious of people, making them more likely to avoid people
and isolate themselves. Furthermore, such behaviors are often not understood by
their family members who are at times unsupportive of them and are likely to
abandon them from their homes (Chen et al., 2015). Thus, lack of support from
family members serves as a risk factor for homelessness among individuals with
chronic schizophrenia.
The absence of familial support and
a lack of patients' adherence to treatment conditions are perhaps the two most
important reasons that make treatment of these patients extremely difficult
(Burra et al., 2009). Additionally, their intense psychotic symptoms contribute
to making them unable to benefit from available treatment programs. Since they
cannot advocate for themselves or convey their needs because of their
disorganized behavior they refuse to seek help from others. Moreover, finding
suitable housing facilities for these patients can be challenging as they are
often reluctant to go to the housing centers or receive treatment because of
their previous unpleasant experiences in such places. Furthermore, individuals
with schizophrenia, released from prison are at a greater risk of becoming
homeless which in turn makes them more prone to substance abuse, further
exacerbating the severity of their symptoms (Hooley et al., 2021; Kushel et
al., 2005). These reasons thus explicate why schizophrenia is difficult to
treat among these patients and is often linked to poor prognosis, and improper
symptom management.
Understanding the challenges in treating
patients with chronic schizophrenia who become homeless, may help in generating
policies that can perhaps prevent them from reaching this state of
homelessness, and help in their recovery. Although healthcare and financial
policies have been made to help these patients, several loopholes exist in them
which make homelessness among patients with chronic schizophrenia a persisting
problem. As discussed above, the housing centers may not be the best places for
several patients, because of the prevalence of their discriminatory treatment.
Thus, a stepping stone toward making these programs more effective would be to
generate awareness among the public and caregivers about the high risk of
homelessness among patients with schizophrenia. Healthcare and housing centers
must destigmatize themselves about this disorder and be sufficiently equipped
to treat them in a way that does not infantilize them or make them feel
incapable of performing daily tasks. Further, the financial policies in place
for these patients often cannot be used by them because applying for such
schemes is difficult (Bailey et al., 2016). Policymakers must amend their
policies to make such financial schemes more accessible to these patients. This
can perhaps be done if the government establishes a body of trained volunteers
who can assist these patients who become homeless, with chores like making
their identity cards, and bank accounts, and helping them withdraw money. This
can help these patients regain their lost self-esteem and realize that they too
have the right to be integrated into society and can function like any other
human being. Lastly, awareness campaigns for patients’ family members are
imperative to help them understand the condition of their loved ones which can
perhaps prevent them from being unsupportive of them and abandoning them.
In conclusion, this blog aimed to unpack the
association between chronic schizophrenia, which often leads to homelessness.
This state of becoming homeless stems from their feelings of social isolation,
not just because of their delusional thoughts, but also because of the
discriminatory treatment they receive from their family and health caregivers.
This coupled with other reasons makes their treatment even more difficult.
Hence, spreading awareness about these patients among their family members,
healthcare providers, and policymakers through educational campaigns can change
the way in which they are treated, bring forth structural reformation in
policies, and develop effective treatment plans to help them efficiently.
References
American Psychological Association.
(2022). Schizophrenia. American
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Bailey, M. S., Engler, D. G., &
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