Douglas E. Frame's Blog

The glitch with Google seems to be fixed. The Yoga Party: Philosophical Writing can be accessed there as far as I can tell.

I am having trouble making my book available. Google Books no longer is able to sell my book because of some glitch. Hopefully this will be resolved soon.

I tried making it 100 percent viewable through preview, but now there are problems with the formatting of the preview. So If anyone wants a copy of the book, email me at frame@framepublishing.com   I will send it out to you free of charge as a PDF file.

Because of the joker that is selling my book at $2475.00 dollars, I have decided to go ahead and update the third edition (the one I am offering to you now) to a 4th edition which I hope to have finished before too long. It will be newly edited and I will throw in some of my poetry as well.

I wanted to assert my solidarity with the OWS peaceful protestors. Be careful folks.

 

 

 

 

 

 

 

 

 

 

 

This book seller is selling my book which I had listed at $9.95 for $2475.00

The Yoga Party: Philosophical Writings

If you buy this book, this sale is not sanctioned by me. In fact it is being sold at this price against my will. I receive no proceeds from this sale. I do not own this copy.

 

Check out my writing at Suite101

I'm happy to report that I have been promoted at Suite101 to Topic Editor. As well as reading other philosopher's writings, I will continue to write my own. Could life be better? Drop by and see my articles there. Thanks!

My Suite101 profile

 

The Argument Against DDT Use 

Malaria is the 11th most common cause of death in the world. It is the 2nd leading cause of death in Africa (Gideon, 2011). There has been little success in eliminating malaria around the world. Many countries are desperate to control this scourge.

DDT has been used in many countries throughout the world. The use of DDT began in the United States in 1945. It was thought to be a miraculous insecticide that seemed to have few toxic effects on humans. It was learned later that it had deleterious effect not only on insects but it also became obvious that it was very toxic to birds, especially predatory birds (World, 1989). One well known effect was that it decreased the shell thickness of many species of birds, causing the shells to crack, and the embryos die when the mother came to roost.

The extent of the effects of DDT are unknown. The toxicity in humans, while previously not regarded as significant, is now a source of great concern. DDT has pronounced environmental effects and there is concern about ecosystem which ultimately support human health and survival. (World, 1989). There are also ethical considerations where the poor, such as farm workers, whom were most likely to be exposed to pesticides.

It is not readily apparent that DDT causes harm to humans, but in this paper I will discuss several articles that make the claim that DDT is in fact toxic to humans. This is a special concern because DDT is known to accumulate in the environment, and is absorbed easily into the soil, and can persist in the environment (World, 1989).

Now there is evidence of the toxic effects of DDT in recent studies. One important issue is is the risk of contamination greater than the benefits of its use, especially when spraying to eliminate mosquitos which carry the Plasmodium parasite which causes Malaria. There are other risks too, including what are the long term implications are on human health as well as the long term effects on the ecology that supports human survival (World, 1989).

When used extensively to eradicate mosquitos, this pesticide was so much more successful that other classes of insecticides. Conditions were markedly improved in areas where Anopheles mosquitos infested. But after its ban in many countries the prevalence of mosquitos returned to their previous levels of infestation.

The choice is not only between whether DDT should be used or not because of its toxicity, but there is evidence that some Anopheles mosquitos are developing some tolerance to DDT. Once DDT is lost in the arsenal, its usefulness for major new outbreaks would be eliminated. So what is the answer?

Is it ethically justified if the fact of DDT's ability to persist and continue to kill mosquitos is also tied with toxicity in humans and the environment?

 

Statistics and Stakeholders

 

The goal of DDT use is to control and eventually eliminate the carrier of plasmodium, the Anopheles mosquito. There are many species of Anopheles mosquitoes which include Anopheles Bambiae in Africa, Anopheles Arabiensis in Uganda, Cameroon, Sudan, Zimbabwe and South Africa.  There are also the species Anopheles Sinesis in China, Anopheles Epiroticus in Vietnam all of which can carry different species of the plasmodium parasite.

"In humans, the parasites (called sporozoites) travel to the liver, where they mature and release another form, the merozoites. These enter the bloodstream and infect the red blood cells." "The parasites multiply inside the red blood cells, which then rupture within 48 to 72 hours, infecting more red blood cells. The first symptoms usually occur 10 days to 4 weeks after infection, though they can appear as early as 8 days or as long as a year after infection. Then the symptoms occur in cycles of 48 to 72 hours". This infection can result in anemia. chills,coma, convulsions, fever headache, jaundice, muscle pain, nausea, bloody stools, sweating, vomiting. (National, 2011) There are 4 types of parasites that can infect humans. These include Plasmodium Vivax which rarely causes death, Plasmodium Malariae which is not usually fatal,  Plasmodium Ovale which is the rarest form and finally Plasmodium Falciparum which is the most lethal (Malaria, 2009)

In 2009 there were 81 million cases of Malaria. In 2006 there were 881,000 deaths. About 860,000 Africans die from malaria each year (Gideon, 2011). In 2001, malaria was ranked the 8th highest contributor to the global Disability Adjusted Life Year (DALY) and 2nd in Africa (Salazar-Garcia, 2004).

As is clear the impact of Malaria in Africa is most severe and affects the quality of life and its socioeconomic status. Since malaria is such a burden on the health care system the stakeholders include hospital personnel, administrators and others. The government has a vital interest in addressing the problem of malaria because of its effect on the standard of health and well-being. Businesses in general too must be concerned about malaria because of days missed due to work, the inability to acquire new investment and to recruit. Also international agencies such as the World Health Organization that are inevitably involved because malaria knows no borders and any effort to eradicate it must involve all of the countries involved. With all stakeholders involved, a concerted effort can be effective. This interest is especially vital in Africa, with plasmodium falciparum, because of it's lethality.

 

Evidence of DDT Toxicity in Humans

 

When deciding if DDT spraying is justified, the central factor is what effect it will have on ecosystems and human health. While it has not been definitively demonstrated that DDT causes harm to humans, there are studies that point out statistical probability that there is toxicity in humans and may even contribute to cancer. There is reason to believe that there may be a dose-response relationship between DDT spraying and human toxicity.

 

Breast Cancer and DDT Toxicity

 

One concern regarding DDT toxicity is that it persists in andipose tissue (World,1989). One female organ, the breast, is composed almost totally of andipose tissue. Over time with long term exposure it is conceivable that DDT can build up in the breast.

DDT first became legal in the US in 1945 and was finally outlawed in 1972. Cohn examined those who had longer exposure with those that had less. "Because DDT was first widely introduced in the United States  beginning in 1945, a woman's age in 1945 is a proxy for the youngest at exposure to DDT for the age when DDT use was peaking" (Cohn, 2007).

Cohn continues " High levels of serum p,p' -DDT, a median 17 years before diagnosis, predicted a 5-fold increased risk of breast cancer among women who were born after 1931. These women were

 

DDT and Neurotoxicity

 

In Salazar-Garcia's study, it indicates a dose dependent toxic relationship between DDT and congenital malformations.  In Salazar-Garcia's study there is also shown a dose dependent relationship between DDT exposure and limitations in neurodevelopment among young Mexican American children (Salazar-Garcia, 2004). There is also a statistical correlation between poverty and the manifestation of DDT's toxic effect (Esenzai, 2006).

 

DDT and Birth Defects

 

In Salazar-Garcia's study there was evidence of a dose dependent increase in congenital deformities among Malaria control workers when the workers had on average 15 years of exposure as chemical workers. " The most common congenital malformations reported were in the nervous system and the osteomuscular system. The number of cases of other birth defects were as follows: eye and ear, leporino lip, chromosomal and other congenital deformities" (Salazar-Garcia, 2004).  Similar to the Cohn study, a dose dependent relationship was pronounced.

 

Is Using DDT Justified in the Battle Against Malaria?

 

First off it should be recognized that DDT is not sufficient in the battle against the Anopheles carrier of the malaria causing parasite. Evidence mounts that resistance is increasing among many of the species of Anopheles mosquitos.

One reason that DDT is the pesticide of choice is because it is less expensive. It is the preferred choice and also the bane of environmentalists for the same reason, it's ability to persist and bioaccumulate. It is considered more effective because it kills longer and therefore has a better outcome. The more money saved, the greater risk of toxicity. Since the harm done to life and humans in particular is unknown, is it prudent to balance health against DDT's persistence in the environment?

DDT is not the only insecticide that is effective against malaria. Others do not bioaccumulate and persist which is what makes DDT more effective. A greater investment in malaria eradication could be just as effective in eliminating this scourge but the political will does not exist.

The largest rate of morbidity and mortality for malaria exists predominately in the poorer countries in Africa and lesser so in Asia and Latin America. It is difficult to establish a cause effect relationship between malaria and poverty since malaria robs a country of its wealth with increased morbidity and mortality. But this poverty supports the claim that something must be done without increasing human suffering.

Not only are there other insecticides that are effective in killing the Anopheles mosquito, but these pesticides do not bioaccumulate. It is my opinion that with the political will malaria can be eliminated. Strategies using treated mosquito nets, improving housing in the affected communities, better management of bodies of water as well (Berg, 2009) and using less "cost effective" insect sprays, there is no reason that malaria cannot be eliminated without threatening ecosystems and human lives.

The evidence is there that DDT bioaccumulates in the environment and in particular human fat cells where it remains indefinitely. It is also clear from the evidence that with this accumulation in the human body that toxic effects are possible. With the political will malaria can be eliminated using safer (and saner) alternatives.

 

References

 

Berg, H. (2009). Global status of DDT and its alternatives for use in vector control to prevent disease. Environmental Health Perspectives, 117(11), 1656-1663. doi:10.1289/ehp.0900785

 

Cohn, B., Wolff, M., Cirillo, P., & Sholtz, R. (2007). DDT and Breast Cancer in Young Women: New Data on the Significance of Age at Exposure. Environmental Health Perspectives, 115(10), 1406-1414. Retrieved from EBSCOhost.

 

Eskenazi, B.,  Marks, A., Bradman, A., Fenster, L.,  Johnston, C., Barr, D., and Jewell, N. (2006) In Utero Exposure to Dichlorodiphenyltrichloroethane (DDT) and Dichlorodiphenyldichloroethylene (DDE) and neurodevelopment among young Mexican American children.  Pediatrics 118.1  p233(9).

 

Gideon (2011) Retrieved on July 9, 2011 from http://web.gideononline.com/web/epidemiology/

 

Malaria Prevention.Info Malaria Types. (2009) Retrieved on July 9, 2011 from  http://www.malariaprevention.info/malaria_types.html

 

National Institute of Health. National Institute of Allergies and Infectious Diseases. Malaria (2011) Retrieved On July 11, 2011 from

http://www.niaid.nih.gov/topics/malaria/Pages/default.aspx

 

Salazar-García, F., Díaz, E., Prudencia Cerón-Mireles, Dana Loomis, & Victor H Borja-Aburto. (2004). Reproductive Effects of Occupational DDT Exposure among Male Malaria Control workers. Environmental Health Perspectives, 112(5), 542-7.  Retrieved July 6, 2011, from Research Library. (Document ID: 711593291).

 

Snow, R., Newton, C., (2003) Disease Control Priorities Project: Working Paper No. 11 The Public Health Burden of Plasmodium falciparum Malaria in Africa: Deriving the Numbers. World Health Organization. Retrieved on July 10, 2011 from http://archives.who.int/prioritymeds/report/append/610snow_wp11.pdf

 

World Health Organization (1989). DDT and Its Derivatives – Environmental Aspects. International Program On Chemical Safety. WHO:Geneva. Retrieved on July 9, 2011 from http://www.inchem.org/documents/ehc/ehc/ehc83.htm

 

 

Its mandibles clutch tight

squeezing life out of a fly

chewing on its carcass

a praying mantis' meal

Along comes a hunter

gun cocked and ready

but the day is dreary

and the drizzle makes haste

a hare runs a streak

a line toward the foliage

escaping a lead bullet

screaming for its head

the hunter stops and ponders

what shall I shoot next?

Then a deer wanders about

revealing itself

The hunter freezes

then moves ever so slowly

arbitrarily scanning the horizon

the mist moistens his brow

But the dear is alerted

and bolts for the wild

but the bullet hones closely

then penetrates

the deer screams

and dies

Food for the needy?

Its just a steak or a hamburger

the favorite food of complacency

readied about plastic wrapped

But what is the story

of this hunk of beef?

Or venison or hare

that perishes

giving up its life?

The story reminds that the pleasure of death

sorts through the unhappiness of life

bringing substance against squalor

for a minute a relief ever so fleeting

then to kill some more

Reveals what is standing

in the hearts of the minions

leaving not for a moment

the rest of exhaustion

And the hunter forages on

brings food to the starving masses

a child, a family, in their humble abode

the miracle is that it is put here for all

for if not what would it be?

A little bit of sunshine snuffed out

a drizzly day passes

but the night draws near

a hunter never rests

Some people call for violent revolution. They are not in the majority. Others call for non-violent resistance, but will this do the trick? The government controls what seems like every aspect of society. But one must not blame the government for the position we are in. The real problem is that we no longer live in a representative democracy. This may be nothing new, but now the hold on power is absolute. The corporate state buys the votes of the representatives in government  as corporations are now people and are entitled to do so. Corporations are now people with "free speech rights" and don't have to report their source of money.

The two party system never has been sympathetic to the needs of individual citizens at large. In the past the Democratic Party protected unions who were once their major contributors. Now with the fall of the unions and the move to the right of the Supreme Court, corporate influence rules the day. Libertarians make the mistake of identifying the government as the source of all our problems, when in fact the government wears the mask for the corporate raiders who actually control the levers of power. Unknowingly these Randians are dupes of the corporate state whose conglomerates have no interest in the needs of its citizens, at least not the middle class and the poor. Few benefit except the rich plutocrats.

A recent story was that there was a "loophole" in Obama's medical plan.  A certain layer of society would receive what were considered undeserved medical benefits because those married had a joint annual income of 64,000 dollars. This supposed loophole was compared to the middle class getting welfare. Most western nations provide universal health care to their citizens, and this just goes to show how miserly the government is, and the powers behind the corporate elites serving the wealthy class. With the wealth moving to the top and the eroding of services, it would seem that something must happen, that someone must act.

The passion for wealth and power never is satisfied. The rich are removed from the suffering of the poor. If someone calls for the redistribution of wealth they are branded a socialist or even a communist. But what are the poor suppose to do, up and die with no complaints? Even if these poor Americans are willing to die out of some sort of allegiance to the country, the alternative and more likely response is a rising up of parents, intellectuals, cultural advocates, and the avant -garde in a form of class action. Whether this action is violent or not remains to be seen. Perhaps the rich will enable those with families, the ill, the unemployed to maintain a subsistence level, but the avarice of the ruling class seems to know no bounds. The levers of power rests with the corporate elite with their sock puppets the government "representatives". There are exceptions in public leaders who serve their function as representatives, but they are dying out rather like the endangered species in the wilderness.

While the full force of the Patriot act has not been brought to bear on those suffering from this economic downturn, these tools are at their disposal and can be aimed almost instantly on any errant target.

When water flows down and encounters an obstacle, no matter what it is, if there is no relief from the ensuing pressure, the force forward of this deluge cannot be denied. Those that want it all live under the fantasy that they are in control.

The control only lasts as long as the sleeping giant lies.

 

Lars Schall posted an article on his website adapting an article I wrote on Suite101. My article was on Hegel's Master/Slave Dialectic. The article on his website addresses how indebtedness is reducing the modern debtor to slavery rather than them being empowered; contrary to the modern assertion that debt is a form of liquidity. This has also been translated into German.

http://www.larsschall.com/2011/06/13/hegels-masterslave-dialectic/

 

Abstract

 

The goal of this research paper is to identify primary factors that causes homeless and lead to the prevalence of homelessness. By identifying these causes, strategies can be implemented by governments and institutions that can improve conditions for those that are susceptible to falling homeless. When evaluating these conditions this research paper will look at the social, environmental, behavioral strategies for intervention to help alleviate the suffering of the homeless. Also discussed will be the imperative of a public health response.

Tackling homeless is a difficult problem. Many mentally ill people become homeless because of their mental illness. Others because of drug and alcohol abuse. Also some people become homeless strictly because of financial insufficiency. But after becoming homeless all are exposed to significant trauma which makes helping this population even more difficult.

When trying to help this population an understanding of all the variables involved with homelessness must be identified, only then can interventions be designed which will help get them off the street. It is an imperative that public policy help this group as this population suffers most of all populations, falling victim to the highest rates of morbidity and mortality.

 

 

 

 

 

 

 

 

In this research paper I will identify the causes of homelessness. I will document different causal factors that lead to homelessness and finally I will offer some strategies of primary prevention for a problem that has so far been resistance to change. It is the hope of this writer that in understanding the varied causes of homelessness including genetics, poverty, mental illness, discrimination, some proposals can be put forward to help this underserved population.

Homelessness can not be isolated in one primary cause. If it could then primary strategies would be more easily implemented and homelessness would be minimized. Unfortunately the causes of homelessness are varied and therefore finding a singular strategy that fits all is useless. Because of the nature of homelessness being the result of a myriad of causes, the treatment regimen whether implemented environmentally, socially, or behaviorally has proven to be bordering on impossible. To look only at one factor is like trying to see the haystack by looking at a hayseed. My project will involve examining the causes of homelessness. In order to do this an attempt will be made to determine what are the primary factors involved. Only then can these primary factor be addressed.

 

Environmental and Social Determinates of Homelessness

 

The lack of success in preventing homelessness is evident. Homelessness is a problem around the world. While the homeless in earlier times were hidden from it's citizens, in the US homeless homelessness is more evident with the deinstitutionalization of the mentally ill, disbanded by mental health facilities. To focus on one risk factor of homelessness one must gloss over the history of failure to address the needs of this burgeoning population.

Buhrich notes the high incidence of schizophrenia. He attempts to estimate the percentage of a homeless populations prevalence of schizophrenia. The expanded Brief Psychiatric Rating Scale (BPRS-E) was used on two hundred and ten homeless men and women residing at or visiting the seven largest refuges in inner-Sidney Australia. An attempt is made to ascertain if with deinstitutionalization there was an increase in the homeless population. The results indicate that deinstitutionalization has not resulted in an increase in the homeless population at the homeless refugee centers. Yet measuring schizophrenia rates is difficult because those that participate underrepresent the homeless population who are less accessible (Buhrich, N., Hodder, T., Teesson, M., 2003). This result may be misleading.

Getting those that are homeless to participate in studies is difficult because of their lack of stability in their lives. They have no residence, no phone, no car and often little of no money. Those that are institutionalized are better able to be followed. Also many of those institutionalized may have been misdiagnosed and may not end up homeless. Therefore the deinstitutionalization of the mentally ill may have in fact increased the number of people on the street (Buhrich, N., Hodder, T., Teesson, M., 2003).

When looking at the conditions of homelessness one finds "As is true of homeless people in general, homeless substance abusers and mentally ill persons are characterized by extreme poverty; underutilization of public entitlements; isolation from family, friends, and other support networks; frequent contact with correctional agencies; and poor general health"(Fischer, P., Breakey, W., 2002) . The health care outcomes of the homeless are abysmal as demonstrated by the following report on a homeless man who sought care from a mobile clinic. It illustrates how the best intentions are often for naught. The homeless schizophrenics are less likely to avail themselves of care, and when their needs are addressed the untreated problems tend to be more advanced. Followup is minimal because of the mental disorganization of the homeless schizophrenic.

When attempting to help the homeless with health needs the provider must be cognizant of the possible lack of adherence to the treatment regimen because of mental illness or potential distrust of the provider. The homeless suffer an increased risk of mortality double of comparable housed patients. Homeless populations have a high prevalence of substance abuse and mental illness. Mental illness decreases the likelihood of receiving proper care. "Compared with controls having depression, homeless schizophrenic adults have fewer medical visits and fewer documented medical problems and are less likely to receive preventative care" (Hastings, J., Zulman, D., & Wali, S 2007).

Helplessness seems to be a constant theme of homelessness. This helplessness manifests itself not only by the homeless person being unable to take care of themselves but also finding themselves unable to navigate the problems presented by societal interaction. Some studies focus on the behavioral factors that decide homelessness (psychological factors) others focus on environmental factors (poverty). Once again this malady is not easily isolated. Schizophrenia has for a long time been thought to be genetic with environmental trigger but the mechanism by which this works is unknown. The schizophrenic homeless comprise a complex and intractable program.

The risk to the health of the homeless is clear and cannot be qualified. "Homeless people have a greatly increased risk of death. Compared with the general youth population of Quebec, mortality rates among street youth in Montreal are 9 times higher for males and 31 times higher for females. Among men using shelters for the homeless in Toronto, mortality rates are 8.3 times higher than the mean for 18-24 year olds, 3.7 times higher than the mean for 25-44 year olds and 2.3 times higher than the mean for 45-64 year olds" (Hwang, 2001). Governments have a moral obligation to address the problem of homelessness.

Looking at it from a narrower perspective is Baxter, tying the social impacts with the individual effects. "The causes of homelessness include unemployment, insufficient decent low-cost housing, and the mass deinstitutionalization of mental patients. The immediate event which precipitates homelessness may include eviction, conditions in prior residences, failure of aftercare provisions for discharged mental patients, withdrawal of familial supports, and loss of income" (Baxter, 1981).

It is found in this study that individuals with schizophrenia are overrepresented in the homeless population. Kelly talks about structural violence. People with schizophrenia are often victims of structural violence. These are the environmental factors that impact behavior negatively. One example of structural violence is that those with schizophrenia are also overrepresented among the prison population. Further structural violence occurs because incarceration increases stigma.

Schizophrenics are marginalized and don't have the option for participation in civic or social life. This population is unable to gain employment, accommodation, and unable to access medical and social services. "This structural violence may be understood by literature looking at socio-economic determinants, homelessness, migration and forensic psychiatry. By looking at the individual experience one can gain first hand knowledge of structural violence" (Kelly, 2005).

Yet the idea that the homeless, especially the mentally ill homeless, are not able to live in independent housing it not always clear. "Given that all study participants had been diagnosed with a serious mental illness, the residential stability demonstrated by residents in the Housing First program–which has one of the highest independent housing rates for any formerly homeless population–indicates that a person's psychiatric diagnosis is not related to his or her ability to obtain or to maintain independent housing" (Tsemberis, S., Gulcur, L., & Nakae, M. , 2004).

If it is true that the homeless are able to live in independent housing but are unable to acquire adequate housing, dislocation must be the result of social and environmental factors that preclude it. "A cohort study of homelessness among patients with schizophrenia in China using a logistic regression model. Significant predictors included a shabby and unstable house or shelter, positive family history of mental disorders, lack of income of the patient; and unmarried, divorced or separated. Multiple risk factors increased the likelihood of homelessness. Evidence indicated that unstably housed patients with schizophrenia would experience multiple psychosocial problems, had few supports and were significantly more likely to be literally homeless." (Ran, M., Chan, C., Chen, E., Xiang, M., Caine, E., Conwell, Y, 2006).

It is difficult to determine whether those that suffer from mental illness who are in dilapidated housing are there because of their inability to circumnavigate societies demands or whether this poor quality of life decreases social functioning. Those that are not considered to be classically mentally ill may find themselves on a downward spiral because of environmental pressures ultimately resulting in extreme dislocation

 

Behavioral Factors in Homelessness

 

Rather than looking at homelessness as simply a social problem, others look inside the homeless' psyche to find the answer. "Life circumstances have significant direct effects on depression…,[y]ounger persons, the chronically homeless, the street-based homeless, the sick and the less educated are also more likely to experience depression" (Gory, M., Ritchey, F., Mullis, J., 1990). The psychological effects of losing one's home and entering the ranks of the homeless are less well understood. "Given the suggestive research evidence presented the implications of psychological trauma theory, may result in many homeless individuals and families may be suffering both short- and long-term psychological devastation wrought by homelessness itself" (Goodman, L. A., Saxe, L., & Harvey, M. , 1991).

The psychological implications of homelessness is apparent. "People who are dually diagnosed with severe mental illness and substance use disorders constitute 10–20% of homeless persons" (Drake, R. E., Osher, F. C., & Wallach, M. A. , 1991). "An attempt is made to understand why some of those who are mentally ill become homeless while others do not. It was thought that schizophrenic men who became homeless would have poorer pre-illness social functioning, higher levels of the positive and negative symptoms of schizophrenia, greater abuse of drugs and alcohol, and more antisocial personality disorder. Also the homeless tend to have greater familial disorganization in childhood. It was thought the homeless would receive less help from the mental health system in finding housing and followup care. Using a case-control study it is shown that there are significantly higher levels of drug abuse, higher rates of antisocial personality disorder. It was shown that those that ended up homeless had not had access to therapy prior to becoming homeless. An association is shown between family disorganization in childhood and poor family support in adulthood. The study identified three domains of risk. Severity of mental illness, family background and prior mental health service use. Standard practice for discharging the homeless to shelters or streets functions to perpetuate the homelessness as this interrupts an mental health intervention because of the vicissitudes of the street" (Caton, C., Carol L. , Shrout, P., Eagle, P., Opler, L., & et al, 1994). It was thought that Xie "that by measuring behavior before the advent of homelessness one can decide what the risk of homelessness is for the individual studied is. Three groups were conceived forming a continuum beginning from milder symptoms to more severe. The mild group was referred to as the early-recovery group. This group was characterized by less severe substance use disorders at baseline and by use of Clozapine. The late recovery group took longer to adhere to treatment but when they did progress was made. This group had more serious substance abuse problems than the early recovery group. The no-recovery group was the largest group of the three. Lack of recovery referred to only substance abuse disorders in the no recovery group" (Xie, 2009).

Homelessness with those that were dual diagnosis (e.g. both mentally ill and substance abusers) took the longest to recover in Xie's study and one would expect this result to be replicated in the general population where treatment regimens are difficult to conform to because of the transient nature of homelessness.

 

Public Health Intervention

 

Even if the homeless can solve their social, psychological and behavioral problems, there are other barriers that confront them and this is the stigma. Once identified as homeless this person becomes a sort of outcast like someone from the Indian untouchable caste. "The homeless man is blamed no less than the domiciled man and generally is stigmatized more severely" (Phelan, J., Link,B., Moore, R., Stueve A., 1997). Even if those that are homeless whose psychologically functioning may improve, their integration back into society may be stilted. In my opinion this may be because first of all the previous behavior of the homeless person may make them suspect. Also those that come in contact with the previously non-domiciled person, may not want to recognize their own potential for falling homeless. It brings the aspect of homelessness to the individual who could have been them.

One way that homelessness is commonly looked at socially is in alienation from society. Homeless people experience growing alienation "Given that homelessness stems, at base, from an inability to afford housing, we next consider the structural conditions of the economy, housing markets, labor markets, and related factors that influence people's ability to afford housing…we look at the ways in which the United States has chosen to address homelessness from the federal level" (Burt, 2001). Only through recognizing environmental factors that lead to homelessness can public health official help the potential homeless before it is too late.

Public health policy must be modified to more clearly reflect the true causes of homelessness. "The magnitude of the problem of homelessness is much greater than most previous attempts to enumerate homeless people have led us to believe. This finding requires reconsideration of inferences about the causes of homelessness that were derived from point-prevalence studies of currently homeless people" (Link, B., Susser, E., Stueve, A., Phelan, J., Moore, R., & Struening, E. ,1994). When attacking the problem of homelessness one must be fully aware of the breadth and and depth of the problem. Not only is the challenge of helping the homeless in general overwhelming due to their numbers but the complexity of the dislocation is difficult to address in the individual.

By early intervention, considering behavioral, psychological and social environmental factors, the rate of homelessness can be reduced. Youth that are substance abusers must receive counseling early, those that suffer from mental disorders must also have professional psychological intervention, especially to prevent dual diagnosis that results in the potential to fall into homeless population. Public health policy must focus on social and environmental determinants. Problems such as poverty, abuse, discrimination, lack of access to medical care in order to help this disenfranchised population.

 

Discussion

When dealing with homelessness early intervention is vital. Only through primary interventions can this problem be solved. A multivariate approach must be implemented. Environmental, social and behavioral aspects that lead to homelessness must be addressed. After people become homeless, secondary intervention is difficult and may in fact be nearly impossible. Once deinstitutionalized or non-domiciled, reintegrating them back into society is very difficulty because of trauma they have faced being homeless. It is probably true that the longer one is homeless, the greater the trauma and therefore the more difficult to integrate them back into society. This difficulty of reintegration is a moot issue if they die prematurely. Because of the extreme difficulty of reintegrating the homeless back into society tertiary intervention almost become a moot issue.

With primary intervention mental health problems can be addressed early as mental health problems often manifest in the late teens or early twenties. But in order for there to be an effective primary intervention many variables must be addressed. While what follows is a wish list it would be helpful for example if those that were mentally ill received prompt treatment. This could be accomplished by having present in the schools and communities easy access to therapist who can help, be it in the schools or community health centers. Parent of teenagers and young persons in general must be made aware of the treatment options available to help. Maladies such as depression can be addressed early as well as more serious mental disorders such as those with manic-depression, schizo-affective disorder, and those with schizophrenia. The reason early intervention is necessary because if these serious cognitive disorders become apparent the less likely that a primary intervention will be effective because of increasing more severe dislocation over time.

In order for the mentally ill to be helped when they become ill a basic change would be needed to in society. Environmental, social and behavioral aspects that contribute to mental illness must all be addressed. In order to do this a more effective mental health delivery system would be needed and all of these mental health professionals would have to have access to both the economically privileged as well as the economically deprived. Only with an effective delivery system can homelessness be avoided, but it remains to be seen if it is more likely than not the case that this political will exists for such a change.

Not only must accessibility to mental health services be available in a timely manner but also those who struggle with adverse environmental pressures must be helped so as to be able to cope with the problem. As evidence seems to indicate, there are genetic factors that can lead to mental illness, there are also considered to be in some cases environmental factor. Finding genetic precursor to mental illness could provide a clue to those who might need help although their anonymity would need to be protected to prevent discrimination. Physical and psychology health of the family is vital for good mental health. Perhaps with much support with this fundamental strength that exists in the family, will the children be able to resist becoming susceptible to environmental pressures. Even with the genetic component if resilience in the face of environmental pressures can be achieved mental illness hopefully can be avoided.

 

Resources:

 

Baxter, E., Hopper, K. (1981) Private Lives/Public Spaces: Homeless Adults on the streets of New York City. Community Service Society of New York: New York. http://www.eric.ed.gov/ERICWebPortal/search/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED201564&ERICExtSearch_SearchType_0=no&accno=ED201564

 

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Burt, Martha. Helping America's Homeless: Emergency Shelter or Affordable Housing? The Urban Institute (2001). Retrieve on January 3, 2011 from http://books.google.com/books?hl=en&lr=&id=8_XzWQEhRGgC&oi=fnd&pg=PA1&dq=homeless+conditions&ots=l-SImY4CGo&sig=qzmLX4BhknFhb6EKeaISb0kvaT8#v=onepage&q=homeless%20conditions&f=false

 

Caton, Carol L M, Shrout, Patrick E, Eagle, Paula F, Opler, Lewis A, & et al. (1994). Risk factors for homelessness among schizophrenic men: A case-control study. American Journal of Public Health, 84(2), 265-70.  Retrieved December 29, 2010, from Research Library. (Document ID: 1514142).

 

Drake, R. E., Osher, F. C., & Wallach, M. A. (1991). Homelessness and dual diagnosis. American Psychologist, 46(11), 1149-1158. doi:10.1037/0003-066X.46.11.1149 http://cv8yh9th3f.scholar.serialssolutions.com/?sid=google&auinit=RE&aulast=Drake&atitle=Homelessness+and+dual+diagnosis&title=American+psychologist&volume=46&issue=11&date=1991&spage=1149&issn=0003-066X

 

Fischer, P., Breakey, W., (2002). The Epidemiology of Alcohol, Drug, and Mental Disorders Among Homeless Persons. Science Direct. Volume 46, Issue 11, Pages 1115-1128. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WY2-46VM2Y7-4P&_user=10&_coverDate=11%2F30%2F1991&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1594617058&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=829fc22d3ed8dd910b8d3285edce6427&searchtype=a

 

Goodman, L. A., Saxe, L., & Harvey, M. (1991). Homelessness as psychological trauma: Broadening perspectives. American Psychologist, 46(11), 1219-1225. doi:10.1037/0003-066X.46.11.1219 http://cv8yh9th3f.scholar.serialssolutions.com/?sid=google&auinit=LA&aulast=Goodman&atitle=Homelessness+as+psychological+trauma:+Broadening+perspectives.&id=doi:10.1037/0003-066X.46.11.1219&title=American+psychologist&volume=46&issue=11&date=1991&spage=1219&issn=0003-066X

 

Gory, M., Ritchey, F., Mullis, J. (1990). Depression Among the Homeless. Journal of Health and Social Behavior. University of Alabama at Birmingham Vol. 31 (March):87-101. http://www.jstor.org/pss/2137047

 

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Kelly, B.  (2005). Structural violence and schizophrenia. Social Science & Medicine, 61(3), 721-730.  Retrieved December 28, 2010, from Research Library. (Document ID: 842438271). see 360

 

Link, B., Susser, E., Stueve, A., Phelan, J., Moore, R., & Struening, E. (1994). Lifetime and five-year prevalence of homelessness in the United States. American Journal Of Public Health, 84(12), 1907-1912. Retrieved from EBSCOhost. http://cv8yh9th3f.scholar.serialssolutions.com/?sid=google&auinit=BG&aulast=Link&atitle=Lifetime+and+five-year+prevalence+of+homelessness+in+the+United+States.&id=doi:10.2105/AJPH.84.12.1907&title=American+journal+of+public+health+%281912%29&volume=84&issue=12&date=1994&spage=1907&issn=0090-0036

 

Phelan, J., Link,B., Moore, R., Stueve A. (1997). The Stigma of Homelessness: The Impact of the Label "Homeless" on Attitudes Toward Poor Persons. Social Psychology Quarterly, 60(4), 323-337.  Retrieved January 3, 2011, from Research Library. (Document ID: 25640843).

 

Ran, M., Chan, C., Chen, E., Xiang, M., Caine, E., Conwell, Y. (2006). Homelessness among patients with schizophrenia in rural China: a 10-year cohort study. Acta Psychiatrica Scandinavica, 114(2), 118-123.  Retrieved December 28, 2010, from Research Library. (Document ID: 1074220841). see 360

 

Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94(4), 651-656. Retrieved from EBSCOhost. http://cv8yh9th3f.scholar.serialssolutions.com/?sid=google&auinit=S&aulast=Tsemberis&atitle=Housing+first,+consumer+choice,+and+harm+reduction+for+homeless+individuals+with+a+dual+diagnosis&id=doi:10.2105/AJPH.94.4.651&title=American+journal+of+public+health+%281912%29&volume=94&issue=4&date=2004&spage=651&issn=0090-0036

 

Xie, H., McHugo, G., & Drake, R.. (2009). Subtypes of Clients With Serious Mental Illness and Co-occurring Disorders: Latent-Class Trajectory Analysis. Psychiatric Services, 60(6), 804-11.  Retrieved December 28, 2010, from Research Library. (Document ID: 1798985071).