For those wishing to understand issues of homelessness, social exclusion and health at a local level by framing these issues in a global context. It expands notions of health by drawing on disciplines outside the fields of housing and health to better comprehend the ways that stigma, identity and urban geographies shape and present homelessness.
A Complex Exile shows that the homelessness sector inadvertently reinforces the social exclusion of people who are homeless. Over 235,000 people couch-surf, stay in emergency shelters, or live on the street in Canada every year. However, the very policies, practices, and funding models that exist to house the homeless, promote social inclusion, and provide mental health care form a homelessness industrial complex. These practices emphasize personal responsibility and individualized responses that ultimately serve to subtly exclude people. This book goes beyond bio-medical and psychological perspectives on homelessness, mental illness, and addiction, to call for a transformation in how we respond to homelessness in Canada.
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Poverty, Mental Health, and Social Inclusion offers a comprehensive selection of chapters written by academic researchers as well as direct practitioners and mental health consumer-survivors to examine the intersection of poverty, mental health, and social exclusion. With the aim of addressing complex issues from homelessness and housing to stigma and mental health, the volume presents the perspectives of a wide range of those affected by poverty and social exclusion including Canadian veterans, Indigenous women, homeless youth and families, and mental health consumer-survivors. Divided into four sections, the chapters explore the effects of social exclusion, examine the trajectory of how it occurs, analyze harmful policies in place that exacerbate the correlation between poverty and mental health issues, and introduce potential solutions to expand social inclusion to marginalized groups. Accessibly written, this text will be a valuable resource for courses on mental health, poverty, and social policy across the disciplines of social work, sociology, and health studies at both the graduate and undergraduate level.
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
For those wishing to understand issues of homelessness, social exclusion and health at a local level by framing these issues in a global context. It expands notions of health by drawing on disciplines outside the fields of housing and health to better comprehend the ways that stigma, identity and urban geographies shape and present homelessness.
Now in its third edition, this comprehensive text provides an in-depth examination of poverty and its impact on the health and quality of life of Canadians. Considering a broad range of topics, Dennis Raphael covers the central issues of defining and measuring poverty; situational and societal causes of poverty; health and social implications for individuals, communities, and society as a whole; and the means of reducing poverty’s incidence through public policy action. Poverty in Canada will foster greater insight into the repercussions of poverty throughout society, encouraging readers to reflect on provocative questions at the end of each chapter. Well updated to reflect current statistics and recent public policy changes, this new edition explores why specific groups of Canadians are over-represented amongst those living in poverty and provides a more developed analysis of the barriers to reducing poverty, including economic globalization and the increased power and influence of the corporate sector under neo liberalism. Emphasizing the lived experiences of poverty, this interdisciplinary volume is a valuable resource to those studying or working in health studies, social work, sociology, and equity studies.
The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.
Drawing on interdisciplinary, cross-national perspectives, this open access book contributes to the development of a coherent scientific discourse on social exclusion of older people. The book considers five domains of exclusion (services; economic; social relations; civic and socio-cultural; and community and spatial domains), with three chapters dedicated to analysing different dimensions of each exclusion domain. The book also examines the interrelationships between different forms of exclusion, and how outcomes and processes of different kinds of exclusion can be related to one another. In doing so, major cross-cutting themes, such as rights and identity, inclusive service infrastructures, and displacement of marginalised older adult groups, are considered. Finally, in a series of chapters written by international policy stakeholders and policy researchers, the book analyses key policies relevant to social exclusion and older people, including debates linked to sustainable development, EU policy and social rights, welfare and pensions systems, and planning and development. The book’s approach helps to illuminate the comprehensive multidimensionality of social exclusion, and provides insight into the relative nature of disadvantage in later life. With 77 contributors working across 28 nations, the book presents a forward-looking research agenda for social exclusion amongst older people, and will be an important resource for students, researchers and policy stakeholders working on ageing.
