The physical and mental health status of homeless adults

Abstract

This paper reviews recent research on the physical and mental health status of homeless single adults and briefly summarizes definitional, sampling, and measurement problems. It presents findings from research examining the physical health status of homeless adults; the data suggest that homelessness places people at greater risk for specific health problems and also complicates treatment. The authors then review findings on the mental health status of homeless adults from several methodologically rigorous studies that carefully define and measure mental illness among the homeless population. The final section discusses what is known about the short‐ and long‐term service needs of the physically and mentally disabled homeless population.

The studies reviewed suggest that individuals with chronic physical or severe mental illnesses are more vulnerable than others to homelessness. Homelessness exacerbates physical and/or mental conditions and complicates their treatment. Despite myths to the contrary, research and demonstration programs have shown that most homeless individuals are willing to receive assistance. By linking health and mental health services to appropriate housing, such individuals can be treated and cared for in community settings. However, local communities often do not have the necessary resources to meet the long‐term needs of severely mentally ill or physically disabled homeless people.     

The genetic and environmental overlap between aggressive and non-aggressive antisocial behavior in children and adolescents using the self-report delinquency interview (SR-DI)

Purpose

This study investigated genetic and environmental commonalities and differences between aggressive and non-aggressive antisocial behavior (ASB) in male and female child and adolescent twins, based on a newly developed self-report questionnaire with good reliability and external validity -- the Self-Report Delinquency Interview (SR-DI).

Methods

Subjects were 780 pairs of twins assessed through laboratory interviews at three time points in a longitudinal study, during which the twins were: (1) ages 9-10 years; (2) age 11-13 years, and (3) age 16-18 years.

Results

Sex differences were repeatedly observed for mean levels of ASB. In addition, diverse change patterns of genetic and environmental emerged, as a function of sex and form of ASB, during the development from childhood to adolescence. Although there was some overlap in etiologies of aggressive and non-aggressive ASB, predominantly in shared environmental factors, their genetic overlap was moderate and the non-shared environmental overlap was low.

Conclusions

Taken together, these results reinforced the importance of differentiating forms of ASB and further investigating sex differences in future research. These results should be considered in future comparisons between youth self-report and parental or teacher report of child and adolescent behavior, and may help elucidate commonalities and differences among informants.     

Parenting education: Primary prevention in a rural community

SUMMARY

The present paper describes the educational background and current role of a community psychologist conducting tobacco control studies at a research institute affiliated with a university medical school. This includes how the author originally became interested in community psychology as an undergraduate, chose a graduate training program and postdoctoral fellowship, and how this training was instrumental in obtaining the current position.     

Democracy or democrazy? Local experiences of democratization in Timor-Leste

Since gaining independence from Indonesia in 1999, Timor-Leste has been pursuing an agenda of democratization. However, in the villages of Timor-Leste traditional ideas of socio-political legitimacy continue to be strong. The purpose of this article is to examine how the new democratic ideals are being incorporated into local politics, where traditional law, or lisan, continues to guide the daily lives of the villagers. This article argues that democratization in this context should not be seen as integrating one ‘type’ of governance (liberal democracy) into a social structure that is informed by another ‘type’ of governance that is qualitatively different and in opposition to the first. Rather, evidence shows that communities are engaging within both spheres of governance simultaneously, as part of the everyday politics of village life. This article critically examines the areas where traditional and democratic institutional spheres come together, resulting in structured systems of mutual recognition, as well as the areas where the spheres have been in conflict. The author concludes that the fundamental areas of tension that have emerged between the spheres tend to be where notions of ‘respect-in-community’ as the basis for human security are threatened.     

Providing Interdisciplinary Services to At‐Risk Families to Prevent the Placement of Children In Foster Care

Grandparents need support to take on the responsibility of children whose parents cannot care for them due to drug addiction, mental health issues, HIV illness, or other health problems. Without support and assistance, these families and children are likely to end up enmeshed in the already overburdened child abuse and neglect system. The University of Maryland has created a model program providing social work and legal services to at‐risk grandparent families to help avoid the unnecessary placement of these children in foster care. In this new program, student attorneys and student social workers worked with the grandparent client to help stabilize the family, providing representation or advice on housing, public benefits, custody, and school‐related issues. Joint education of student attorneys and student social workers in a clinical experience enhances their understanding of their roles and those of the other profession and prepares them for a more thoughtful and informed approach to family law, child welfare cases, and at‐risk children.     

Police confirmation of use of force in Australia: ‘To be or not to be?’

Despite significant transgressions during encounters with Indigenous peoples and marginalised groups, all six state police organisations in Australia espouse the principle of minimum force and identify service and crime prevention as paramount in community interaction and intervention. This article offers some insight and perspective of police talk and thinking about the potential use or avoidance of force. The four Victoria Police focus groups, when confronted by the specific police use of force scenario, speak of the adrenalin rush and the need to achieve results, if reasonable and necessary by force, but also of the desire to control the situation and follow proper police procedures. Officers support ‘Safety First’ principles that advocate a cautionary and suspicious approach to the scenario combined with rational and methodical tactics rather than emotional responses. The reflective talk of individual officers about the hypothetical situation parallels actual behaviour when police collectively and visibly confront public disorder. Control and containment of the situation—whether the scenario or a major crowd disturbance—are paramount while time, in the form of acting slowly and adopting a low-key approach, can be seen as assets in achieving objectives. In both the scenario and police planning for collective action, a readiness to threaten force, rather than actually employ it, appears central to police thinking. Police justification of non-coercive tactics in certain situations can be revealing about their thinking processes in justifying force in other circumstances.

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Screening for cocaine metabolite fails to detect an intoxication

Testing for the presence of cocaine (COC) is common in postmortem and clinical laboratories. COC use may be detected by screening urine specimens for COC metabolite. In the forensic arena, screening positive results are confirmed by a more specific and sensitive technique, such as gas chromatography-mass spectrometry. This article reports the case of an individual who died of COC intoxication but whose immunoassay screen (EMIT) for COC metabolite was negative. Gas chromatography-mass spectrometry analysis of the urine detected benzoylecgonine (BE) at a concentration of 75 ng/mL and COC at 55 ng/mL. These concentrations explain the negative screening result since the cutoff concentration of the assay was 300 ng/mL for BE. The reported cross reactivity with COC was 25,000 ng/mL. However, heart blood concentrations of COC and BE were 18,330 and 8640 ng/mL, respectively. The results from this case provide evidence that an EMIT test alone may fail to detect COC use. Individuals utilizing results of drug screening by immunoassay must be aware of the limitations of this testing methodology.