Better Care Possible
by Dr. med. Stefanie Schreiter, Prof. Dr. med. Felix Bermpohl, Prof. Dr. med. Michael Krausz, Prof. Dr. med. Stefan Leucht, Prof. Dr. med. Wulf Rössler, PD Dr. med. Meryam Schouler-Ocak, and Dr. med. Stefan Gutwinski in issue 40/2017
The meta-analysis by Schreiter et al. (2017) shows the significant supply deficit for homeless people who have severe mental illnesses with overall multimorbidity. Against the background of my experience as a psychiatrist in the health department and in working with homeless people in Berlin, I believe that better care of these people would be possible in the context of integration support. Homeless people suffer from the same mental illnesses yet do not live like people who receive integration support, who are largely well provided for in their own homes, in shared apartments, or in care homes. In contrast, homeless people find themselves in this distressing situation because they could not sufficiently adapt to the rules of institutions and administrations. In general, they live in shelters or emergency shelters, or sleep rough on the streets, in house entrances, or in makeshift camps. Integration support can also offer these affected people a dignified existence.
If we are to implement inclusion according to the UN Convention on Rights of Persons with Disabilities, and participation according to the German Federal Participation Act (Bundesteilhabegesetz), this group of homeless persons with mental health multimorbidity must also be reached. Therefore, I propose the following measures:
- Provide single rooms with bathrooms for homeless people;
- Avoid „either ... or“ in social housing assistance and integration support, providing instead a case management for social services;
- Equip homeless facilities with outreach social work according to the criteria of integration support;
- Equip the social psychiatric services and infectious disease protection in health departments with sufficient and especially specialist medical staff to provide the appropriate outreach assistance appropriate.
Dr. med. Jan Podschus
12437 Berlin, Germany
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Schreiter S, Bermpohl F, Krausz M, Leucht S, Rössler W, Schouler-Ocak M, Gutwinski S: The prevalence of mental illness in homeless people in Germany—a systematic review and meta-analysis. Dtsch Arztebl Int 2017; 114: 665–72 VOLLTEXT|