Perspectives of homeless people on their health and health needs priorities.

AIM: This paper is a report of a study of the perspectives of homeless individuals on their health and healthcare needs.
BACKGROUND: Many studies show the high incidence and severity of diseases, physical and mental, amongst the homeless populations. However, the views of homeless people themselves are usually omitted. In order to provide appropriate care, healthcare professionals need to be aware of these perspectives.
METHOD: A descriptive, exploratory design, using semi-structured interviews and observational field notes, was chosen for this qualitative study. A convenience sample of 24 participants experiencing homelessness was recruited in one Canadian city in 2005.
FINDINGS: Participants described their health and healthcare needs in a holistic sense. They reported concerns about physical illnesses, mental health, addictions and stress. Shelter life promoted spread of diseases and lacked privacy. Violence was rampant in shelters and on the streets, leading to constant fear. There was emotional distress over social exclusion and depersonalization. Participants wanted to work and to be housed, yet felt trapped in a dehumanizing system.
CONCLUSION: The recommendations are (a) elimination or mitigation of most health problems of the homeless through safe, affordable housing; (b) reintegration into the community through job counselling, treatment of addictions and employment. Negative societal attitudes towards these clients need to change. Healthcare professionals, particularly community nurses, have opportunities to collaborate respectfully with these clients and work for changes in public policies, such as national housing and addiction treatment policies, and for streamlined, humanized services to smooth the processes of social reintegration.