Bhui Kamaldeep, Shanahan Lisa, Harding Geoff
Institute of Community Health Sciences, Barts and The London School of Medicine, Queen Mary University of London.
Int J Soc Psychiatry. 2006 Mar;52(2):152-65. doi: 10.1177/0020764006062096.
Homelessness and mental illness together confer significant morbidity and mortality because of physical health problems. Healthcare provision is undergoing significant review, and, as part of the Department of Health's policy reforms, the service user's view is central to the future restructuring of NHS services.
A literature review of homeless service users' perceptions of services for homeless mentally ill people was supplemented by a qualitative in-depth survey of 10 homeless people. This article reports on their views about the services they receive. Mismatch between expectations and provision, disputes with healthcare providers, dissatisfaction with the degree to which they have choice in their care, and suspicions about the intentions of health professionals demonstrate the extent to which powerlessness and social exclusion are replicated in healthcare economies. The inadequacy of hostels and their staff are also emphasised, with some recommendations for services.
There are few data on homeless people's perceptions of services for mental health problems. Homeless people have strong views about the adequacy of services to meet their needs. They were particularly concerned about stigma, prejudice and the inadequacy and complexity of services that they have to use. This article reports their recommendations for change.
无家可归与精神疾病共同导致了因身体健康问题而产生的高发病率和高死亡率。医疗保健服务正在经历重大审查，并且作为卫生部政策改革的一部分，服务使用者的观点对于国民保健服务体系（NHS）服务的未来重组至关重要。
对无家可归服务使用者对无家可归精神疾病患者服务的看法进行文献综述，并对10名无家可归者进行定性深入调查作为补充。本文报告了他们对所接受服务的看法。期望与服务提供之间的不匹配、与医疗服务提供者的纠纷、对在护理中选择程度的不满以及对医护人员意图的怀疑，表明了在医疗保健经济中无力感和社会排斥被复制的程度。还强调了收容所及其工作人员的不足，并对服务提出了一些建议。
关于无家可归者对心理健康问题服务看法的数据很少。无家可归者对服务满足其需求的充分性有强烈看法。他们特别关注耻辱感、偏见以及他们必须使用的服务的不足和复杂性。本文报告了他们对变革的建议。
