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“系统会把你捞起来然后把你吐出去,然后他们就不管你了”:从服务提供者的角度看智障/发育障碍与无家可归的交叉点。

"The System Tends to Scoop You Up and Spit You Out and They're Done With You": The Intersection of Intellectual/Developmental Disability and Homelessness From the Perspectives of Service Providers.

机构信息

School of Nursing, The University of Texas at Austin, Austin, TX, USA.

出版信息

Qual Health Res. 2023 Sep;33(11):1017-1029. doi: 10.1177/10497323231186880. Epub 2023 Aug 7.

Abstract

People with intellectual and developmental disabilities (IDD) experience elevated risk for poor health and social outcomes in adulthood and are at risk for experiencing homelessness and housing instability. Although the exact prevalence of IDD among homeless populations is unknown, a small body of literature related to the intersection of IDD and homelessness suggests differential health needs and service use patterns, with a need for targeted health and social services. In this study, we explore the perceptions and experiences of 18 homeless or disability service providers about (a) their clients at the intersection of IDD and homelessness and (b) their role and the services provided at the intersection of IDD and homelessness. Participants struggled to provide appropriate, accessible services for this population, owing to lack of training and awareness of specific needs, fragmented systems, and inadequately funded healthcare and housing support. Our findings also reveal that clients at this intersection have high contact with public systems, which places them at risk for losing their right to self-determination. Recommendations center on systems transformation to facilitate the ability of providers to collaborate and to make data-driven decisions to deliver person-centered care.

摘要

智障和发育障碍人士(IDD)在成年后面临健康状况和社会结果不佳的风险,并且有遭受无家可归和住房不稳定的风险。尽管无家可归人群中 IDD 的确切患病率尚不清楚,但与 IDD 和无家可归交叉相关的少量文献表明存在不同的健康需求和服务使用模式,需要有针对性的健康和社会服务。在这项研究中,我们探讨了 18 名无家可归或残疾服务提供者对(a)他们的同时患有 IDD 和无家可归的客户,以及(b)他们在 IDD 和无家可归交叉点的角色和提供的服务的看法和经验。由于缺乏特定需求的培训和认识、零碎的系统以及医疗保健和住房支持资金不足,参与者难以为这一人群提供适当、可及的服务。我们的研究结果还表明,处于这一交叉点的客户与公共系统有密切接触,这使他们有失去自主决定权的风险。建议的重点是进行系统转型,以促进提供者的协作能力,并做出数据驱动的决策,以提供以患者为中心的护理。

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