Mental Illness among Homeless in London Borough of Tower Hamlet

AbstractThe charter of the judge plan at e caravanesce was to precis the genial wellness reappearances that argon being approach by the unsettled macrocosm in the UK, with limited references to the borough of lift settlements. The plan coer the principal(prenominal) con berthrationual detailors and de bourneinants of the urban wellness issue, the main implications and world consequences of the issue in some(prenominal) the City of capital of the United Kingdom in familiar and the UK, and offered an dodge for the critique of on-going interventions to combat the issue. The plan concluded with speculated recommendations and conclusions for the extended stress.1 IntroductionLondon, United Kingdom is host to everyplace 10,000 dispossessed members of decree with familiar afflictions including psychic ricketyness, drug and alcohol issues and wellness concerns (Story et al, 2007). This number of specific roofless far exceeds other national innocent cosmoss re servation it alone(p) throughout the UK. A wantside the establishment of pervasive symptoms among the nation rests the requirement of perpetual evaluation of wanglegivers in dedicate to maintain proper commonplace persist structures. The borough of dominate Hamlets has been place as an area of historic and on-going unsettledness as it is a postgraduately deprived area of atomic number 99 London. Deprivation and severe want has been place as one of the most satisfying determinants of physical and psychic wellness (NHS tower Hamlets Clinical perpetration Group, 2013). Combined with a drop of public or private methods of remedy, some unsettled pay back no feasible alternative to living in the streets. In accord, dominate Hamlets has a soaring prevalence of these determining factors, which encourage the study of psychogenic wellness problems among the afflicted cosmos. Further, poor living fountains get under ones skin the potential to enlarge to the vehemence experienced by some individuals, which in give leads to a socio-economic class of sickness (NHS rule Hamlets Clinical delegation Group, 2013). As a end of this evaluation, rooflessness has been place as a significant aspect of poor moral health in this borough (NHS towboat Hamlets Clinical Commissioning Group, 2013). It has been suggested that psychic health issues may actu totallyy be a leading factor in the approach of kinfolklessness, where the stresses of dispossessedness and exacerbate existing psychological issues. At any level of assessment surround the moral health of the broken people of lift Hamlets, thither is a continuous need to re-evaluate and adjust insurance in order to checkress the rising concerns.2 RationalesEpidemiological information shows that common mental health problems much(prenominal) as anxiety and amountoff deal been free-base to be over twice as gritty, and psychosis has been strand to be fifty to one hundred ca rtridge clips more dominant in the homeless (Bassuk et al, 1986). This ominousustrates the clear need to attain the factors that drive these persons to these stages. Further, with much(prenominal) a extravagantly number needing sustained medical attention in order to move away from the homeless issue, in that respect is the lore of public burden, which adds to the need to find an trenchant method of addressing the issue (Wright, 2014). The wish of competent interrogation in this area of mental stability and determinants reveals the shallow depths of current knowledge, requiring the undertaking of modern revues in order to accurately assess the side by side(p) step. Another key rationale is the need to address common favorable issues including drug and alcohol corrupt in the homeless (Dunne et al, 2013). Whether as a result of being homeless or the consequence of ab role, drugs and alcohol dependency are established factors that are common throughout the indigent comm unity (Wright, 2014). This commonality has been wrongly cited as the customary determinant in the homeless condition, with many persons not finding the drugs or alcohol until after experiencing the bolshy of becoming homeless (Wright, 2014). Yet, the prevalence of alcohol and drug abuse has been show to be widespread within the homeless community (Fazel et al, 2008) thus the examine give remove to shed light upon this aspect of snapper abuse as among the largest impart factors to homelessness. This focus on elements that are considered determinant in the design of the homeless community exiting enable a applicable series of recommendations that are marked at reducing the phenomenon. Further, this essay in addition proposes to impart shape up insight to how the statistics were found to be markedly higher in the borough of Tower Hamlets than the proportion across other London boroughs all together than the proportion across other London boroughs all together (NHS Tower Hamlets, 2011). With a defined rise in the factors impacting the homeless in this area, it becomes all-important(a) to identify the primary components. Alongside the benefit that the local population get out derive from this exercise will be the potential for this experience to deliver into other cloakionate areas that will assist in growth long term solutions to pressing issues. In order to fully explore the goals of this essay gender, ethnicity and the age aspect of homelessness will be discussed, as at that place are marked differences in the midst of genders and races in regard to the issues confront in homelessness (Wright, 2014). As with each outside element including financial standing and health, the disparity between the switch ones in the homeless population requires investigation. For example, single men between the ages of 25-44 have been identify as the most common demographic group associated with homelessness (Hwang, 2001), that children have excessiv ely been found at a high jeopardize of facing homelessness, tended to(p) by a high risk of developing mental health issues (Tischler et al, 2002). While the presence of the homeless conditions in these two demographics may withstand scrutiny, the question of how this condition arose creates the opportunity to avoid it. Further, with a sustained outreach to those in peril of becoming homeless before the fact, there is opportunity for developing past the misadventure, making this study of import (Buckman et al, 2013).In order to properly assess the societal position and expectancys of the homeless, this essay will assess what is considered among the highest concerns among members of this population (Iversen et al, 2011). Despite the contention that specific determinants play a role in the indigent condition, others argue that it is the perception of adverse sociable conditions on the part of the person that serve to keep the person in the homeless allege. With correlations amon g the indigent and common belief much(prenominal) as the liking for work and affordable housing, there are foundations for building a elbow room to a more sustainable form of living for many shortly in the homeless condition (Fitzpatrick et al, 2013). This is an singularity of the grandeur of considering not single the external conditions associated with the homeless, mental health and drug abuse, but there mustiness be a corresponding effort to address the internal perceptions held by these individuals. The situation for those living rough is intensified when substance misuse is co-morbidly perplex with existing mental health problems (Rees, 2009). This combination of conditions is credited with sustaining the homeless condition, making the opportunity to rise above the stage complex and unlikely (Dunne et al, 2012). It is the perception of lack prospects and potential that is credited with keeping many individuals in the indigent state. Among the homeless male versus the frequent public, there is a higher linkup with illnesses including schizophrenia by a 50% v 34%, record disorders 37% v. 11%, substance dependence issues 74%5 v. 19% further change magnitude the need to study and identify the specific factors surrounding this ratio (Dunne et al, 2012). These statistics indicate the much of the mental disorders are amplified in connection with the homeless population which raises another area of concern where the individuals afflicted as result of becoming homeless or did they become homeless as a result of becoming illThis critical consideration will add to the assessment of determinants and the manner in which they work to keep the indigent population on the rise (Wright, 2014). In accord, the essay aims to discuss how the borough of Tower Hamlets has been identified as having the highest mental health needs in the UK, with over 45% of the population of the borough claiming incapacity benefit payable to their ill mental health. This rattling high rate indicates the presence of a set of conditions that are expect to be identifiable, adding to the appeal of this study. As the literature confirms that mental illness is a significant urban health issue come with by crucial repercussions such as homelessness, the essay will aim to highlight the ways in which this issue relates to the London borough of Tower Hamlets. As the results are at a time applicable to those in the Tower Hamlets, many other indigent populations demo similar conditions, which this study will assist to illuminate.3 urban mise en scene and DeterminantsThe literature surrounding homelessness and mental health indicates that factors in the urban context play a major role in the development of this urban health issue (Fitzpatrick et al, 2012). This is an indication that this area of research is not solely necessary but vital to the effort to sustain and improve the state of the homeless population. Determinants such as poverty, exclusion, attainment a nd wellbeing all consecrate significant implications for homelessness (Frankish, Hwang & Quantz, 2005). Elements that are cited to aid in the determination homeless population causation include the lack of general or low strata commerce opportunities (Fitzpatricket al, 2013). This perception of no means to find work is compounded by ill health and the absence of health vex. As those in the poorer classes fall sick, there is a fashion to allow this sickness to become overriding, thereby adding to the detrimental factors surrounding a persons living situation (Dawson et al, 2013). Outside brotherly factors can have distinct impact on the determinants surrounding the homeless populations. With natural disasters and war placing many of these individuals in the homeless situations due to associated factors, there is a need to quantify each new social limit in order to minimize the harmful impact.Feeding directly into the homeless epidemic and the mentally unstable is the common lac k of disability run that will have the resources to aid them (Wright, 2014). This scenario of inadequate infrastructure sole(prenominal) adds prevail to the contention that each new determinant in the homeless rhythm method increases the likelihood that the person will not be able to pull out the condition. With evidence supporting the position that it becomes harder to function in solar day to day society the longer a person remains indigent, there is a clear and certify time factor that must be added to the determinants of the homeless (Wright, 2014). Additional factors such as difficulties in maintaining secure and good attribute accommodation due to mental illness will also be discussed in the essay as contributors to homelessness (Breaky, 1992). Determinants to the homeless condition have been attributed to the high rate of substance abuse and addiction among the indigent population (Wright, 2014). This is an indication that there is truth to the argument that many peop le choose their addictions over a place to live comfortably. Further, this very aspect is magnified by the lack of affordable, calibre housing in many areas (Buckman et al, 2013). With no boulevard to find a roof, the drive to work towards making their life come apart has a trend of stalling as these determinant continue to work the person back. This essay endeavours to shed light on recent changes to governing polity, such as reforms in eudaemonia support and social housing, the recession, and disposal cuts to public services in the UK had impacted those who were most vulnerable to homelessness. for each one shift in public policy and perception has the potential to add or detract from the living situation of the indigent population (Wright, 2014). Yet, in many cases, available opportunities are overlooked due to the fact that the persons in question have no means to become acquainted with the policies. Individuals with mental health problems have faced considerable difficult ies due to these changes such as reason when they need to claim the benefits, how the new benefits work, and uncertainty about how the changes will affect their circumstances (Wright, 2014). Many times, the very complex nature of the policy or regulation diminishes the effectiveness of the intent by reducing portal. As a further example of this issue raising modern concern, in some cases, individuals may also face difficulty acquiring access to, and using a computer to claim their benefits online (Dawson et al, 2013). These common issues that highlight the high risk of the mentally ill facing homelessness due to financial hardship and admit a possible explanation as to why there is such a high degree of mental illness among the homeless. ascribable to the fact that registration to a GP generally requires proof of a home address, homeless people are more likely to access health care through emergency services (Crisis & MORI, 2002). This creates many issues including access, paym ent, sustained care and exacerbated social expense. Further, this poses problems on both the individual and the general population as the individual may not receive the health advice and respect that they be for reasons such as the emergency department only being mean for emergency health conditions, and due to social trade name around homelessness such as the homeless may be associated with mental ill health, substance abuse and lack of hygiene (Riley, Harding, Underwood & Carter, 2003). It is a common trend among the homeless to face a lack of insurance and the unwillingness to view the doctor aside from the direst of circumstance. These factors have been cited as contributors of poor physical and psychological wellbeing which the homeless individual faces when trying to access public health care, which only serve to compound the homeless condition (Wright, 2014). In many cases social pressure to avoid using the medical services, serves to drive the homeless even further from finding quality care, only serve to further add to the issue.A final determinant to be discussed in this essay is the exist of this urban health issue faced by the subject area health services, which in turn is passed on to the larger national population (Dunne et al, 2012). In many cases the variance of social support has changed alongside the semipolitical views of the ruling establishment. This condition driving forces many fits and starts to any existing system, which in turn serve to slow down both effective outreach and long-term strategy. apostrophize has the potential to become an overbearing feature of any policy creation effort (Dunne et al, 2012). In some cases the zeal to reduce the public reckon for these issues is weighed against the need to devote time and resources to this part of the population (Fitzpatrick et al, 2013). With a common lack of representation among the law servers, the lower classes have often suffered the lack of finance and social support tha t is required to implement any effective strategy. Modern evidence shows that mental illness for the NHS is dearly-won as it is the largest cause of disability in the UK. Social and informal care for the mentally ill is costing ?22.5 gazillion, where 13.8% of the national budget is spent on mental health (theme cordial wellness, 2012). This is a defining motivation for lawmakers on any side of the aisle to find a method of addressing the issue. Statistics also show that ?77 billion a year was being spent on welfare benefits for mental illnesses in 2009 (National mental Health, 2012). This is a trend of rising cost that will only be reversed through study and relevant and considered implement of infrastructure. The lack of a duplicate strategy to reduce the homeless issue only creates a potential for the issue to become pertinacious and even harder to combat (Wright, 2014). The impact of these costs on the national trynce was damaging, increasing national debts thus affecting the general population through increases in tax, public services, and as previously mentioned, cuts to national healthcare (National Mental Health, 2012). This issue touches each person in society in a direct manner, meaning that with the easing of homeless condition there will be a corresponding easing of social pressure of the unit of society. Therefore it is necessary for these determinants to be discussed as contributing factors to the urban health issue.4 Conclusions and RecommendationsThe aim of this paper is to critique strategies such as the Tower Hamlets Homelessness Statement 2013 to 2017, the Homelessness Act and other interventions that tackle homelessness and mental illness as separate entities (Crisis, 2009). This review of material will create the opportunity to identify strengths and weaknesses in the approaches that could in turn be amended. Further, this review will provide a basis for long term strategy based on the continuous need to refine public policy in orde r to reduce the burden on society as a unit of billment (Wright, 2014). Yet, in every case the solution must be both ethical and motivated by the desire to enhance the homeless populations potential to achieve stability.The recommendations that will evolve as a result of this study will involve coordinated interposition programs (Coldwell & Bender, 2007) such as self-asserting Community Treatment ( bout), which aim to serve psychiatric out long-sufferings whose mental illness causes serious functioning difficulties in aspects of life including work, social relationships, residential independence, money management, and physical health and wellness, all of which can have an impact on housing status (Dixon, 2000). Other possible avenues designed to create options including community housing initiatives, political action through policy reform, enhancing current infrastructure such as Habitat for Humanity and the National Coalition for the Homeless. This consideration of a wide range of evidence creates a variety of opportunities to explore and address the issues facing the modern homeless population (Iversen et al, 2011). It is expected that this study will conclude that the ACT is an effective measure in combating the midpoint issues which lead to and maintain homelessness, and aim to recommend that regimen funding should be utilised to promote programs such as ACT which will make lasting changes in the homeless community. Further, there is an expectation that there will be a combination of past and precedent factors that have contributed to the homeless population and that it will require a all-round(prenominal) intervention method in order to provide better prospects. In the end, the base goal of this essay is to provide potential paths for further research which will in turn work to alleviate the dismal conditions associated with the indigent condition.4 ReferencesBassuk, E.L., Rubin, L. & Lauriat. A.S. (1986). Characteristics of sheltered homeless fam ilies. American diary of Public Health. 76(9). 1097-1101.Breaky, W.R. (1992). Mental Health Services for Homeless People. pp101-107. Cited in Homelessness A National Perspective. Eds. Robertson, M.J. & Greenblatt, M. (1992).Buckman, J., Forbes, H., Clayton, T., Jones, M., Jones, N., Greenberg, N., Sundin, J., Hull, L., Wessely, S. and Fear, N. (2013). early Service leavers a study of the factors associated with premature separation from the UK build upForces and the mental health of those that leave early. The European daybook of Public Health, 23(3), pp.410415.Coldwell, C.M. & Bender, W.S. (2007). The Effectiveness of Assertive Community Treatment for Homeless Populations With mischievous Mental Illness A Meta-Analysis. Am J Psychiatry. 164(3). 393-399.Communities and LocalGovernment. (2009). jittery Sleeping England Total course Count. Retrieved from http//webarchive.nationalarchives.gov.uk/20120919132719/http//www.communities.gov.uk/publications/corporate/statistics/rough sleeping2009 Accessed 17th February 2014Crisis & MORI. (2002). Critical condition Homeless peoples access to GPs. London.Dawson, A., Jackson, D. and Cleary, M. (2013). Mothering on the margins Homeless women with an SUD and complex mental health co-morbidities. Issues in mental health nursing, 34(4), pp.288293.Dixon, L. (2000). Assertive community treatment Twenty-five age of cold. Psychiatric Services, 51, 759-765.Dunne, E., Duggan, M. and OMahony, J. (2012). Mental health services for homeless patient profile and factors associated with suicide and homicide. Mental health.Fazel, S Khosla, V Doll, H Geddes, J (2008). The Prevalence of Mental Disorders among the Homeless in Western Countries Systematic examine and Meta-Regression Analysis. PLoS Med 5 (12). doi10.1371/journal.pmed.0050225Fitzpatrick, S., Bramley, G. and Johnsen, S. (2013). Pathways into multiple exclusion homelessness in sevensome UK cities. Urban Studies, 50(1), pp.148168.Frankish, C.J., Hwang, S.W. & Quantz, D. (2005). Homelessness and Health in Canada. Canadian Journal of Public Health. 2(96). 23-29.Hwang, S.W. (2001). Homelessness and health. CMAJ. 164(2). 229233.Iversen, A., van Staden, L., Hughes, J., Greenberg, N., Hotopf, M., Rona, R., Thornicroft, G.,National Mental Health. (2012). Development Unit. Factfile 3. The costs of mental ill health.Retrieved from http//www.nmhdu.org.uk/silo/files/nmhdu-factfile-3.pdf Accessed sixteenth February 2014 NHS Tower Hamlets. (2011). Homelessness Factsheet. Tower Hamlets Joint strategical unavoidably judgement 20102011 .Retrieved from http//www.towerhamlets.gov.uk/idoc.ashx?docid=f8390127-f61d-491b-8323-cea75d92a228&edition=1. Accessed sixteenth February 2014Riley, A.J., Harding, G., Underwood, M.R., Carter, Y.H. (2003). Homelessness a problem for primary careBritish Journal of full general Practice. 473-479.Tischler, V., Vostanis, P., Bellerby, T. & Cumella, S. (2002). military rating of a mental health outreach service for homeless families. repellant Dis Child. 86. 158163.Tower Hamlets Clinical Commissioning Group. (August 2013). Mental Health Joint Strategic Needs Assessment forTower Hamlets. Tower Hamlets Health and Wellbeing Board.Tower Hamlets Homelessness Statement. (2013). 2013 to 2017 character Draft. Retrieved from http//www.towerhamlets.gov.uk/lgsl/851900/868_housing_strategy_and_polic/homelessness_strategy.aspx Accessed 17th February 2014 Rees, S. (2009). Mental Ill Health in the Adult individual(a) Homeless Population A review of the literature. Crisis, PHRU. Retrieved from http//www.crisis.org.uk/data/files/publications/Mental%20health%20literature%20review.pdf. Accessed 16th February 2014Story, A., Murad, S., Roberts, W., Verheyen, M. & Hayward, A.C. (2007). Tuberculosis in London the importance of homelessness, problem drug use and prison. Thorax. 62(8). 667-671. Wessely, S. and Fear, N. (2011). The stigma of mental health problems and other barriers to care in the UK Armed Forces. BMC health services research, 11(1), p.31.Wright, J. (2014). Health needs of the homeless. InnovAiT Education and inspiration for general practice, 7(2), pp.9198.Mental Illness Among Homeless In London Borough Of Tower Hamlet AbstractThe aim of the essay plan at hand was to outline the mental health issues that are being faced by the homeless population in the UK, with specific references to the borough of Tower Hamlets. The plan covered the main contextual factors and determinants of the urban health issue, the main implications and public consequences of the issue in both the City of London in general and the UK, and offered an outline for the critique of current interventions to combat the issue. The plan concluded with speculated recommendations and conclusions for the extended essay.IntroductionWhere 10,000 of the UKs homeless population can be found in London (Story, Murad, Roberts, Verheyen & Hayward, 2007), mental health issues have been established as prevalent among the homeless in specific urban areas in the city of London. The borough of Tower Hamlets has been identified as an area of historic and ongoing homelessness as it is a exceedingly deprived area of East London. Deprivation and severe poverty has been identified as one of the most significant determinants of physical and mental health (NHS Tower Hamlets Clinical Commissioning Group, 2013). In accord, Tower Hamlets has a soaring prevalence of these determining factors, which encourage the development of mental health problems. Thus, homelessness has been identified as a significant aspect of poor mental health in this borough (NHS Tower Hamlets Clinical Commissioning Group, 2013). It has been suggested that mental health issues may actually be a leading factor in the onset of homelessness, where the stresses of homelessness further exacerbate existing psychological issues.RationaleEpidemiological data shows that common mental health problems such as anxiety and low have been found to be over twice as high, a nd psychosis has been found to be fifty to one hundred times more prevalent in the homeless (Bassuk, Rubin & Lauriat, 1986). A local audit in East London has shown that serious mental illness is more prevalent in the black rather than the white population (NHS Tower Hamlets Clinical Commissioning Group, 2013). The prevalence of alcohol and drug abuse has been found to be widespread within the homeless community (Fazel, Khosla, Doll, Geddes, 2008) thus the essay will aim to shed light upon this aspect of substance abuse as the largest contributing factor to homelessness. The essay will also aim to provide further insight to how the statistics were found to be markedly higher in the borough of Tower Hamlets than the proportion across other London boroughs all together (alcohol 26%, drugs 36%) (NHS Tower Hamlets, 2011). Furthermore, the gender, ethnicity and age aspect of homelessness will be discussed, as there are marked differences between genders and races in regard to the issues f aced in homelessness. For example, single men between the ages of 25-44 have been identified as the most common demographic group associated with homelessness (Hwang, 2001), yet children have also been found at a high risk of facing homelessness, accompanied by a high risk of developing mental health issues (Tischler, Vostanis, Bellerby & Cumella, 2002). The situation for those living rough is intensified when substance misuse is co-morbidly present with existing mental health problems (Rees, 2009). In accord, the essay aims to discuss how the borough of Tower Hamlets has been identified as having the highest mental health needs in the UK, with over 45% of the population of the borough claiming incapacity benefit due to their ill mental health. Furthermore, certain groups such as rough sleepers, domestic violence victims, sex workers and ex offenders are at a higher risk of homelessness and 70% of these individuals will be likely to have a mental health condition (Tower Hamlets Home lessness Statement, 2013). As the literature confirms that mental illness is a significant urban health issue among the population of Tower Hamlet accompanied by crucial repercussions such as homelessness, the essay will aim to highlight the ways in which this issue relates to the London borough of Tower Hamlets.Urban Context and DeterminantsThe literature surrounding homelessness and mental health indicates that factors in the urban context play a major role in the development of this urban health issue. The essay will endeavour to discuss determinants such as poverty, exclusion, attainment and wellbeing, which all hold significant implications for homelessness (Frankish, Hwang & Quantz, 2005). Long term unemployment and overcrowded households have played a major role in the development of mental illnesses, and have even lead to homelessness (NHS Tower Hamlets Clinical Commissioning Group, 2013). Additional factors such as difficulties in maintaining secure and good quality accommo dation due to mental illness will also be discussed in the essay as contributors to homelessness (Breaky, 1992). Moreover, light will also be shed on recent changes to government policy, such as reforms in welfare support and social housing, the recession, and government cuts to public services in the UK, and their impact on those who were most vulnerable to homelessness. Individuals with mental health problems have inevitably faced considerable difficulties due to these changes such as understanding when they need to claim the benefits, how the new benefits work, and uncertainty about how the changes will affect their circumstances. In some cases, individuals may also face difficulty getting access to, and using a computer to claim their benefits online (Crisis & MORI, 2002). These issues highlight the high risk of the mentally ill facing homelessness due to financial hardship, and provide an explanation to why there is mental illness among the homeless. Due to the fact that regist ration to a GP generally requires proof of a home address, homeless people are more likely to access healthcare through emergency services (Crisis & MORI, 2002). This poses problems on both the individual and the general population as the individual may not receive the health advice and respect that they deserve for reasons such as the emergency department only being intended for emergency health conditions, and due to social stigma around homelessness such as the homeless may be associated with mental ill health, substance abuse and lack of hygiene (Riley, Harding, Underwood & Carter, 2003). These factors will be discussed as contributors of poor physical and psychological wellbeing which the homeless individual faces when trying to access public health care. Moreover, the waiting time in emergency departments will affect both the individual and the general public as the individual may not want to stress medical help due to long waiting hours and discrimination, and the general pu blic may have to wait longer to be seen for an emergency due to homeless individuals being seen for general health concerns. Another factor that is aimed to be discussed in the essay is the cost of this urban health issue faced by the National health services. Evidence shows that mental illness for the NHS is costly as it is the largest cause of disability in the UK. Social and informal care for the mentally ill is costing ?22.5 billion, where 13.8% of the national budget is spent on mental health (National Mental Health, 2012). Statistics also show that ?77 billion a year was being spent on welfare benefits for mental illnesses in 2009. The impact of these costs on the national economy was damaging, increasing national debts thus affecting the general population through increases in tax, public services, and as previously mentioned, cuts to national healthcare. Therefore these determinants will also be discussed as contributing factors to the urban health issue.Strategies & Interve ntions for Critique Speculated Recommendations & ConclusionsThe aim of the paper will be to critique strategies such as the Tower Hamlets Homelessness Statement 2013 to 2017, the Homelessness Act and other interventions that tackle homelessness and mental illness as separate entities (Crisis, 2009). The recommendations I will make will involve coordinated treatment programs (Coldwell & Bender, 2007) such as Assertive Community Treatment (ACT), which aim to serve psychiatric outpatients whose mental illness causes serious functioning difficulties in aspects of life including work, social relationships, residential independence, money management, and physical health and wellness, all of which can have an impact on housing status (Dixon, 2000). I expect to conclude that ACT is an effective measure in combating the core issues which lead to and maintain homelessness, and aim to recommend that government funding should be utilised to promote programs such as ACT which will make lasting c hanges in the homeless community.ReferencesBassuk, E.L., Rubin, L. & Lauriat. A.S. (1986). Characteristics of sheltered homeless families. American Journal of Public Health. 76(9). 1097-1101.Breaky, W.R. (1992). Mental Health Services for Homeless People. pp101-107. Cited in Homelessness A National Perspective. Eds. Robertson, M.J. & Greenblatt, M. (1992).Coldwell, C.M. & Bender, W.S. (2007). The Effectiveness of Assertive Community Treatment for Homeless Populations With Severe Mental Illness A Meta-Analysis. Am J Psychiatry. 164(3). 393-399. Communities and Local Government. (2009). Rough Sleeping England Total Street Count. Retrieved from http//webarchive.nationalarchives.gov.uk/20120919132719/http//www.communities.gov.uk/publications/corporate/statistics/roughsleeping2009 Accessed 17th February 2014 Crisis & MORI. (2002). Critical condition Homeless peoples access to GPs. London. Dixon, L. (2000). Assertive community treatment Twenty-five years of cold. Psychiatric Services, 51 , 759-765.Fazel, S Khosla, V Doll, H Geddes, J (2008). The Prevalence of Mental Disorders among the Homeless in Western Countries Systematic canvass and Meta-Regression Analysis. PLoS Med 5 (12). doi10.1371/journal.pmed.0050225Frankish, C.J., Hwang, S.W. & Quantz, D. (2005). Homelessness and Health in Canada. Canadian Journal of Public Health. 2(96). 23-29.Hwang, S.W. (2001). Homelessness and health. CMAJ. 164(2). 229233.National Mental Health. (2012). Development Unit. Factfile 3. The costs of mental ill health. Retrieved from http//www.nmhdu.org.uk/silo/files/nmhdu-factfile-3.pdf Accessed 16th February 2014 NHS Tower Hamlets. (2011). Homelessness Factsheet. Tower Hamlets Joint Strategic Needs Assessment 20102011 . Retrieved from http//www.towerhamlets.gov.uk/idoc.ashx?docid=f8390127-f61d-491b-8323-cea75d92a228&version=1. Accessed 16th February 2014Riley, A.J., Harding, G., Underwood, M.R., Carter, Y.H. (2003). Homelessness a problem for primary careBritish Journal of General Prac tice. 473-479.Tischler, V., Vostanis, P., Bellerby, T. & Cumella, S. (2002). Evaluation of a mental health outreach service for homeless families. Arch Dis Child. 86. 158163. Tower Hamlets Clinical Commissioning Group. (August 2013). Mental Health Joint Strategic Needs Assessment for Tower Hamlets. Tower Hamlets Health and Wellbeing Board. Retrieved from http//www.towerhamletsccg.nhs.uk/Get_Involved/Tower%20Hamlets%20Mental%20Health%20Joint%20Strategic%20Needs%20Assessment%20Part%20One%20-%20Population%20Needs.pdf Accessed 17th February 2014Tower Hamlets Homelessness Statement. (2013). 2013 to 2017 Consultation Draft. Retrieved from http//www.towerhamlets.gov.uk/lgsl/851900/868_housing_strategy_and_polic/homelessness_strategy.aspx Accessed 17th February 2014 Rees, S. (2009). Mental Ill Health in the Adult Single Homeless Population A review of the literature. Crisis, PHRU. Retrieved from http//www.crisis.org.uk/data/files/publications/Mental%20health%20literature%20review.pdf. Acces sed 16th February 2014 Story, A., Murad, S., Roberts, W., Verheyen, M. & Hayward, A.C. (2007). Tuberculosis in London the importance of homelessness, problem drug use and prison. Thorax. 62(8). 667-671.