Missing link in community psychiatry: When a patient with schizophrenia was expelled from her home
Journal
Journal of the Formosan Medical Association
Journal Volume
114
Journal Issue
6
Pages
553-557
Date Issued
2015
Author(s)
Abstract
Treatment and disposition of homeless patients with schizophrenia represent a great challenge in clinical practice. We report a case of this special population, and discuss the development of homelessness, the difficulty in disposition, their utilization of health services, and possible applications of mandatory community treatment in this group of patients. A 51-year-old homeless female was brought to an emergency department for left femur fracture caused by an assault. She was diagnosed with schizophrenia about 20 years ago but received little help from mental health services over the decades. During hospitalization, her psychotic symptoms were only partially responsive to treatment. Her family refused to handle caretaking duties. The social welfare system was mobilized for long-term disposition. Homeless patients with schizophrenia are characterized by family disruption, poor adherence to health care, and multiple emergency visits and hospitalization. We hope this article can provide information about the current mental health policy to medical personnel. It is possible that earlier intervention and better outcome can be achieved by utilizing mandatory community treatment in the future, as well as preventing patients with schizophrenia from losing shelters. ? 2012.
SDGs
Other Subjects
olanzapine; risperidone; adult; Article; case report; disorientation; emergency ward; female; femur fracture; fracture fixation; hallucination; homelessness; human; leg swelling; middle aged; persecutory delusion; personal hygiene; schizophrenia; self care; social psychiatry; social support; social worker; Taiwan; thought disorder; Femoral Neck Fractures; homeless person; hospital emergency service; hospitalization; housing; legislation and jurisprudence; mandatory program; mental health service; psychology; schizophrenia; social psychiatry; social welfare; standards; utilization; Community Psychiatry; Emergency Service, Hospital; Female; Femoral Neck Fractures; Homeless Persons; Hospitalization; Housing; Humans; Mandatory Programs; Mental Health Services; Middle Aged; Schizophrenia; Social Welfare; Taiwan
Publisher
Elsevier
Type
journal article