Chapter 8 Article Summary

Chapter 8 explores substance misuse with a co-occurring mental disorder or disability. The article I found titled Helping Homeless Individuals with Co-occurring Disorders: The Four Components explains how individuals who suffer with co-occurring disorders, who are also homeless, are affected and how they can be best helped.

Homeless individuals with severe mental illness and substance use disorder are one of the most vulnerable populations. This article explains four key components that must be addressed to ensure that these individuals receive the best help possible:

1. It must be ensured that individuals have effective transitions from hospitals, foster care, prisons, or residential programs back into the community. 

This is very important for those who were homeless or those who are at risk for being homeless because once they leave an institution, they need a plan instead of just ending up back on the street. Clients must be set up with a complete discharge plan that includes government assistance or employment, housing options, and treatment. This component includes the other three components.

2. Access to resources must be increased.

It has ben found that not many homeless people use all of the resources that they have, including Food Stamps and Medicaid. This could be due to a few reasons: Homeless individuals have a lower sense of self-efficacy, which leads to deficient service-seeking behavior, agency and staff discrimination discourage homeless individuals from seeking services, or homeless individuals consider their housing needs the top priority and do not pursue the secondary sources of aid. Social workers must make sure homeless clients seek and apply for all government programs.

Homeless individuals with co-occurring disorders also struggle to find work due to bias in employment and trouble working with their disorders. Also, many times, these individuals do not want to lose their government assistance when they get a job. As a helper working with these clients, it is important to instill hope about a client's ability to recover and to work. Clients should be linked with job opportunities that supports recovery. The article uses bartending as an example of a job that does not support recovery. Money management needs to be taught and treatment options that do not conflict with work should be coordinated.

3. Individuals should be linked to supportive housing options.

These individuals are suffering from multiple disorders while also trying to find a place to sleep every night. To help these individuals, it is important to find them housing, whether it is public housing or not. Some studies show that housing individuals with disabilities and/or addictions before they are treated increases the chances of their treatment success. 

4. Individuals should be found the best treatment option. 

Multiple types of treatment are available for those with co-occurring disorders but the struggle is finding one that is successful. Research on treatments stress that it is a long-term process, harm reduction, outreach techniques, establishment of a trusting relationship, skills and support to manage illnesses, and relapse prevention. Methods that are commonly used include modified assertive community treatment, motivational interviewing, cognitive-behavioral therapy, contingency management, and COD specialized self-help groups.

This article relates very closely with what we are learning in Chapter 8. We have been learning about individuals with co-occurring disorders. This article pairs this with the homeless population. I feel as though helping homeless individuals who are also affected with CODs has to be one of the hardest things social workers face. This task must be extremely challenging and complex. This article shows all of the components and tasks that must be completed for individuals to successfully complete treatment and no longer be homeless.

Sun, A. (2012). Helping homeless individuals with co-occurring disorders: The four components. Social Work, 57(1), 23-37. 

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