Homelessness and Mental Illness: Medicalizing a Housing Crisis

IF 1.4 Q2 SOCIAL WORK
Anne Zimmerman
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Abstract

This paper explores the custody and removal of homeless individuals as well as their rights and ability to defend themselves from unwanted psychiatric assessments and involuntary hospitalization. Involuntary hospitalization, a form of detention, is contextualized in public policy concerning housing and the social determinants of health, individual rights, the city’s shelter system and the right to shelter, and the racism and discrimination inherent in the distribution of homelessness. Involuntary psychiatric care dismisses personal views on psychiatry and medicine. Some adults who are homeless in New York City are at risk due to policies and practices that Mayor Adams suggests were meant to support adults who are experiencing homelessness and “appear” to have severe mental illness. As housing is a social determinant of health, a proper housing system very well may decrease the societal burden of mental illness. Individuals must not be subjected to nonconsensual psychiatric assessments or care due primarily to their lack of housing. Consensual care may be beneficent and its availability ethically appropriate. Beneficence is not an appropriate justification for involuntary hospitalization, so the additional ethical justification of preventing imminent danger is needed.

无家可归与精神疾病:将住房危机医学化
本文探讨了对无家可归者的监护和遣送,以及他们的权利和能力,以保护自己免受不必要的精神评估和非自愿住院治疗。非自愿住院是一种拘留形式,其背景是有关住房和健康的社会决定因素、个人权利、城市庇护所系统和庇护权的公共政策,以及无家可归者分布中固有的种族主义和歧视。非自愿的精神病治疗否定了个人对精神病学和医学的看法。亚当斯市长认为,纽约市一些无家可归的成年人面临的风险是政策和做法造成的,而这些政策和做法是为了支持那些无家可归且 "看起来 "患有严重精神疾病的成年人。由于住房是健康的社会决定因素,一个适当的住房系统很可能会减轻精神疾病的社会负担。绝不能主要因为缺乏住房而对个人进行未经同意的精神评估或护理。双方同意的护理可能是有益的,其提供在伦理上也是适当的。有益性并不是非自愿住院的适当理由,因此还需要防止迫在眉睫的危险这一额外的伦理理由。
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来源期刊
CiteScore
2.00
自引率
8.30%
发文量
33
期刊介绍: This journal offers an outlet for articles that support social work as a human rights profession. It brings together knowledge about addressing human rights in practice, research, policy, and advocacy as well as teaching about human rights from around the globe. Articles explore the history of social work as a human rights profession; familiarize participants on how to advance human rights using the human rights documents from the United Nations; present the types of monitoring and assessment that takes place internationally and within the U.S.; demonstrate rights-based practice approaches and techniques; and facilitate discussion of the implications of human rights tools and the framework for social work practice.
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