Health and wellbeing needs of the homeless, the physiotherapist's role

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Accesibility of Health Care

Barriers to Accessing Healthcare

There are various factors that can contribute to the lack of access to healthcare services in the homeless population. Some intrinsic factors include their fear and denial of poor health, problems communicating their health needs, self-esteem issues and lack of understanding of the health care system. A study done by Geber (1997) shows that 31% of the homeless respondents thought that their medical conditions are not serious enough to see a GP, 11% of them claims that they will “tough it out” by themselves and 8% of them do not think that they are ready to handle their health issues. Some of them felt that they are neglected from the healthcare system and a group of them felt that they were “labelled” (Martin, 2008). Patients who are homeless often describe their experience to the GP as “humiliating” due to insensitive comments made by the GPs and being judged by the practice staffs and by other patients (Pfeil and Howe, 2004). It was also noted that some of the homeless people felt that they are being discharged prematurely even though their medical needs are not resolved (Martins, 2008). Therefore, the homeless population does not have a positive impression of health care services and that the quality of care for them are discriminatory and compromised. As such, many homeless people rather not seek for health care services. A study done by Nickasch and Marnocha (2009) mentioned that the great majority of homeless people have an external locus of control, which means that they attribute their experiences to external circumstances that is beyond their control, such as luck and fate. Having an external locus of control can be one of a major factor that leads to their negative perceptions of the health care services, and therefore deter them from using the services available.

There are also extrinsic factors such as rejection upon visiting the local GP and also the inability to attend consultation during daytime (Lamb & Joels, 2014. BBC, 2001). Healthlink (2004) undertook a survey within the homeless population and asked the participants to describe their experiences within the healthcare system. A number of themes arose within the group including; lack of training and understanding about homelessness, no continuity of care, experiences of stereotyping and discrimination, GP’s not having long enough to look at the patient holistically and a constant feeling of being stigmatised.

However, it is important to note that different countries have different health policies. Due to the limited number of UK research done on the topic of homelessness, some articles from other countries such as Canada and US were referenced above. There will be differences in the perceptions and experiences of the homeless population in regards to health services due to the health policies differences in each countries.

References

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