Substance Use and Mental Health Effects of Disrupting Treatment and Shelter Services on Boston Harbor’s Long Island
Keywords:
addiction, social determinant of health, displacement, homelessness, housingAbstract
Objective: To understand the impact of Boston’s October 2014 Long Island Bridge Closure. Methods: We conducted a qualitative analysis of semi-structured interviews with nine individuals displaced from programs on the Island. Participants were recruited and interviewed during March and April of 2015. Interviewers administered a 22-item questionnaire and a semi-structured interview at the temporary shelters and programs at South End Fitness Center, BHCHP, Woods-Mullen Shelter, and Shattuck Hospital. Thematic analysis of the transcribed interview data was conducted using an inductive framework approach. Results: Thematic analysis of the interviews revealed that the most prominent ramifications of the bridge closure were worsening of mental health, substance use behavior, and housing insecurity. Further analysis revealed the importance of stable housing in maintaining sobriety and mental health. Conclusions: When medical and social services for vulnerable populations are at risk of closure, careful planning, quick mobilization of resources, and investment in affordable housing, are crucial in preventing adverse mental health outcomes. Maintaining shelter and substance use treatment programs should be a high priority, even when government funding is at risk.References
Pressley A. Responding To The Impact Of The Abrupt Closing Of The Long Island Bridge On Boston's Homeless And Recovery Communities. Boston, MA: Committee on Healthy Women, Families, and Communities, 2015.
Irons M, Dungca N. Abrupt closing of Long Island Bridge was slow to arrive. The Boston Globe, 2014 Dec 14. Available at https://www.bostonglobe.com/metro/2014/12/13/bridge/CKX45L7z1CXdtMmsYkXP1N/story.html.
Office of Mayor Martin Walsh, Blue Cross/Blue Shield of Massachusetts Foundation. Addiction and Recovery Services in the City of Boston. Boston, MA: Office of Recovery Services, City of Boston, 2015 Jan. Available at https://www.cityofboston.gov/news/uploads/7551_21_20_25.pdf.
Boston Health Care for the Homeless Program. Long Island Bridge closure: Impact and recommendations. Boston, MA: Boston Health Care for the Homeless Program, 2014 Nov. Available at https://www.bhchp.org/sites/default/files/field/image/LIS%20Fact%20Sheet_0.pdf.
Abel D. Displaced Long Island homeless crowd South End shelter. The Boston Globe, 2014 Oct 21. Available at http://www.bostonglobe.com/metro/2014/10/21/stress-mounts-city-copes-with-displaced-homeless-from-long-island/sXpZnRDzPJratjADhI8NCJ/story.html.
Swasey B. Boston Opens Expanded Southampton Street Homeless Shelter. WBUR News, 2015 Jun 25. Available at http://www.wbur.org/2015/06/25/boston-homeless-shelter-action-plan.
Boston Public Health Commission. City of Boston 35th Annual Homeless Census. Boston, MA: Emergency Shelter Commission, Boston Public Health Commission, City of Boston, 2015 Jul.
Abramson DM, Redlener I. Hurricane Sandy: Lessons learned, again. Disaster Med Public Health Prep. 2013 Apr 01;6(4):328-9.
Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K. 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981—2001. Psychiatry. 2002 Sept;65(3):207-39.
Mackey TK, Strathdee SA. Big events and risks to global substance using populations: Unique threats and common challenges. Subst Use Misuse. 2015 Feb 27;50(7):885-890.
Galea S, Nandi A, Vlahov D. The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005 Jul 01;27:78–91.
Pouget ER, Sandoval M, Nikolopoulos GK, Friedman SR. Immediate impact of Hurricane Sandy on people who inject drugs in New York City. Subst Use Misuse. 2015 Mar 16;50(7): 878-884.
Kessler RC, Hurricane Katrina Community Advisory Group. Hurricane Katrina’s impact on the care of survivors with chronic medical conditions. J Gen Intern Med. 2007 Jul 27;22(9): 1225-1230.
Brodie M, Weltzien E, Altman D, Blendon RJ, Benson JM. Experiences of Hurricane Katrina evacuees in Houston shelters: Implications for future planning. Am J Public Health. 2006 Mar 29;96(8): 1402-8.
Sastry N, VanLandingham M. One year later: Mental illness prevalence and disparities among New Orleans residents displaced by Hurricane Katrina. Am J Public Health. 2009 Nov;99, Suppl 3: S725-31.
Wang PS, Gruber MJ, Powers RE, et al. Disruption of existing mental health treatments and failure to initiate new treatment after Hurricane Katrina. Am J Psychiatry. 2008 Jan;165(1): 34-41.
Galea S, Brewin CR, Gruber M, et al. Exposure to hurricane-related stressors and mental illness after Hurricane Katrina. Arch Gen Psychiatry. 2007 Dec;64(12):1427-34.
Rhodes J, Chan C, Paxson C, Rouse CE, Waters M, Fussell E. The impact of Hurricane Katrina on the mental and physical health of low-income parents in New Orleans. Am J Orthopsychiatry. 2010 Apr;80(2):237-47.
Cepeda A, Saint Onge JM, Kaplan C, and Valdez A. The association between disaster-related experiences and mental health outcomes among drug using African American Hurricane Katrina evacuees. Community Ment Health J. 2010 Dec;46(6):612-20.
National Center for Chronic Disease Prevention. HRQOL-14: Healthy Days Measure. Atlanta, GA: Centers for Disease Control and Prevention, 2016. Available at https://www.cdc.gov/hrqol/hrqol14_measure.htm.
National Center for Chronic Disease Prevention. Health-Related Quality of Life Database. Atlanta, GA: Centers for Disease Control and Prevention, 2016. Available at https://www.cdc.gov/hrqol/applications/report_cards.htm.
Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013 Sep 18; 13(1):117.
Riley R. Bridge closure forces evacuation of hundreds. The Boston Globe, 2014 Oct 8. Available at https://www.bostonglobe.com/metro/2014/10/08/long-island-bridge-closure-prompts-evacuation-hundreds-people/pM0qkQ4uiFCItbefZMtq7I/story.html.
Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths: United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016 Dec 30;65:1445-1452.
Wolitski RJ, Kidder DP, Pals SL, et al. Randomized trial of the effects of housing assistance on the health and risk behaviors of homeless and unstably housed people living with HIV. AIDS Behav. 2010 Jun; 14(3):493-503.
Kirst M, Zerger S, Wise Harris D, Plenert E, Stergiopoulos V. The promise of recovery: narratives of hope among homeless individuals with mental illness participating in a Housing First randomised controlled trial in Toronto, Canada. BMJ Open. 2014 Mar 3;4(3)e004379.
Wright BJ, Vartanian KB, Li HF, Royal N, Matson JK. Formerly homeless people had lower overall health care expenditures after moving into supportive housing. Health Aff (Millwood). 2016 Jan; 35(1):20-27.
Kyle T, Dunn JR. Effects of housing circumstances on health, quality of life and healthcare use for people with severe mental illness: a review. Health Soc Care Community. 2007 Aug 28; 16(1):1-15.
Rollins C, Glass NE, Perrin NA, et al. Housing instability is as strong a predictor of poor health outcomes as level of danger in an abusive relationship: Findings from the SHARE study. J Interpers Violence. 2011 Oct 10; 27(4):623-43.
Jacobs DE, Brown MJ, Baeder A, et al. A systematic review of housing interventions and health: Introduction, methods, and summary findings. J Public Health Manag Pract. 2010 Sep-Oct; 16 Suppl 5:S5-10.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.