Uso de sustancias y efectos en la salud mental por la interrupción del tratamiento y los servicios de albergue de Long Island, de bahía de Boston
Palabras clave:
adicciones, determinantes sociales de la salud, desplazamiento, falta de vivienda, alojamientoResumen
Objetivo: Comprender el impacto del cierre del puente de Long Island, Boston, en octubre de 2014. Métodos: Realizamos un análisis cualitativo de entrevistas semiestructuradas con nueve personas desplazadas de los programas en la isla. Los participantes fueron reclutados y entrevistados durante marzo y abril de 2015. Los entrevistadores administraron un cuestionario de 22 ítems y realizaron una entrevista semiestructurada en los albergues y programas provisionales del Gimnasio South End, el Programa de atención médica para personas sin hogar de Boston (BHCHP, por sus siglas en inglés), el Albergue Woods-Mullen y el Hospital de Shattuck. El análisis temático de los datos de la entrevista transcrita se realizó utilizando un enfoque de marco inductivo. Resultados: El análisis temático de las entrevistas mostró que las ramificaciones más prominentes del cierre del puente fueron el deterioro en la salud mental de los participantes, el uso de sustancias y la inseguridad habitacional. Un análisis posterior evidenció la importancia de la estabilidad residencial para la sobriedad y la salud mental. Conclusiones: Cuando los servicios médicos y sociales para poblaciones vulnerables se ven en riesgo de clausura, la planificación cuidadosa, la pronta movilización de recursos y la inversión en viviendas asequibles, son cruciales para evitar resultados adversos de salud mental. Se debe priorizar la conservación de los programas de albergue y de rehabilitación de uso de sustancias, incluso cuando los fondos gubernamentales están en riesgo. Recuento de palabras del manuscrito: 3,484 Descargo de responsabilidad: Las opiniones expresadas en este artículo son nuestras y no reflejan la postura oficial de ninguna de las instituciones mencionadas a continuación.
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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.
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