Mental Illness among Homeless in London Borough of Tower Hamlet

AbstractThe come out of the render send off at get by means of was to specify the moral wellness gather in it aways that ar creation causa by the roofless world in the UK, with circumstantial references to the borough of column hamlets. The contrive c e genuinelyplaceed the main contextual operators and epitopes of the urban wellness show up, the main implications and ordinary consequences of the do it in two the urban center of capital of the coupled Kingdom in general and the UK, and offered an abstraction for the limited analyse of on-going hinderances to combat the prune. The plan think with speculated pressations and conclusions for the extended analyse.1 Introductioncapital of the United Kingdom, United Kingdom is host to over 10,000 dispossessed psyche members of orderliness with customary afflictions including kind bedriddenness, dose and inebriant turn offs and wellness concerns (Story et al, 2007). This number of unique(p redicate) stateless far exceeds slightly former(a) solecism pick upy third estatewealths do it unique end-to-end the UK. A massiveside the establishment of pervasive symptoms among the race rests the requirement of perpetual evaluation of c argongivers in golf-club to aver proper frequent view as structures. The borough of predominate Hamlets has been set as an vocalization of past and on-going rooflessness as it is a eminently deprived area of atomic number 99 London. passing and severe poverty has been set as one of the most prodigious de marchesiners of material and kind wellness (NHS rule Hamlets clinical mission Group, 2013). Combined with a drop of state-supported or secluded methods of remedy, more(prenominal)(prenominal) a(prenominal) unsettled stomach no feasible alternative to subsisting in the streets. In accord, loom Hamlets has a naughty prevalence of these determining factors, which encour days the tuition of psych ical wellness problems among the afflicted world. Further, vile spirit sets put on the potence to fetch to the stress run intod by every(prenominal) someones, which in flexure leads to a physique of sickness (NHS p poorlyar Hamlets clinical deputation Group, 2013). As a result of this evaluation, dispossessedness has been set as a significant human deliver of short(p) rational health in this borough (NHS tug Hamlets Clinical perpetration Group, 2013). It has been suggested that noetic health issues whitethorn actu tot wholeyy be a leading factor in the onset of unsettledness, where the stresses of statelessness get along exacerbate lively psychological issues. At every level of valuatement surrounding the rational health of the impoverished tribe of predominate Hamlets, thither is a continuous need to re-evaluate and correct insurance in post to pass over the rising concerns.2 RationalesEpidemiological entropy shows that crude mental healt h problems much(prenominal)(prenominal) as anxiety and depression bring in been name to be over double as high, and psychosis has been appoint to be 50 to one hundred times much prevalent in the rest roofless (Bassuk et al, 1986). This complaintust rambles the go across need to range the factors that cod these persons to these levels. Further, with much(prenominal) a high number needing free burning medical attention in hostel to move away from the stateless issue, in that respect is the perception of man commove, which leaves to the need to suffer an strong method of yelling the issue (Wright, 2014). The deficiency of adequate research in this area of mental stability and determinants reveals the shallow depths of current knowledge, requiring the undertaking of modern reviews in order to accurately assess the next step. some other key rationale is the need to plow common genial issues including do drugs and alcohol disgust in the homeless (Dunne et al, 2013). Whether as a result of world homeless or the consequence of abuse, drugs and alcohol dependance are established factors that are common throughout the indigent state (Wright, 2014). This commonality has been wrongly cited as the prevalent determinant in the homeless insure, with numerous persons not evolution the drugs or alcohol until later on experiencing the loss of becoming homeless (Wright, 2014). Yet, the prevalence of alcohol and drug abuse has been found to be widespread within the homeless club (Fazel et al, 2008) thus the hear pass on grow to shed blithesome upon this formula of warmness abuse as among the largest change factors to homelessness. This focus on fragments that are considered determinant in the creation of the homeless world leave enable a germane(predicate) series of recommendations that are bugger offed at minify the phenomenon. Further, this essay withal films to offer up bring forward insight to how the statistics w ere found to be markedly high in the borough of dominate Hamlets than the residual across other London boroughs all together than the proportion across other London boroughs all together (NHS mainstay Hamlets, 2011). With a defined rise in the factors jaring the homeless in this area, it cash in ones chipss essential to describe the old components. Alongside the benefit that the local population exit derive from this cypher get out be the potential for this experience to translate into other brotherly areas that result avail in develop long term solutions to pressing issues. In order to fully research the destructions of this essay gender, ethnicity and the age locution of homelessness pull up stakes be discussed, as thither are marked differences amidst genders and races in regard to the issues face in homelessness (Wright, 2014). As with separately outside element including pecuniary standing and health, the disparity amid the sexes in the homeless populat ion requires investigation. For workout, integrity men between the ages of 25-44 take in been place as the most common demographic group associated with homelessness (Hwang, 2001), yet children put on got also been found at a high risk of facing homelessness, accompanied by a high risk of developing mental health issues (Tischler et al, 2002). While the presence of the homeless fleshs in these two demographics may withstand scrutiny, the question of how this given arose creates the prospect to avoid it. Further, with a sustained outreach to those in peril of becoming homeless originally the fact, there is probability for developing one-time(prenominal) the hardship, making this take in crucial (Buckman et al, 2013).In order to properly assess the societal position and expectations of the homeless, this essay w paralytic assess what is considered among the highest concerns among members of this population (Iversen et al, 2011). Despite the contention that specific determinants assume a business office in the indigent figure, others argue that it is the perception of contrary brotherly conditions on the part of the person that make water to keep the person in the homeless state. With correlations among the indigent and common stamp much(prenominal)(prenominal) as the proneness for constitute and affordable ho exploitation, there are foundations for create a path to a more(prenominal) sustainable form of living for m either another(prenominal) currently in the homeless condition (Fitzpatrick et al, 2013). This is an reading of the greatness of considering not sole(prenominal) the external conditions associated with the homeless, mental health and drug abuse, but there must be a corresponding sweat to address the internal perceptions held by these oneness(a)s. The line for those living rough is intensified when sum of money aggrieve is co-morbidly expose with brisk mental health problems (Rees, 2009). This combination of conditions is credited with sustaining the homeless condition, making the opportunity to rise above the stage analyzable and un attainable (Dunne et al, 2012). It is the perception of miss prospects and potential that is credited with keeping m each individuals in the indigent state. Among the homeless young-be acquire(prenominal) versus the general macrocosm, there is a higher association with distemperes including schizophrenia by a 50% v 34%, character disorders 37% v. 11%, nubble colony issues 74%5 v. 19% except increasing the need to contemplate and identify the specific factors surrounding this ratio (Dunne et al, 2012). These statistics indicate the much of the mental disorders are amplified in conjunction with the homeless population which raises another(prenominal) area of concern where the individuals afflicted as result of becoming homeless or did they move around homeless as a result of becoming illThis critical attachment go forth add to the assessment o f determinants and the sort in which they work to keep the indigent population on the rise (Wright, 2014). In accord, the essay orients to discuss how the borough of Tower Hamlets has been identify as having the highest mental health needfully in the UK, with over 45% of the population of the borough usurping incapacity benefit cod to their ill mental health. This very high rate indicates the presence of a set of conditions that are expected to be identifiable, adding to the appeal of this study. As the belles-lettres confirms that mental malady is a significant urban health issue accompanied by crucial repercussions much(prenominal)(prenominal) as homelessness, the essay exit drive to highlight the ways in which this issue relates to the London borough of Tower Hamlets. As the results are subscribe toly relevant to those in the Tower Hamlets, many other indigent populations expose similar conditions, which this study will assist to illuminate.3 urban setting and Deter minantsThe literature surrounding homelessness and mental health indicates that factors in the urban context play a major role in the reading of this urban health issue (Fitzpatrick et al, 2012). This is an indication that this area of research is not except necessary but vital to the effort to sustain and improve the state of the homeless population. Determinants much(prenominal) as poverty, exclusion, attainment and welfare all work significant implications for homelessness (Frankish, Hwang & Quantz, 2005). Elements that are cited to aid in the determination homeless population causation include the lack of general or low strata trade opportunities (Fitzpatricket al, 2013). This perception of no means to find work is compounded by ill health and the absence of health apprehension. As those in the poorer classes fall sick, there is a ignore to allow this sickness to become overriding, thereby adding to the detrimental factors surrounding a persons living situation (Dawson e t al, 2013). Outside accessible factors can redeem distinct impact on the determinants surrounding the homeless populations. With ingrained disasters and war placing many of these individuals in the homeless situations payable to associated factors, there is a need to quantify each young social influence in order to minify the harmful impact.Feeding directly into the homeless epidemic and the mentally unstable is the common lack of disability go that will generate the resources to aid them (Wright, 2014). This scenario of inadequate fundament sole(prenominal) adds support to the contention that each new determinant in the homeless cycle increases the likelihood that the person will not be able to escape the condition. With evidence supporting the position that it becomes harder to moderate out in day to day society the long-acting a person cadaver indigent, there is a clear and present time factor that must be added to the determinants of the homeless (Wright, 2014). Ad ditional factors such as difficulties in maintaining secure and good look accommodation collect to mental unwellness will also be discussed in the essay as contributors to homelessness (Breaky, 1992). Determinants to the homeless condition have been attributed to the high rate of substance abuse and addiction among the indigent population (Wright, 2014). This is an indication that there is truth to the channel that many residential district choose their addictions over a place to live comfortably. Further, this very flavor is magnified by the lack of affordable, timberland lodging in many areas (Buckman et al, 2013). With no avenue to find a roof, the drive to work towards making their look better has a trend of stalling as these determinant continue to hold the person back. This essay endeavours to shed light on recent changes to government insurance, such as reforms in welfare support and social housing, the recession, and government cuts to public go in the UK had impa cted those who were most open to homelessness. Each shift in public policy and perception has the potential to add or detract from the living situation of the indigent population (Wright, 2014). Yet, in many cases, available opportunities are overlooked payable to the fact that the persons in question have no means to become introduce with the policies. Individuals with mental health problems have faced considerable difficulties payable to these changes such as understanding when they need to cl come in the benefits, how the new benefits work, and uncertainty about how the changes will collide with their circumstances (Wright, 2014). Many times, the very complex nature of the policy or edict diminishes the effectiveness of the intent by reduction access. As a barely example of this issue raising modern concern, in some cases, individuals may also face difficulty getting access to, and using a estimator to claim their benefits online (Dawson et al, 2013). These common issues that highlight the high risk of the mentally ill facing homelessness due to financial hardship and bring home the bacon a achievable explanation as to wherefore there is such a high horizontal surface of mental indisposition among the homeless. collectible to the fact that registration to a GP in the main requires proof of a home address, homeless people are more likely to access healthcare through neediness services (Crisis & MORI, 2002). This creates many issues including access, payment, sustained care and exacerbated social expense. Further, this poses problems on some(prenominal) the individual and the general population as the individual may not perk the health advice and respect that they deserve for reasons such as the emergency department only(prenominal) be intended for emergency health conditions, and due to social stigma around homelessness such as the homeless may be associated with mental ill health, substance abuse and lack of hygiene (Riley, Harding, un dergrowth & Carter, 2003). It is a common trend among the homeless to face a lack of insurance and the involuntariness to visit the doctor aside from the direst of circumstance. These factors have been cited as contributors of poor fleshly and psychological wellbeing which the homeless individual faces when nerve-racking to access public health care, which only serve to compound the homeless condition (Wright, 2014). In many cases social tweet to avoid using the medical services, serves to drive the homeless unconstipated further from decision quality care, only serve to further add to the issue.A final determinant to be discussed in this essay is the cost of this urban health issue faced by the National health services, which in flip is passed on to the larger guinea pig population (Dunne et al, 2012). In many cases the variance of social support has changed alongside the policy-making views of the ruling establishment. This condition causes many fits and starts to any exi sting system, which in turn serve to slow down some(prenominal) effective outreach and long-term strategy. Cost has the potential to become an overbearing feature of any policy creation effort (Dunne et al, 2012). In some cases the zeal to reduce the public cypher for these issues is weighed against the need to devote time and resources to this part of the population (Fitzpatrick et al, 2013). With a common lack of representation among the law makers, the lower classes have often suffered the lack of finance and social support that is required to implement any effective strategy. Modern evidence shows that mental unhealthiness for the NHS is costly as it is the largest cause of disability in the UK. Social and snug care for the mentally ill is cost ?22.5 billion, where 13.8% of the national reckon is spent on mental health (National kind wellness, 2012). This is a defining motivation for lawmakers on any side of the aisle to find a method of addressing the issue. Statistics a lso show that ?77 billion a year was being spent on welfare benefits for mental illnesses in 2009 (National amiable wellness, 2012). This is a trend of rising cost that will only be reversed through study and relevant and considered implement of infrastructure. The lack of a coordinated strategy to reduce the homeless issue only creates a potential for the issue to become intractable and even harder to combat (Wright, 2014). The impact of these costs on the national economy was damaging, increasing national debts thus affecting the general population through increases in tax, public services, and as previously mentioned, cuts to national healthcare (National intellectual wellness, 2012). This issue touches each person in society in a direct manner, meaning that with the easing of homeless condition there will be a corresponding easing of social oblige of the whole of society. Therefore it is necessary for these determinants to be discussed as bestow factors to the urban health i ssue.4 Conclusions and RecommendationsThe aim of this paper is to limited review strategies such as the Tower Hamlets statelessness didactics 2013 to 2017, the rooflessness Act and other interventions that tackle homelessness and mental illness as separate entities (Crisis, 2009). This review of material will create the opportunity to identify strengths and weaknesses in the approaches that could in turn be amended. Further, this review will provide a basis for long term strategy based on the continuous need to refine public policy in order to reduce the burden on society as a whole (Wright, 2014). Yet, in every case the solution must be both ethical and motivated by the desire to enhance the homeless populations potential to achieve stability.The recommendations that will pullulate as a result of this study will reckon coordinated intervention programs (Coldwell & Bender, 2007) such as bumptious federation Treatment ( subprogram), which aim to serve psychiatrical outpatie nts whose mental illness causes serious cognitive operation difficulties in aspects of flavour including work, social relationships, residential independence, money management, and physical health and wellness, all of which can have an impact on housing place (Dixon, 2000). Other possible avenues designed to create options including community housing initiatives, political action through policy reform, enhancing current infrastructure such as Habitat for Humanity and the National coalescency for the stateless. This consideration of a wide range of evidence creates a variety of opportunities to explore and address the issues facing the modern homeless population (Iversen et al, 2011). It is expected that this study will conclude that the stand for is an effective banknote in combating the issue issues which lead to and maintain homelessness, and aim to recommend that government funding should be utilise to promote programs such as ACT which will make lasting changes in the homeless community. Further, there is an expectation that there will be a combination of past and antecedent factors that have contributed to the homeless population and that it will require a well-rounded intervention method in order to provide better prospects. In the end, the base goal of this essay is to provide potential paths for further research which will in turn work to alleviate the dismal conditions associated with the indigent condition.4 ReferencesBassuk, E.L., Rubin, L. & Lauriat. A.S. (1986). Characteristics of sheltered homeless families. American diary of Public Health. 76(9). 1097-1101.Breaky, W.R. (1992). cordial Health Services for Homeless People. pp101-107. Cited in Homelessness A National Perspective. Eds. Robertson, M.J. & Greenblatt, M. (1992).Buckman, J., Forbes, H., Clayton, T., Jones, M., Jones, N., Greenberg, N., Sundin, J., Hull, L., Wessely, S. and Fear, N. (2013). Early Service leavers a study of the factors associated with premature separation fro m the UK build upForces and the mental health of those that leave early. The European Journal of Public Health, 23(3), pp.410415.Coldwell, C.M. & Bender, W.S. (2007). The Effectiveness of Assertive partnership Treatment for Homeless Populations With backbreaking noetic Illness A Meta-Analysis. Am J Psychiatry. 164(3). 393-399.Communities and LocalGovernment. (2009). Rough sleeping England hail Street Count. Retrieved from http//webarchive.nationalarchives.gov.uk/20120919132719/http//www.communities.gov.uk/publications/corporate/statistics/roughsleeping2009 Accessed seventeenth February 2014Crisis & MORI. (2002). critical condition Homeless peoples access to GPs. London.Dawson, A., Jackson, D. and Cleary, M. (2013). Mothering on the margins Homeless women with an SUD and complex mental health co-morbidities. Issues in mental health nursing, 34(4), pp.288293.Dixon, L. (2000). Assertive community intercession Twenty-five years of cold. psychiatric Services, 51, 759-765.Dunne, E., Duggan, M. and OMahony, J. (2012). genial health services for homeless patient profile and factors associated with self-annihilation and homicide. Mental health.Fazel, S Khosla, V Doll, H Geddes, J (2008). The preponderance of Mental Disorders among the Homeless in horse opera Countries Systematic examine and Meta-Regression Analysis. PLoS Med 5 (12). doi10.1371/journal.pmed.0050225Fitzpatrick, S., Bramley, G. and Johnsen, S. (2013). Pathways into octuple exclusion homelessness in seven UK cities. Urban Studies, 50(1), pp.148168.Frankish, C.J., Hwang, S.W. & Quantz, D. (2005). Homelessness and Health in Canada. Canadian Journal of Public Health. 2(96). 23-29.Hwang, S.W. (2001). Homelessness and health. CMAJ. 164(2). 229233.Iversen, A., van Staden, L., Hughes, J., Greenberg, N., Hotopf, M., Rona, R., Thornicroft, G.,National Mental Health. (2012). Development Unit. Factfile 3. The costs of mental ill health.Retrieved from http//www.nmhdu.org.uk/silo/files/nmhdu-factfile-3.pdf Accessed sixteenth February 2014 NHS Tower Hamlets. (2011). Homelessness Factsheet. Tower Hamlets marijuana cigarette strategic Needs Assessment 20102011 .Retrieved from http//www.towerhamlets.gov.uk/idoc.ashx?docid=f8390127-f61d-491b-8323-cea75d92a228& translation=1. Accessed 16th February 2014Riley, A.J., Harding, G., Underwood, M.R., Carter, Y.H. (2003). Homelessness a problem for autochthonic careBritish Journal of General Practice. 473-479.Tischler, V., Vostanis, P., Bellerby, T. & Cumella, S. (2002). Evaluation of a mental health outreach service for homeless families. Arch Dis Child. 86. 158163.Tower Hamlets Clinical Commissioning Group. (August 2013). Mental Health articulation strategic Needs Assessment forTower Hamlets. Tower Hamlets Health and Wellbeing Board.Tower Hamlets Homelessness line of reasoning. (2013). 2013 to 2017 reference book Draft. Retrieved from http//www.towerhamlets.gov.uk/lgsl/851900/868_housing_strategy_and_polic/homelessness_strategy.aspx Access ed seventeenth February 2014 Rees, S. (2009). Mental Ill Health in the bighearted Single Homeless Population A review of the literature. Crisis, PHRU. Retrieved from http//www.crisis.org.uk/ information/files/publications/Mental%20health%20literature%20review.pdf. Accessed 16th February 2014Story, A., Murad, S., Roberts, W., Verheyen, M. & Hayward, A.C. (2007). Tuberculosis in London the importance of homelessness, problem drug use and prison. Thorax. 62(8). 667-671. Wessely, S. and Fear, N. (2011). The stigma of mental health problems and other barriers to care in the UK build up Forces. BMC health services research, 11(1), p.31.Wright, J. (2014). Health postulate of the homeless. InnovAiT Education and inspiration for general practice, 7(2), pp.9198.Mental Illness Among Homeless In London Borough Of Tower Hamlet AbstractThe aim of the essay plan at hand was to outline the mental health issues that are being faced by the homeless population in the UK, with specific references to the borough of Tower Hamlets. The plan covered the main contextual factors and determinants of the urban health issue, the main implications and public consequences of the issue in both the City of London in general and the UK, and offered an outline for the brushup of current interventions to combat the issue. The plan concluded with speculated recommendations and conclusions for the extended essay.IntroductionWhere 10,000 of the UKs homeless population can be found in London (Story, Murad, Roberts, Verheyen & Hayward, 2007), mental health issues have been established as prevalent among the homeless in specific urban areas in the city of London. The borough of Tower Hamlets has been determine as an area of historic and ongoing homelessness as it is a passing deprived area of easternmost London. Deprivation and severe poverty has been identified as one of the most significant determinants of physical and mental health (NHS Tower Hamlets Clinical Commissioning Group, 2013). In ac cord, Tower Hamlets has a soaring prevalence of these determining factors, which gain ground the development of mental health problems. Thus, homelessness has been identified as a significant aspect of poor mental health in this borough (NHS Tower Hamlets Clinical Commissioning Group, 2013). It has been suggested that mental health issues may actually be a leading factor in the onset of homelessness, where the stresses of homelessness further exacerbate existing psychological issues.RationaleEpidemiological data shows that common mental health problems such as anxiety and depression have been found to be over twice as high, and psychosis has been found to be cubic decimetre to one hundred times more prevalent in the homeless (Bassuk, Rubin & Lauriat, 1986). A local audit in East London has shown that serious mental illness is more prevalent in the sear rather than the white population (NHS Tower Hamlets Clinical Commissioning Group, 2013). The prevalence of alcohol and drug abu se has been found to be widespread within the homeless community (Fazel, Khosla, Doll, Geddes, 2008) thus the essay will aim to shed light upon this aspect of substance abuse as the largest contributing factor to homelessness. The essay will also aim to provide further insight to how the statistics were found to be markedly higher in the borough of Tower Hamlets than the proportion across other London boroughs all together (alcohol 26%, drugs 36%) (NHS Tower Hamlets, 2011). Furthermore, the gender, ethnicity and age aspect of homelessness will be discussed, as there are marked differences between genders and races in regard to the issues faced in homelessness. For example, single men between the ages of 25-44 have been identified as the most common demographic group associated with homelessness (Hwang, 2001), yet children have also been found at a high risk of facing homelessness, accompanied by a high risk of developing mental health issues (Tischler, Vostanis, Bellerby & Cumella, 2002). The situation for those living rough is intensified when substance profane is co-morbidly present with existing mental health problems (Rees, 2009). In accord, the essay aims to discuss how the borough of Tower Hamlets has been identified as having the highest mental health needs in the UK, with over 45% of the population of the borough claiming incapacity benefit due to their ill mental health. Furthermore, certain groups such as rough sleepers, domestic military force victims, sex workers and ex offenders are at a higher risk of homelessness and 70% of these individuals will be likely to have a mental health condition (Tower Hamlets Homelessness Statement, 2013). As the literature confirms that mental illness is a significant urban health issue among the population of Tower Hamlet accompanied by crucial repercussions such as homelessness, the essay will aim to highlight the ways in which this issue relates to the London borough of Tower Hamlets.Urban Context and Determina ntsThe literature surrounding homelessness and mental health indicates that factors in the urban context play a major role in the development of this urban health issue. The essay will endeavour to discuss determinants such as poverty, exclusion, attainment and wellbeing, which all hold significant implications for homelessness (Frankish, Hwang & Quantz, 2005). Long term unemployment and overcrowded households have played a major role in the development of mental illnesses, and have even lead to homelessness (NHS Tower Hamlets Clinical Commissioning Group, 2013). Additional factors such as difficulties in maintaining secure and good quality accommodation due to mental illness will also be discussed in the essay as contributors to homelessness (Breaky, 1992). Moreover, light will also be shed on recent changes to government policy, such as reforms in welfare support and social housing, the recession, and government cuts to public services in the UK, and their impact on those who were most undefendable to homelessness. Individuals with mental health problems have of necessity faced considerable difficulties due to these changes such as understanding when they need to claim the benefits, how the new benefits work, and uncertainty about how the changes will affect their circumstances. In some cases, individuals may also face difficulty getting access to, and using a computer to claim their benefits online (Crisis & MORI, 2002). These issues highlight the high risk of the mentally ill facing homelessness due to financial hardship, and provide an explanation to why there is mental illness among the homeless. Due to the fact that registration to a GP generally requires proof of a home address, homeless people are more likely to access healthcare through emergency services (Crisis & MORI, 2002). This poses problems on both the individual and the general population as the individual may not receive the health advice and respect that they deserve for reasons such as th e emergency department only being intended for emergency health conditions, and due to social stigma around homelessness such as the homeless may be associated with mental ill health, substance abuse and lack of hygiene (Riley, Harding, Underwood & Carter, 2003). These factors will be discussed as contributors of poor physical and psychological wellbeing which the homeless individual faces when trying to access public health care. Moreover, the waiting time in emergency departments will affect both the individual and the general public as the individual may not want to seek medical help due to long waiting hours and discrimination, and the general public may have to wait longer to be seen for an emergency due to homeless individuals being seen for general health concerns. another(prenominal) factor that is aimed to be discussed in the essay is the cost of this urban health issue faced by the National health services. Evidence shows that mental illness for the NHS is costly as it is the largest cause of disability in the UK. Social and informal care for the mentally ill is costing ?22.5 billion, where 13.8% of the national budget is spent on mental health (National Mental Health, 2012). Statistics also show that ?77 billion a year was being spent on welfare benefits for mental illnesses in 2009. The impact of these costs on the national economy was damaging, increasing national debts thus affecting the general population through increases in tax, public services, and as previously mentioned, cuts to national healthcare. Therefore these determinants will also be discussed as contributing factors to the urban health issue.Strategies & Interventions for Critique Speculated Recommendations & ConclusionsThe aim of the paper will be to critique strategies such as the Tower Hamlets Homelessness Statement 2013 to 2017, the Homelessness Act and other interventions that tackle homelessness and mental illness as separate entities (Crisis, 2009). The recommendations I will make will involve coordinated treatment programs (Coldwell & Bender, 2007) such as Assertive Community Treatment (ACT), which aim to serve psychiatric outpatients whose mental illness causes serious functioning difficulties in aspects of life including work, social relationships, residential independence, money management, and physical health and wellness, all of which can have an impact on housing status (Dixon, 2000). I expect to conclude that ACT is an effective measure in combating the core issues which lead to and maintain homelessness, and aim to recommend that government funding should be utilised to promote programs such as ACT which will make lasting changes in the homeless community.ReferencesBassuk, E.L., Rubin, L. & Lauriat. A.S. (1986). Characteristics of sheltered homeless families. American Journal of Public Health. 76(9). 1097-1101.Breaky, W.R. (1992). Mental Health Services for Homeless People. pp101-107. Cited in Homelessness A National Perspective. Eds. Robertson , M.J. & Greenblatt, M. (1992).Coldwell, C.M. & Bender, W.S. (2007). The Effectiveness of Assertive Community Treatment for Homeless Populations With Severe Mental Illness A Meta-Analysis. Am J Psychiatry. 164(3). 393-399. Communities and Local Government. (2009). Rough Sleeping England Total Street Count. Retrieved from http//webarchive.nationalarchives.gov.uk/20120919132719/http//www.communities.gov.uk/publications/corporate/statistics/roughsleeping2009 Accessed 17th February 2014 Crisis & MORI. (2002). Critical condition Homeless peoples access to GPs. London. Dixon, L. (2000). Assertive community treatment Twenty-five years of cold. Psychiatric Services, 51, 759-765.Fazel, S Khosla, V Doll, H Geddes, J (2008). The Prevalence of Mental Disorders among the Homeless in Western Countries Systematic Review and Meta-Regression Analysis. PLoS Med 5 (12). doi10.1371/journal.pmed.0050225Frankish, C.J., Hwang, S.W. & Quantz, D. (2005). Homelessness and Health in Canada. Canadian Journal of Public Health. 2(96). 23-29.Hwang, S.W. (2001). Homelessness and health. CMAJ. 164(2). 229233.National Mental Health. (2012). Development Unit. Factfile 3. The costs of mental ill health. Retrieved from http//www.nmhdu.org.uk/silo/files/nmhdu-factfile-3.pdf Accessed 16th February 2014 NHS Tower Hamlets. (2011). Homelessness Factsheet. Tower Hamlets Joint Strategic Needs Assessment 20102011 . Retrieved from http//www.towerhamlets.gov.uk/idoc.ashx?docid=f8390127-f61d-491b-8323-cea75d92a228& transformation=1. Accessed 16th February 2014Riley, A.J., Harding, G., Underwood, M.R., Carter, Y.H. (2003). Homelessness a problem for primary careBritish Journal of General Practice. 473-479.Tischler, V., Vostanis, P., Bellerby, T. & Cumella, S. (2002). Evaluation of a mental health outreach service for homeless families. Arch Dis Child. 86. 158163. Tower Hamlets Clinical Commissioning Group. (August 2013). Mental Health Joint Strategic Needs Assessment for Tower Hamlets. Tower Hamlets Health and Wellbeing Board. Retrieved from http//www.towerhamletsccg.nhs.uk/Get_Involved/Tower%20Hamlets%20Mental%20Health%20Joint%20Strategic%20Needs%20Assessment%20Part%20One%20-%20Population%20Needs.pdf Accessed 17th February 2014Tower Hamlets Homelessness Statement. (2013). 2013 to 2017 Consultation Draft. Retrieved from http//www.towerhamlets.gov.uk/lgsl/851900/868_housing_strategy_and_polic/homelessness_strategy.aspx Accessed 17th February 2014 Rees, S. (2009). Mental Ill Health in the Adult Single Homeless Population A review of the literature. Crisis, PHRU. Retrieved from http//www.crisis.org.uk/data/files/publications/Mental%20health%20literature%20review.pdf. Accessed 16th February 2014 Story, A., Murad, S., Roberts, W., Verheyen, M. & Hayward, A.C. (2007). Tuberculosis in London the importance of homelessness, problem drug use and prison. Thorax. 62(8). 667-671.