PerspectivesAre you interested in submitting a Perspective Article? Be sure to read The Science Advisory Board's Editorial Guides for Perspective Articles. Click here. Trauma and Homelessness by Reverend Susan Brandt  To be a woman homeless on our city streets is to be raped and sexually assaulted.The homeless are vulnerable to trauma because of their scavenger lifestyle and instability. In this editorial you will learn about physical and sexual abuse in the homeless population and the medical options for treating such individuals. Results from various epidemiological studies [including the University of Ottawa] show that between 10% and 40% of homeless men and women have been violently victimized at some time in their lives. Here are some of the more shocking statistics: - 91% of homeless women report being assaulted at some time in their lives. - 90% of those who had been battered suffered at least one injury more serious than bruises during their worst beating. - 42% of these long-term homeless women reported an assault incident within the last 12 months. - 73% of the homeless women in one study reported that their most recent assault was from a present or former sexual partner Assault is a risk factor for depression, Post Traumatic Stress Disorder, alcoholism and drug abuse. Newly homeless women may attach themselves to a man for protection. The homeless subculture tends to be quite macho, which leads to an emphasis on sexual favors in exchange for protection. However, having a "protector " paradoxically puts women at an increased risk for further abuse. As the period of homelessness is decreased, the perceived need for male protection may be reduced. Because they are escaping from an abusive intimate environment, women who become homeless may end up experiencing more abuse because of the presence of street violence. Bruised skin and soft-tissue trauma as well as sexually transmitted diseases are some of the presenting health signs of sexual abuse. Homeless women experience unintended pregnancies from rape or victimization more frequently than other women do. The causes of homelessness are complex and multifaceted. Approximately half of all homeless women have experienced childhood physical abuse. Some women are escaping domestic violence and end up at a shelter while some have ran from riches to poverty. The most frequent violent trauma occurring among homeless women was rape and amongst homeless men it was physical assault. The majority of the traumatic events took place in the year preceding the onset of homelessness. Risk factors such as antisocial personality disorder, substance abuse, and major depression is often coupled with aggressive behavior within the homeless population. Some individuals say they would rather be living on the streets rather than stay in a shelter and this declaration may be because shelters are often over crowded, poorly staffed and run like a prison environment. In fact many instances of sexual abuse - in both men and women - are perpetrated in homeless shelters The homeless with mental illnesses and those with physical or developmental disabilities are more susceptible to sexual and physical harm. They spend hours wandering in public places, displaying detachment and responding slowly to events due to their illness or disability. Many homeless individuals prefer the allusion and numbing factor of substance abuse rather than facing such a daily harsh reality. Unfortunately, few treatment programs address trauma issues when offering detoxification services to this population. Once the "medicine" or numbing factor is removed from the homeless person’s system, symptoms of Post Traumatic Stress Disorder may surface and if left untreated, may lead to further relapse or abreaction. Should dual diagnosed treatment be offered to this vulnerable population? The ensuing healing and empowerment would in my opinion greatly facilitate a speedier journey from the curbside to independent housed living. ### Susan Brandt is a trained nurse, a certified addiction therapist and an ordained chaplain. She recently won a scholarship to study restorative justice at Queens University in Kingston, Ontario. For more information on the homeless, please visit the Reverernd Brand’s Web site Interested in discussing the comorbidities associated with homelessness? Visit our Discussion Forum . ### << Previous Next >> [ View All Perspectives ] |
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