ABSTRACT

Globally, one of the main causes of street homelessness is the reality of chronic mental illness. In societies where mental illness is misunderstood, stigmatized, or sparsely treated, or where treatment is inaccessible for the poor, the link between street homelessness and chronic mental illness becomes even greater. This article considers the stories of specific individuals living with chronic mental illness in the City of Tshwane, South Africa, which caused them to be homeless. It also reflects on the infrastructure available to persons with chronic mental illness who are homeless, and recommends ways to scale up and replicate good practices, while transforming unutilized or ineffective infrastructure. Data were collected through drawings and naïve sketches from participants housed at a community-based health centre in Tshwane which acts as a “bridge” between mental health institutions, home and/or even the street. Ten participants voluntarily participated in the study and five in-depth interviews were held with the staff members at the centre. The insights indicated that the ripple effects of a deinstitutionalization plan for a sustainable policy package, could improve the quality of life for mentally ill homeless persons while housed in such community-based centres.

摘要

在全球范围内，街头无家可归的主要原因之一是慢性精神疾病的现实。在精神疾病被误解、污名化或治疗很少，或者穷人无法获得治疗的社会中，街头无家可归与慢性精神疾病之间的联系变得更大。本文考虑了南非茨瓦尼市患有慢性精神疾病的特定个体的故事，这些疾病导致他们无家可归。它还反映了无家可归的慢性精神疾病患者可用的基础设施，并推荐了扩大和复制良好做法的方法，同时改造未使用或无效的基础设施。数据是通过居住在茨瓦内社区卫生中心的参与者的图纸和简单草图收集的，该中心充当精神卫生机构、家庭和/甚至街道之间的“桥梁”。10名参与者自愿参加了研究，并与中心工作人员进行了5次深度访谈。这些见解表明，针对可持续一揽子政策的去机构化计划的连锁反应可以改善精神病无家可归者在此类社区中心的生活质量。