Abstract
Mental health professionals and researchers have emphasized the importance of conducting outreach to locate homeless persons with mental illness, and of creatively engaging these persons into a therapeutic relationship. These outreach and engagement activities raise challenging issues in the areas of client-staff boundaries, professional ethics, and staff safety. While several issues in each of these three key areas have received attention in the growing literature on homelessness, certain issues within each area remain unexplored. The authors draw from the street experiences of outreach staff in a federally funded homeless outreach project to further explore each of these areas, and suggest that experiences of outreach workers are essential in shaping and redefining work activities in these, and other important areas.
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REFERENCES
Oakley D, Dennis DL: Responding to the needs of homeless people with alcohol, drug and/or mental disorders, in Homelessness in America. Edited by Baumohl J. Phoenix, Oryx Press, 1996.
Randolph F: Improving service systems through systems integration: The ACCESS program. American Rehabilitation 21:36–38, 1995.
Center for Mental Health Services: Making a difference: Interim status report of the McKinney demonstration program for homeless adults with serious mental illness. Rockville, Center for Mental Health Services, 1994.
Dennis DL, Buckner JC, Lipton FR, et al: A decade of research and services for homeless mentally ill persons. American Psychologist 46:1129–1138, 1991.
Cohen NL, Marcos LR: Outreach intervention models for the homeless mentally ill, in Treating the Homeless Mentally Ill: A Report of the Task Force on the Homeless Mentally Ill. Edited by Lamb HR, Bachrach LL, Kass FI. Washington DC, American Psychiatric Association, 1992.
Cohen NL, Tsemberis S: Emergency psychiatric intervention on the street. New Directions for Mental Health Services, 52:3–16, 1991.
Barrow SM, Hellman F, Lovell AM, et al: Evaluating outreach services: Lessons from a study of five programs. New Directions for Mental Health Services 52:29–45, 1991.
Cohen MB: Social work practice with homeless mentally ill people: Engaging the client. Social Work, 34:505–509, 1989.
Rife JC, First RJ, Greenley RW, et al: Case management with homeless mentally ill people. Social Work, 16:58–67, 1991.
Interagency Council on the Homeless: Reaching out: A guide for service providers. Washington DC, Interagency Council on the Homeless, 1991.
Brickner PW: Medical concerns of homeless persons, in Treating the Homeless Mentally Ill: A Report of the Task Force on the Homeless Mentally Ill. Edited by Lamb HR, Bachrach LL, Kass FI. Washington DC, American Psychiatric Association, 1992.
Susser E, Goldfinger SM, White A: Some clinical approaches to the homeless mentally ill. Community Mental Health Journal, 25:463–480, 1990.
Kass FI, Kahn DA, Felix A: Day treatment in a shelter: A setting for assessment and treatment, in Treating the Homeless Mentally Ill: A Report of the Task Force on the Homeless Mentally Ill. Edited by Lamb HR, Bachrach LL, Kass FI. Washington DC, American Psychiatric Association, 1992.
Alpert A, Greer H: A guide to assessment: Working with people who are homeless and mentally ill. New York, Project HELP, 1990.
Lopez M: The perils of outreach work: Overreaching the limits of persuasive tactics, in Coercion and Aggressive Community Treatment: A New Frontier in Mental Health Law. Edited by Dennis DL, Monahan J. New York, Plenum Press, 1996.
Cournos F: Involuntary medication and the case of Joyce Brown. Hospital and Community Psychiatry 40:736–740, 1989.
Cohen NL, Marcos LR: Psychiatric care of the homeless mentally ill. Psychiatric Annals 16:729–732, 1986.
Berg JW, Bonnie RJ: When push comes to shove: Aggressive community treatment and the law, in Coercion and Aggressive Community Treatment: A New Frontier in Mental Health Law. Edited by Dennis DL, Monahan J. New York, Plenum Press, 1996.
Health Care for the Homeless Clinicians' Network: Sample safety guidelines in homeless health service programs. Washington DC, U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration Bureau of Primary Health Care of Programs for Special Populations, 1996.
Homeless Health Care Los Angeles: Health and safety in the shelter. Los Angeles, Homeless Health Care Los Angeles, 1996.
Rowe M, Hoge MA, Fisk D: Critical issues in serving people who are homeless and mentally ill. Administration and Policy in Mental Health, 23:555–565, 1996.
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Fisk, D., Rakfeldt, J., Heffernan, K. et al. Outreach Workers' Experiences in a Homeless Outreach Project: Issues of Boundaries, Ethics and Staff Safety. Psychiatr Q 70, 231–246 (1999). https://doi.org/10.1023/A:1022003226967
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DOI: https://doi.org/10.1023/A:1022003226967