A Primary Care Approach to Treating Women Without Homes

Roseanna H. Means, MD, MSc

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In This Article

Screening for Homelessness

One cannot predict homelessness by physical appearance. Many women without homes do not fulfill the stereotype of the homeless bag lady. And because homelessness carries a social stigma, humiliation and shame may prevent homeless women from reporting their social conditions to clinicians. In studies comparing homeless and domiciled women, homeless women were found to experience more social isolation, more hostility, and lower self-esteem[21]; more depression, posttraumatic stress disorder (PTSD), and substance abuse[22]; higher emergency room use and longer length of hospital stays[23]; more residential instability[24]; and more irrational stoicism.[25]

Clinicians must consider housing status when faced with patients who make unexpectedly poor choices, are inconsistent in their follow-through, reveal evidence of marginal finances, suffer from mental illness or substance abuse, do not have firm social supports, have spotty employment histories, or are victims of repeated abuse.[26]

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