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Vulnerable Population Health Policy Proposal
Kyla Hoag
NURS-FPX6026: Biopsychosocial Concepts for Advanced Nursing Practice 2
Capella University
Kathryn Sheppard
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Need for Policy
The homeless is an example of a vulnerable population and they face an assortment of
healthcare challenges, both physical and mental. The homeless population is susceptible to many
physical health related problems such as chronic pain, impaired mobility, impaired hearing or
vision, and obesity. “Chronic pain is thought to be common among homeless people, in part due
to frequent injuries and the high prevalence of concurrent health conditions” (Hwang et. al.,
2011, p. 1). For many people with chronic pain, common pain relief methods are ineffective, and
opioids are used an alternative. It is easy for this population to end up addicted to opioids and
other substances because of chronic pain. Homelessness causes a lack of stability, which can lead
to drug addiction. The homeless population often self-medicates with street drugs, and they use
substances to numb the pain and stressors that comes with living on the street. “According to the
National Coalition for the Homeless, substance abuse is more prevalent in people who are
homeless than in those who are not” (Mosel, 2022). It can be challenging for homeless people to
stop using substances because they have smaller support networks. They also typically do not
have easy access to traditional recovery programs, detox centers, and rehab programs. It is then
crucial to look for a solution that will allow the homeless population to effectively manage their
chronic health conditions such as pain or mental health issues, and to most importantly get them
into a safe environment, where they do not have access to substances to continue feeding their
addiction.
Proposed Policy
The proposed policy I will be discussing is an interdisciplinary pain rehabilitation
program. The interdisciplinary approach to institutional and community problems occurs when
members of different disciplines work inter-dependently (as opposed to the term “multi-
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disciplinary,” which describes members of different disciplines who function independently”
(Hamel, 2001, p. 58). An interdisciplinary program is necessary for this population because they
face a variety of issues that make traditional drug rehabilitation programs less efficient. An
interdisciplinary program addresses the contributors to chronic pain which include behavioral,
psychological, and physical aspects. “To effectively serve the homeless population, rehab
programs must do at least three things: provide services that address the needs for employment,
income, and housing; offer access to affordable interventions; and provide long-term care,
treatment, and support” (Smith, 2020). The most effective rehab programs for the homeless
population understand that substance abuse cannot be managed without addressing the needs of
the person as a whole.
Interprofessional Approach
Effective rehab programs for the homeless population should provide patient-centered
services that are multidisciplinary, meaning competent enough to treat various conditions and
coordinate further services. Chronic pain is important to get under control, but most importantly,
the homeless population’s primary concern that needs to be addressed is housing. Substance
abuse often correlates directly with homelessness, therefore, the sooner the patient can find
stable housing, their chances of falling into addiction are drastically reduced. For treatment to be
effective, the homeless must have a stable living situation. Once basic needs are met, problems
with addicted can be focused on. An interprofessional team should be established to help develop
this type of patient’s plan of care. This team should include: a primary care provider, a pain
specialist, nurses, a mental health professional such as a therapist or psychiatrist, and social
services. There needs to be coordination between inpatient and outpatient social services as this
population is ready to transition into the community again.
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Conclusion
Individuals experiencing homelessness face unusual challenges in accessing healthcare.
These challenges include lack of transportation, loss of housing, financial hardships, lack of
insurance, and negative encounters within the health care system. There are many aspects of
being homeless that can cause a person to struggle with drug addiction. However, traditional
rehab programs hardly work for the homeless as they face a wide range of problems, including
mental, behavioral, and physical. I am proposing an interdisciplinary pain rehabilitation program
to help these patients lessen drug use, increase psychological functioning, promote healthy
behaviors, and have a safe place to call home, temporarily.
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References
Hamel, Pauline. (2001). Interdisciplinary perspectives, service learning, and advocacy:
A nontraditional approach to geriatric rehabilitation. Topics in Geriatric Rehabilitation.
17(1):53–70. https://doi.org/10.1097/00013614-200109000-00005
Hwang S., Wilkins E., Chambers C., Estrabillo E., Berends J., MacDonald A. (2011). Chronic
pain among homeless persons: Characteristics, treatment, and barriers to management.
BMC Fam Pract. 12(73), 2-9. https://doi.org/10.1186/1471-2296-12-73
Mosel, S. (2022). Substance abuse & homelessness: statistics & rehab treatment. American
Addictions Center. Retrieved from https://americanaddictioncenters.org/rehab-
guide/homeless
Smith, Johnelle. (2020). Drug And alcohol rehab programs for homeless individuals. Addiction
Resources. Retrieved from
https://www.addictionresource.net/treatment/inpatient/homeless-
individuals/#homelessness-and-addiction
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