Assignment: Substance Misuse Case Study- Plan of Care

Assignment: Substance Misuse Case Study- Plan of Care

Assignment: Substance Misuse Case Study- Plan of Care

Case Study:

Plan of Care for this patient
USE MOST RECENT APA FORMAT- use headers
APA- Use 3 peer reviewed & scholarly references
CITE SOURCES
You can use the following as headers which are also requirements for the assignment:
• Explain what the patient is at risk for.
• Articulate safety concerns or issues at home.

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• Explain 2 challenges that might prevent the patient from seeking medical care.
• Articulate all patient education for the patient and treatment plan.
• Explain an understanding of the diagnosis and treatment.
• Identify 2 short-term goals & 2 long-term goals.
• Identify 2 outcomes for the patients.
Cite sources.

Substance Misuse Case Study- Plan of Care

The development and adoption of a comprehensive Mental Health Plan can assist healthcare service providers and program administrators to effectively work with vulnerable individuals who are in dire need of mental health treatment and at risk of substance abuse and homelessness. The case of Richie presents a typical scenario where the implementation of a tailored Treatment Improvement Protocol (TIP) may prove instrumental in enabling the individual to gain access to requisite health and social care services to enhance quality of life in all key areas namely: social, psychological and physical. In this report, focus is placed on addressing the key concerns for Richie, and providing relevant guidance, points of reflection to assist in the assessment and enforcement of a Collaborative Plan for Richie.

Risks faced by Patient

Given the status of the client as a homeless person, the patient faced increased risk of exposure to physical violence and attacks, engagement in substance abuse, healthcare needs and psychiatric impairments. Polcin (2016) insisted that persistent homelessness may contribute to increased risk of developing drug and alcohol problems, thus complicating efforts by the client to secure stable housing. Rogers (2018) commented that the inherent inability to secure stable housing may expose the affected individual to become victims of crimes and harassment, with the most notable cases involving sexual and physical assault.

Safety Concerns or Issues At Home

With reduced parental involvement in the patient’s life, some of the main issues concerns include lack of access to permanent stable housing, lack of access to basic needs including good food and clean water, secure environment, clothing and other associated areas including health and education (Center for Substance Abuse Treatment, 2013b). As a result, the patient is at risk of experiencing co-occurring substance abuse, mental health issues and other negative experiences that could have detrimental impact on his social, physical and psychological areas of life (Polcin, 2016).  

Challenges that May Prevent Patient from Seeking Medical Care

A major challenge is the prevalence of entrenched stereotypes and stigmas facing homeless individuals in the mainstream society. The Center for Substance Abuse Treatment, (2013a) commented there is widespread negative perceptions of homelessness as an outcome of blatant laziness and non-committal approach to personal development and the treatment of homeless persons as merely alcoholics and drug addicts. However, these stereotypes may greatly undermine the pursuit of required medical care and social support.  In the case of Richie, the pain, stress, trauma, depression, and other negative forces including poor mental health associated with homelessness and substance abuse may have a major role in shaping the ultimate decision to seek for medical support and care (Rogers, 2018).

The second challenge that could more likely prevent Richie from seeking the requisite medical care is the poor socio-economic status facing the patient. Gillis et al., (2010) commented that homeless individuals are often unemployed and hence faces significant financial constraints that could practically undermine their ability to access appropriate social and medical care services. Polcin (2016) added that the past homeless episodes experienced by vulnerable individuals may heighten their incidences of developing substance use disorders and psychiatric disorders that may in turn contribute to the increased risk of developing serious mental illnesses.

 Patient Education and Treatment Plan

Special Needs of the Patient

Richie stands out as a Behavioral Health client with a set of special needs and requirements that must be given ultimate consideration. As a homeless person, the client is first in need of a placement at an appropriate recovery home. Equally, the client also experiences a list of psychiatric impairments, criminal justice concerns, and drug use problems, social, personal and healthcare needs that must be evaluated to inform effective case management efforts as well as treatment planning (Rogers, 2018).

Regarding the Treatment Plan, adoption of a Recovery-Oriented Care Approach may provide a useful starting point for identifying and responding to the special needs experienced by the identified client. Gillis et al., (2010) asserted that recovery homes are involved in the provision of different on-site services, and hence can become a useful entry point for vulnerable people into homeless service systems, especially those seeking to reside in drug and alcohol-free settings.

In the case of Richie, the treatment plan may encompass his placement in a peer-managed recovery home in order to tackle the need for permanent sober housing for the client.  The Center for Substance Abuse Treatment, (2013b) noted that the practical importance of peer-managed recovery homes is based on how they enable the homeless individual to gain some degree of stability and autonomy through involvement in sober living programs. Polcin (2016) commented that while the lack of formal service on-site in many of the peer-managed recovery homes is a common disadvantage, the existence of psychiatric and housing problems among residents makes it necessary to consider community-based and professional services aimed at enabling the mentally-ill patients to successfully complete their residential treatment programs (Michael’s House, 2020). Moreover, the recent years have witnessed increased availability of outpatient treatment programs aimed at assisting residents to gain access to appropriate treatment options for the core purpose of achieving abstinence and improvement in quality of life.

Diagnosis and Treatment

The Center for Substance Abuse Treatment (2013a) noted that homeless individuals, especially those with persistent mental and substance abuse disorders, experience specific challenges in treatment. A proper diagnosis of the patient may provide a useful starting point for identifying all the core issues to be addressed in order to ensure effective treatment. Rogers (2018) insisted that the adoption of integrated interventions for homeless persons with co-occurring substance abuse and mental illness may prove instrumental in contributing to positive treatment outcomes for the patient. Gillis et al. (2010) commented that the use of a tailored psychosocial rehabilitation program can have leveraged treatment outcomes in terms of contributing to increased abstinence from substance abuse, access to work therapy and stable housing.

Short term Goals

1. Housing Access- A stable and secure living environment is a key contributing factor in recovery of the homeless patient
2. Client-centered Services– A holistic, tailored and patient-centered treatment plan can offer a leveraged approach to recovery through identifying and responding to their distinct needs, wants and demands of the patient.

 Long-term Goals

1. Integrated Service– Considering the existence of co-occurring substance use and mental illness affecting homeless individuals, the in-house deployment of multi-disciplinary professionals can offer coordinated and centralized care and treatment for enhanced patient outcomes (Michael’s House, 2020)
2. Comprehensive Services– Given the complexity of homelessness, the provision of diverse range of services aimed at meeting the physical, psychological and social needs of the affected person can prove instrumental in fast-tracking successful recovery.

Outcomes for the Patient

1. Access to recovery supports provided by professionals will enable the patient to achieve genuine recovery from substance abuse, mental disorders and the effects of homelessness.
2. Reduced potential for and effects of trauma and violence associated with being homeless.

References

Center for Substance Abuse Treatment, (2013a). Behavioral Health Services for People Who Are Homeless. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2013. (Treatment Improvement Protocol (TIP) Series, No. 55.) Part 1, Chapter 1. https://www.ncbi.nlm.nih.gov/books/NBK138719/

Center for Substance Abuse Treatment, (2013b). Behavioral Health Services for People Who Are Homeless. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2013. (Treatment Improvement Protocol (TIP) Series, No. 55.) Part 2, Chapter 1. https://www.ncbi.nlm.nih.gov/books/NBK138728/

Gillis, L., Dickerson, G., & Hanson, J. (2010).Recovery and Homeless Services: New Directions for the Field. The Open Health Services and Policy Journal, 3, 71-79. https://homelesshub.ca/sites/default/files/gxr0lb4g.pdf

Hwang, S.W., & Garner, R.E. (2005).Interventions to improve the Health of the Homeless Systematic Review. American Journal of Preventive Medicine, 29(4), 1-75. www.10.1016/j.amepre.2005.06.017  

Michael’s House, (2020).The Connection between Homelessness and Addiction. https://www.michaelshouse.com/drug-abuse/study-homelessness-addiction/ 

Polcin, D.S. (2016).Co-occurring substance abuse and mental health problems among homeless persons: Suggestions for research and practice. Journal of Social Distress and Homelessness, 1-10. https://doi.org/10.1179/1573658X15Y.0000000004 

Rogers, J.D. (2018).Mental health care for the homeless. https://commons.lib.jmu.edu/cgi/viewcontent.cgi?article=1125&context=edspec201019