One of the greatest challenges to low-income people is managing Chronic Illness. This is a disease that lasts longer than 3 months and cannot be cured with medicine or treatment.
Chronic illness is a world of losses. Loss of freedom and security; if you have heart or lung or mobility issues you can’t go hiking or long walks at the beach or spontaneous road trips. Loss of income: managing it with medication or assistance tools is costly. Repairing damage to body and belongings is never free – take the example of a person with Epilepsy who has to fix teeth. Loss of dreams: finding a partner, lover, altered career ambitions.
A person with a chronic illness will die an average of 25 years sooner.
When your Chronic Illness is a Mental Illness you can add to this growing list the bonuses of fear from other members of society, alienation from family and friends. 68% of adults with mental health issues have other chronic health issues.
75% of all health care costs are related to Chronic Illness and 1 in 3 people have a chronic illness and over half of the deaths in America are Chronic Illness related.
Why are you reading this in a blog about homelessness? The answer is simply because people with lower incomes are more likely to be in the 1/3rd who have a Chronic Illness. Poverty, lack of social support, adverse life events, abuse and neglect and household dysfunction in childhood increases the likelihood of adult poverty and chronic illness as adults. What is more, comorbidity is the rule, not the exception. It is pretty rare to find someone who only has Fibromyalgia and does not also have Depression.
There are not enough Clinical Mental Health providers and Psychiatrist so Primary Care Physicians (who had a 1-month Psych rotation) are trying to add this to their duties.
It is important to involve the client in their own care. “What do you think you will do? What medications do you plan to follow through on taking? What will you do when you feel gross or groggy?”, are important conversations to start. A specific follow up plan needs to be implemented. You don’t need to be a doctor to ask these questions – this conversation can happen in the mirror, with a friend, caregiver or anyone else.