Marcel Slockers

120 Chapter 8 for women only is necessary to be able to recover from traumatic experiences in a stable and peaceful environment and to build a new future. Recently, partly based on the street doctors’ recommendations, a shelter for women was established in Rotterdam. Homelessness after release from a psychiatric institution: It is often difficult to initiate care in mental health institutions. However, literature shows that homelessness often occurs because people run away from or are suspended from a psychiatric institution, an assisted housing facility or an institution for people with intel- lectual disabilities. It is counterproductive to return to the turmoil of night shelters without adequate social support after an involuntary admission for withdrawal or severe psychiatric problems. The large numbers of homeless people with psychiatric disorders and addiction problems described in this thesis, therefore, require a review of the suspension and discharge policies within institutions for psychiatric and/or addiction problems. Improving social medical care for homeless people Chronically ill homeless people Damage to cardiovascular and respiratory organs caused by drugs, smoking and alcohol during the episode of homelessness appears to contribute to an early death. The proportion of patients with endocrine disorders, cardiovascular diseases and oncological problems is increasing among homeless people and requires good preventive and chronic care. Nursing departments within the shelter locations can play a role in this regard. Homeless people with addiction This thesis has reported a decreasing share of hard drug and alcohol abuse and an increasing share of soft drug use among homeless people. Monitoring of substance abuse among vulnerable groups and prevention appear to be important. A reconsideration of the soft drugs policy in the Netherlands might be an option. This could include more information, active support for people who want to reduce the use of soft drugs, regulation of the THC content in hashish and cannabis, and agreements on use in institutions for sheltered living, comparable to agreements on where smoking is allowed. Good and accessible basic medical health care for homeless people Our studies of the effects of changed health insurance policy in 2015 have shown several factors that impede access to basic medical healthcare for this group.