[The homeless alcoholic: who cares?].
Two homeless alcoholics, males aged 58 and 40 years, suffered from multiple health problems. Sleeping outdoors, excessive drinking and incompetence refrained them from seeking proper assistance. The patients were assessed on many occasions at primary care services provided in shelters in Amsterdam, at police stations and in the streets. They were also frequently admitted to shelter infirmaries, alcohol clinics and general hospitals. Despite substantial individual health damage, community costs and extreme care consumption, coercive treatment was not applied to prevent the death of the first patient and to stabilise the situation of the second. It is stated that a specific group such as homeless alcoholics can hardly be treated except during moments of crisis. Coercive treatment should be applicable in order to stabilise these patients so as to prevent early mortality among the alcoholic homeless with comparable health problems. Outreach primary care services for the alcoholic homeless should actively cooperate with addiction and mental health services in providing adequate care.
van Laere
I R A L
IR
Gemeentelijke Geneeskundige en Gezondheidsdienst, cluster Maatschappelijke Geestelijke Gezondheidszorg, Ambulant Medisch Team voor dak- en thuislozen, Postbus 2200, 1000 CE Amsterdam. ilaere@gggd.amsterdam.nl
D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003068:Coercion; D003153:Community Health Services; D017809:Fatal Outcome; D006304:Health Status; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care