Authors: Lynne Hannan, Grant Sara, Lisa Woodland, Catherine O'Brien, NSW
Event: 1999 TheMHS Conference
Subject: book of proceedings, Socio-geographic drift, DISADVANTAGE, HOMELESSNESS, The Sutherland Division of Mental Health
Type of resource: Conference Presentations and Papers
Abstract: The Sutherland Division of Mental Health has developed a model for working with clients (and their families) who are at risk of socio-geographic drift or who have already drifted. This paper is an outline of that model.
Socio-geographic drift is a process where people with mental illness experience rapid socio-demographic decline, weakened family and social support networks and multiple changes of geographic location usually resulting in residence in disadvantaged areas. Drift can result in homelessness, chronic residential instability and exposure to extreme adversity. Thus, people with mental disorders are found in disproportionate numbers among those who live in shelters, boarding houses and on the streets of disadvantaged inner-city areas. It is a problem endemic to the large cities of the western world.
Little is known about the interaction between an individual's mental illness and this process of drift. It is argued here, however, that drift is highly relevant to mental health care for the following reasons:
1. Drift may interact negatively with the course of the illness by contributing to the length of untreated or undertreated psychosis. When people with mental illnesses drift they can lose contact with the mental health professionals who know them well, and may fail to make timely contact with new mental health services. As a result, their illnesses may be undertreated, untreated or misdiagnosed. When acutely ill, treatment may be delayed. Wyatt (1995) has suggested that untreated psychosis may be biologically toxic and contribute to long-term morbidity. Thus, the longer the period of untreated acute illness, the longer the time to remission and the lower the degree of remission.
2. The adversity associated with drift may interact negatively with the course of the illness and result in severe but preventable secondary deficits. It is argued here that exposure to adversity at a critical time in the course of the illness, when biological and psychological changes are being laid down, may lead to a poorer long-term outcome.
3. By weakening and eroding social support networks, drift may contribute to a loss of protective factors. Much research points to the importance of preserving family and social relationships for people with mental illness.