A report analyzing the 2009 spike in deaths among Santa Barbara’s homeless population was released last week by county Public Health Department officials. Though it doesn’t fully explain why so many homeless people died last year and in the early part of this year, it does illuminate the web of factors behind homeless peoples’ greater vulnerability to death and where the county is failing to help them.
The report, completed by the Homeless Death Review Team and commissioned by the Board of Supervisors in February, is replete with charts, tables, and pie graphs analyzing all the various illnesses that plagued the 45 homeless individuals who died in the county between January 2009 and March 2010. One drawback of the analyses is that in eight of the 45 cases, or 18 percent, no cause of death was included on death certificates. On the other hand, medical records revealed a good deal of information about these individuals’ encounters — or lack of encounters — with public health and mental health systems.
An “overwhelming” number had an addiction to alcohol or drugs, read the report, and the prevalence of mental illness among the 45 was very high. In fact, half of the 45 had a diagnosed mental health condition, yet only 16 made any contact with Alcohol, Drug, and Mental Health Services (ADMHS). “This does suggest a need to explore ways to improve mental health outreach efforts [to the homeless] and coordination of care between public health and ADMHS providers,” the report states.
When people received services from both the county Public Health Department and ADMHS, the report went on, no communication was reportedly occurring between departments. This means clinicians had no knowledge of what kinds of prescription drugs or other treatments another health worker was prescribing, fueling the potential for abuse of medications and overmedicating.