What is the problem that needs to be addressed? Please describe how it is related to mental health.
Homeless Dermatology. People who are homeless are disproportionately experiencing mental illness. Homelessness presents several dermatological issues including: skin cancers, crabs, scabies, etc.
Why is this a concern for Orange County? What can Orange County and other counties learn from this project?
Orange County has made investments in housing and healthcare for people who are or have experienced mental illness and/or homelessness. The cited goal is to return to a baseline level of functioning which may include employment or volunteering. Crabs and scabies can signficiantly disturb a person during a work or volunteer day and also be passed to others. Prior NIH officials have cited a disparity/inequity in life expectancy for people experiencing homelessness/mental illness. Skin cancer is possibly a valid cause of this reduced life expectancy.
What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?
Cost effective interventions that include: 1) Bug ovens for clothes 2) Access to permethrin (or other treatments) & showers 3) Skin exams by licensed professionals 4) Resources to segregate clothing/bedding as it goes through decontamination that may have a prolonged time table 5) Laundry facilities 6) Broad Brimmed Hats 7) Sun screen training These are not observed in the Orange County mental health care system.
What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.
Doing it for people experiencing mental illness/homelessness.
What is the project idea? Please describe how this project will operate.
Project A) Mobile facility to assist with scabies/crabs decontamination that includes a bug oven, licensed providers to prescribe permethrin (or other options), bags to sequester clothing/bedding. When a person moves from homelessness to housing this mobile facility would be available to ensure the move doesn’t bring extra critters. Project B) Sun Protection Outreach Training by Students (http://spots.wustl.edu/) has a precanned, evidence based curriculum to teach people about sun protection and skin cancer. It isn’t common sense. Project C) Sourcing and providing sun protection equipment and dermatological care. Sun protection equipment isn’t common sense and the best ones tend to be expensive. Budgeting for broad spectrum sun screen on an SSI budget doesn’t work too well.
What can be learned from this project: The challenges of addressing the risk of skin cancer in a homeless demographic. The challenges of addressing crabs/scabies in a demographic without access to housing/shower/clothing sequestration resources. Understanding how skin cancer impacts the life expectancy inequity/disparity. What is project success: Protecting the mental health consumer from risks of skin cancer and treating crabs/scabies.