Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: The intersection of policy, drug use, trauma, and urban space
Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: The intersection of policy, drug use, trauma, and urban space
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DOI：
10.1016/j.drugpo.2013.10.011
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发表时间：
2014-05-01
影响因子：
4.4
通讯作者：
Riley, Elise D.
中科院分区：
文献类型：
--
作者：
Knight, Kelly R.;Lopez, Andrea M.;Riley, Elise D.
背景资料：由于城市贫困人口中共病药物使用和精神健康诊断的比例很高，审查毒品政策和场所的交叉点需要考虑住房在吸毒者精神健康中的作用。在旧金山弗朗西斯科，由于地理上的局限性以及不断进步的卫生和住房政策，单人房旅馆已成为一个主要的城市建筑环境，用于为同时存在吸毒和精神健康问题的贫困人口提供住房。使用非法药物的不稳定居住的妇女有很高的终身和当前创伤率，与稳定居住的妇女相比，这表现在创伤后应激障碍（PTSD）、焦虑和抑郁的比例不成比例地高。我们报告的数据来自定性访谈研究（n=30）和四年的人种志进行了住房政策制定者和不稳定的住房妇女谁使用毒品和生活在SRO。结果：研究中的妇女生活在一系列SRO建造的环境中，从公共资助的新建SRO到私人拥有的破旧建筑，这为人种学比较提供了丰富的机会。应用罗兹等人的社会结构脆弱性的框架，我们探讨如何SROs可以作为“心理健康风险环境”中的宏观结构因素（住房政策塑造建筑环境）与中观层面的因素（SROs内的社会关系）和微观层面的互动，行为应对策略，以影响妇女的心理健康。自律组织建立的环境在宏观层面上对“创伤敏感”的程度在梅萨和微观层面上对妇女的心理健康产生了重大影响。妇女谁是生活在SRO加剧了恐惧和焦虑的尝试，成功有限，部署战略的梅萨和微观层面上管理他们的心理健康symptoms.Conclusion：研究结果强调了住房政策的重要性，考虑物质使用的背景下，目前和累积的创伤经验，以提高生活质量和心理健康的不稳定居住的妇女。(C)2013爱思唯尔有限公司版权所有。
Background: Due to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women.Methods: We report data from a qualitative interview study (n=30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs.Results: Women in the study lived in a range of SRO built environments, from publicly funded, newly built SROs to privately owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.'s framework of socio-structural vulnerability, we explore how SROs can operate as "mental health risk environments" in which macro-structural factors (housing policies shaping the built environment) interact with mesa-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women's mental health. The degree to which SRO built environments were "trauma-sensitive" at the macro level significantly influenced women's mental health at mesa- and micro-levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the mesa- and micro-level to manage their mental health symptoms.Conclusion: Study findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma experiences in order to improve quality of life and mental health for unstably housed women. (C) 2013 Elsevier B.V. All rights reserved.