Denigration or Decline: Reflections on Offering Staff Consultation Focussing on End-of-Life Care In a Homeless Hostel

IF 0.5 Q4 PSYCHIATRY British Journal of Psychotherapy Pub Date : 2023-12-14 DOI:10.1111/bjp.12883

Jonathan Day

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Abstract

People experiencing homelessness are subject to entrenched health inequalities and obstacles to accessing care. Numerous studies have highlighted that structural and organisational obstacles result in people experiencing homelessness living with unmet healthcare needs. Over time, this is associated with a reduced life expectancy compared with the national average in the UK. Although combating health inequalities has become a mandate for many healthcare providers, attempts to improve parity and access for people experiencing homelessness has stalled. This article utilises a case study method to highlight instances of psycho-social exclusion that homeless patients can be subject to and examples where healthcare staff can collude in this exclusion. The article concludes with highlighting the benefits of psychologically informed staff consultation, which creates reflective spaces to gain a better understanding of people experiencing multiple disadvantage and exclusion. In addition, staff consultation allows space to process feelings that are stoked in professionals who struggle to comprehend why it is difficult for some people to accept offers of care.

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诋毁还是衰落：对在无家可归者宿舍提供以临终关怀为重点的员工咨询的思考

无家可归者在获得医疗服务方面面临着根深蒂固的健康不平等和障碍。大量研究强调，结构性和组织性障碍导致无家可归者的医疗保健需求得不到满足。随着时间的推移，与英国全国平均水平相比，这与预期寿命缩短有关。尽管消除医疗不平等已成为许多医疗服务提供者的任务，但改善无家可归者的均等性和就医机会的努力却停滞不前。本文采用案例研究的方法，强调了无家可归的病人可能受到的社会心理排斥，以及医护人员可能与这种排斥串通一气的例子。文章最后强调了员工心理咨询的益处，员工心理咨询可以创造反思空间，从而更好地了解遭受多重不利条件和排斥的人群。此外，员工咨询还能让专业人员有空间处理自己的感受，因为他们很难理解为什么有些人难以接受护理服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Psychotherapy PSYCHIATRY-

CiteScore

0.90

自引率

50.00%

发文量

期刊介绍： The British Journal of Psychotherapy is a journal for psychoanalytic and Jungian-analytic thinkers, with a focus on both innovatory and everyday work on the unconscious in individual, group and institutional practice. As an analytic journal, it has long occupied a unique place in the field of psychotherapy journals with an Editorial Board drawn from a wide range of psychoanalytic, psychoanalytic psychotherapy, psychodynamic, and analytical psychology training organizations. As such, its psychoanalytic frame of reference is wide-ranging and includes all schools of analytic practice. Conscious that many clinicians do not work only in the consulting room, the Journal encourages dialogue between private practice and institutionally based practice. Recognizing that structures and dynamics in each environment differ, the Journal provides a forum for an exploration of their differing potentials and constraints. Mindful of significant change in the wider contemporary context for psychotherapy, and within a changing regulatory framework, the Journal seeks to represent current debate about this context.