Homeless in New York Crisis on the Streets Discussion no plagiarize, spell check, and check your grammar. Please only use the reference below. Ask at leas

Homeless in New York Crisis on the Streets Discussion no plagiarize, spell check, and check your grammar. Please only use the reference below.

Ask at least one question in response to an original peer post that you would like the author to explore further.

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The City I live in is the only City in all of Orange County (CA) where the homeless can get a warm meal 7 days a week. We have a long ways to go to being able to shelter everyone in need all year long but they do a pretty good job in the winter time. There are many, even in my community, who believe that by providing the homeless services, they only attract more homeless from other Cities. How do you feel about this argument?

FYI- I am from New York so when you reply to the discussion above please make reference of residing in new york

References

Desmarais, S.L., Johnson, K.L., Van Dorn, R.A., Grimm, K.J., Douglas, K.S., & Swartz, M.S. (2014). Community violence perpetration and victimization among adults with mental illnesses. American Journal of Public Health, online February 2014. DOI: 10.2105/AJPH.2013.301680

Homeless in New York: Crisis on the Streets https://www.youtube.com/watch?v=qOraK2E58vo RESEARCH AND PRACTICE
Community Violence Perpetration and Victimization
Among Adults With Mental Illnesses
Sarah L. Desmarais, PhD, Richard A. Van Dorn, PhD, Kiersten L. Johnson, MS, Kevin J. Grimm, PhD, Kevin S. Douglas, PhD, and Marvin S. Swartz, MD
The risk of violence associated with mental
illnesses is a topic of research, media coverage,
and debate. Research indicates that between
11% and 52% of adults with mental illnesses
have been violent within a 12-month period,1—7
and data from the National Comorbidity Survey show that rates of violence for adults with
mental illnesses are 2 to 8 times greater than in
the general population.8 Other studies show
modest but signi?cant relationships between
mental illness and violence,3,9,10 even after
controlling for substance abuse.11 Although
highly publicized cases of violence perpetrated by adults with mental illnesses have
highlighted their “dangerousness,” data suggest they experience victimization at rates
comparable to or higher than their rates of
perpetration.12 Studies show 12-month prevalence rates between 20% and 44%,7,12—15
and indicate the likelihood of experiencing
violent victimization is 23 times higher in
adults with mental illnesses compared with
the general population.12 Despite these ?ndings, there remains a focus on violence perpetration to the neglect of victimization in this
vulnerable population.
The increased risk of violent outcomes that
is associated with mental illnesses represents
a substantial public health burden. Violence
can be devastating to victims and perpetrators
alike, as well as being costly to the public.16,17 In
addition to physical injury, violence may precipitate the loss of personal liberty because of
incarceration18 or civil commitment,19 require
implementation of expensive clinical and risk
assessment and management strategies,20 perpetuate the stigma associated with mental
illness,21 and disrupt continuity of care.22
Consequently, an understanding of the prevalence and nature of community violence—both
perpetration and victimization—among adults
with mental illnesses is critical to public health
research and practice.
Unfortunately, the empirical literature is
limited. First, there are many more studies of
Objectives. In a large heterogeneous sample of adults with mental illnesses,
we examined the 6-month prevalence and nature of community violence
perpetration and victimization, as well as associations between these outcomes.
Methods. Baseline data were pooled from 5 studies of adults with mental
illnesses from across the United States (n = 4480); the studies took place from
1992 to 2007. The MacArthur Community Violence Screening Instrument was
administered to all participants.
Results. Prevalence of perpetration ranged from 11.0% to 43.4% across
studies, with approximately one quarter (23.9%) of participants reporting
violence. Prevalence of victimization was higher overall (30.9%), ranging from
17.0% to 56.6% across studies. Most violence (63.5%) was perpetrated in
residential settings. The prevalence of violence-related physical injury was
approximately 1 in 10 overall and 1 in 3 for those involved in violent incidents.
There were strong associations between perpetration and victimization.
Conclusions. Results provided further evidence that adults with mental
illnesses experienced violent outcomes at high rates, and that they were more
likely to be victims than perpetrators of community violence. There is a critical
need for public health interventions designed to reduce violence in this
vulnerable population. (Am J Public Health. 2014;104:2342–2349. doi:10.2105/
AJPH.2013.301680)
perpetration than victimization; a review of
the literature found 3 times as many publications about the link between mental illness
and violence compared with the link between mental illness and victimization.23
Second, although they are risk factors for
each other,24—26 there have been few studies
of community violence perpetration and
victimization. Only a handful of peerreviewed publications report on both outcomes in the same sample of adults with
mental illnesses during the same reference
period.27—30 Third, studies that have examined both outcomes have restricted power
and generalizability because of the relatively
small, nonrepresentative samples. Fourth,
there is heterogeneity in the operational
de?nitions of violence, preventing meaningful comparisons or aggregation of ?ndings.
Fifth, violent outcomes are frequently measured with a single yes or no question (e.g.,
“Have you been victimized in the past 12
months?”), a measurement approach with
limited sensitivity.31
2342 | Research and Practice | Peer Reviewed | Desmarais et al.
THE PRESENT STUDY
There have been few large-scale investigations of community violence perpetration and
victimization in a sample of adults with mental
illnesses; our study addressed this empirical
gap through secondary data analyses. We
pooled data across 5 studies that assessed
violence and victimization using the same
measure and timeframe. First, we examined the
6-month prevalence of community violence
perpetration and victimization. Second, we
reported on the prevalence of physical injuries
resulting from violence perpetrated by adults
with mental illnesses and the prevalence of
physical injuries they incurred as victims.
Third, we explored statistical associations between the occurrence of community violence
perpetration and victimization. When possible,
we compared ?ndings by study of origin,
participant characteristics (e.g., age, sex, race/
ethnicity), and primary diagnoses. Fourth, we
described the locations in which adults with
mental illnesses perpetrated violence.
American Journal of Public Health | December 2014, Vol 104, No. 12
RESEARCH AND PRACTICE
METHODS
We pooled baseline data from 5 studies of
adults with mental illnesses (n = 4480). All
studies included broad inclusion and minimal
exclusion criteria and enrolled a range of
participants, from exacerbated inpatients to
partially remitted outpatients. Study protocols
were approved by relevant institutional review
boards, and all participants gave written informed consent. The institutional review
boards of North Carolina State University, RTI
International, and University of California,
Davis approved the present analyses.
Facilitated Psychiatric Advance Directive
Study
The Facilitated Psychiatric Advance Directive (F-PAD) Study32 investigated the implementation of a facilitated psychiatric advance
directive intervention. Participants (n = 469)
were recruited from 2 mental health systems in
North Carolina. Inclusion criteria were (1) aged
18 to 65 years, (2) schizophrenia-spectrum or
major mood disorder, and (3) currently in
treatment. Data were collected between 2003
and 2007.
MacArthur Mental Disorder and Violence
Risk Study
The MacArthur Mental Disorder and Violence Risk (MacRisk) Study2 examined violence
risk among civil psychiatric patients. Participants (n = 1136) were recruited from 3 sites:
Pittsburgh, Pennsylvania; Kansas City, Missouri; and Worcester, Massachusetts. Inclusion
criteria were (1) English-speaking White, Black,
or Hispanic; (2) aged 18 to 40 years; and (3)
schizophrenia-spectrum, depression, mania,
brief reactive psychosis, delusional disorder,
other psychotic disorder, substance abuse or
dependence, or personality disorder. Data were
collected between 1992 and 1995.
Schizophrenia Care and Assessment
Program
The Schizophrenia Care and Assessment
Program (SCAP)5 examined clinical, functional,
and service utilization outcomes for adults with
schizophrenia. Participants (n = 404) were
recruited from treatment facilities across North
Carolina. Inclusion criteria were (1) aged 18
years or older, (2) schizophrenia, and (3)
current service use. Data were collected between 1997 and 2002.
MacArthur Mandated Community
Treatment Study
The MacArthur Mandated Community
Treatment (MacMandate) Study33 collected
data regarding lifetime experience of leverage
(e.g., money, housing, criminal justice, outpatient commitment) to improve treatment
adherence among psychiatric outpatients.
Participants (n = 1011) were recruited from
5 sites: Chicago, Illinois; Durham, North
Carolina; San Francisco, California; Tampa,
Florida; and Worcester, Massachusetts. Inclusion criteria were (1) aged 18 to 65 years,
(2) English- or Spanish-speaking, (3) current
outpatient treatment, and (4) ?rst service
occurred at least 6 months before study entry.
Data were collected between 2002 and
2003.
Clinical Antipsychotic Trials of
Intervention Effectiveness Study
The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Study34 examined the effectiveness of second- compared
with ?rst-generation antipsychotic medication
for treating adults with schizophrenia. Participants (n = 1460) were recruited from 57 sites
(16 university clinics, 10 state mental health
agencies, 7 Veteran’s Affairs Medical Centers,
6 private nonpro?t agencies, 4 private practice
sites, and 14 mixed system sites) across the
United States. Inclusion criteria were (1) aged
18 to 65 years, (2) schizophrenia, and (3)
ability to take oral antipsychotics. Data were
collected between 2001 and 2004.
Measures
Community violence. Prevalence of community violence perpetration and victimization
was assessed using the MacArthur Community
Violence Screening Instrument (MCVSI).2 The
MCVSI includes 8 behaviorally based selfreport questions. Items assess
1. pushing, grabbing, or shoving;
2. kicking, biting, or choking;
3. slapping;
4. throwing an object;
5. hitting with a ?st or object;
6. sexual assault;
December 2014, Vol 104, No. 12 | American Journal of Public Health
7. threatening with a weapon in hand; and
8. using a weapon.
For each item, participants were ?rst asked if
someone did this to them, and then they were
asked if they did this to someone else. When
there was a positive response, information
pertaining to the location of the incident and
resulting injury was collected. Community
violence was de?ned as a positive response to
at least 1 item querying if the participant did
this behavior to someone else, and community victimization was de?ned as a positive
response to at least 1 item querying if someone else did this behavior to the participant.
Studies that reported ?ndings of the MacRisk
and MacMandate studies used the labels
“violence” and “other aggressive acts” to describe and distinguish between severity of
acts. However, we used the label violence in
the present study, quali?ed by whether injuries were incurred, to describe these behaviors. This de?nition was consistent with
the de?nitions of violent crime used in reports
by the Bureau of Justice Statistics and the
Federal Bureau of Investigation Uniform
Crime Reporting Program.35,36 This approach was used in other studies that also
used the MCVSI.37
We dichotomized responses to obtain the
prevalence of violent outcomes (yes or no) in
the 6 months before the baseline interviews or
before hospitalization for participants who
were inpatients at baseline. Data on repeated
incidents of perpetration were available in the
MacRisk, SCAP, and MacMandate studies; repeated incidents of victimization were available
in the SCAP and CATIE studies. Whether
participants physically injured the victim(s)
during their perpetration of violence was queried in all studies, except the SCAP study.
Whether participants were injured as a result of
victimization was queried only in the CATIE
study. Location of violence was assessed in the
MacRisk, MacMandate, and F-PAD studies, but
only for perpetration and not victimization.
(Data on the availability of outcomes by study
are available as a supplement to the online
version of this article at http://www.ajph.org.)
Participant characteristics. Information pertaining to participant age (in years), sex, race/
ethnicity (White, Black, Hispanic, other),
primary diagnosis (schizophrenia, bipolar
Desmarais et al. | Peer Reviewed | Research and Practice | 2343
RESEARCH AND PRACTICE
disorder, major depressive disorder, substance
use disorder, other), and hospitalization within
3 months of the baseline (yes or no) was
collected through interview and review of
of?cial records.
Statistical Analysis
We ?rst calculated descriptive statistics. To
address our ?rst research aim, we computed
prevalence of self-reported violence perpetration and victimization, and to address our
second aim, we computed prevalence of injuries resulting from violence perpetration and
victimization. Results were then compared
using the ?2 analysis by study, demographic
characteristics, primary psychiatric diagnosis,
and whether the patient was hospitalized in the
3 months before the baseline assessment. To
address our third aim, we calculated partial
correlations and odds ratios to examine the
magnitude of the association between perpetration and victimization, controlling for study.
We again examined ?ndings across demographic characteristics, primary diagnoses, and
hospitalization. To address our fourth aim, we
categorized and computed prevalence of the
locations in which violence was perpetrated by
participants.
RESULTS
Across studies, almost two thirds of participants were male (59.8%). About half (51.4%)
were White, one third (37.7%) were Black,
7.1% were Hispanic, and 3.9% were other
races/ethnicities. Participant ages ranged between 18 and 71 years (mean = 38.97 years;
SD = 11.30 years). Schizophrenia was the most
prevalent primary diagnosis (63.5%), followed
by major depression (18.4%), bipolar disorder
(9.6%), substance use disorder (6.1%), and
other disorders (e.g., anxiety; 2.5%). Approximately one third of participants (39.6%) were
hospitalized within 3 months of the baseline
assessment.
prevalence ranging from 11.0% (SCAP) to
43.4% (MacRisk) across studies. Of those who
reported perpetrating violence, about one third
(36.7%) reported perpetrating violence on
more than 1 occasion; the range across studies
for repeat perpetration was much smaller (from
34.2% in SCAP to 37.4% in CATIE). Almost
one third of participants (30.9%) reported at
least 1 incident of violent victimization in the
community, with prevalence ranging from
17.0% (SCAP) to 56.6% (MacRisk) across
studies. Of those who reported being victimized, almost half (43.7%) reported being victimized on more than 1 occasion; again, the
range across studies was small (from 42.8% in
MacMandate to 47.6% in SCAP). The prevalence of community violence victimization
overall and repeated victimization was signi?cantly higher than the prevalence rates for
perpetration (P < .001). Analyses revealed signi?cant differences in prevalence rates as a function of the study of origin and participant characteristics (Table 1). Speci?cally, prevalence of violence perpetration and victimization were almost twice the overall rate in the MacRisk study compared with the other studies. Prevalence of violence perpetration and victimization were more than twice as high in younger compared with older participants, although rates of repeated perpetration and victimization were similar across age groups. Women were signi?cantly more likely to report violence perpetration and multiple incidents of perpetration and victimization; however, prevalence of any victimization in women and men were comparable. Hispanic participants reported lower rates of perpetration and victimization than White and Black participants. Compared with participants with other primary diagnoses, rates of perpetration and victimization were lower for those with schizophrenia and higher for those with substance use disorders. Violence perpetration and victimization were more prevalent among participants who had been hospitalized within 3 months of baseline. Prevalence of Community Violence Perpetration and Victimization Prevalence of Physical Injuries Table 1 shows the 6-month prevalence of community violence perpetration and victimization. Approximately one quarter of participants (23.9%) reported perpetrating at least 1 incident of community violence, with Table 2 shows the prevalence of physical injuries resulting from violence perpetration and victimization. Ranging from 4.2% (MacMandate) to 16.6% (MacRisk) across studies, the overall prevalence of physical injuries 2344 | Research and Practice | Peer Reviewed | Desmarais et al. resulting from violence perpetration (8.7%) was higher than prevalence of injuries associated with victimization (7.5%; P = .05). The ratio of any violence perpetration to perpetration resulting in physical injury was approximately 3:1 and the ratio of any victimization to victimization resulting in physical injury was approximately 4:1; that is, for every 3 adults with mental illnesses who perpetrated violence, 1 of them physically injured the victim(s), and for every 4 adults with mental illnesses who was victimized, 1 of them was physically injured. Approximately 1 in 3 participants who reported violence—perpetration or victimization—also reported injuries, but injuries were reported more frequently by those who were victimized (39.3%) than those who perpetrated violence (34.7%; P < .001). Comparisons by study and participant characteristics revealed differences that often mirrored differences in prevalence of perpetration and victimization (Table 2). Injury rates overall were much higher in younger compared with older participants, for both community violence perpetration (12.4% vs 4.5%) and victimization (9.7% vs 6.0%). However, comparisons also revealed notable differences; for instance, women reported higher rates of perpetration compared with men (25.5% vs 22.8% of the sample), but more men reported perpetrating violence that resulted in injury than did women (9.4% vs 7.7%). Similarly, the ratio of perpetration to perpetration resulting in physical injury was similar for the MacRisk and CATIE studies (3:1), but different for the F-PAD (2:1) and MacMandate (5:1) studies; that is, for every 3 participants in the MacRisk and CATIE studies who perpetrated violence, 1 of them physically injured the victim(s), whereas 1 of every 2 participants in the F-PAD and 1 of every 5 participants in the MacMandate studies who perpetrated violence in?icted injury. Associations Between Violence Perpetration and Victimization Table 3 shows the correlations and odds ratios, which were calculated controlling for the study, between the 6-month prevalence of community violence perpetration and victimization, overall and across participant characteristics. Results showed a strong association (0.50) and substantial shared variance (25.0%) between perpetration and victimization, and American Journal of Public Health | December 2014, Vol 104, No. 12 RESEARCH AND PRACTICE TABLE 1—Prevalence of Community Violence Perpetration and Victimization Among Adults With Mental Illnesses: Five Studies in the United States, 1992–2007 Perpetration Variable Overall (n = 4474) Study F-PAD (n = 469) > 1 Incident Among
Perpetrators
Victimization
> 1 Incident
Among Victims
%
P
%
P
%
P
%
P
23.9
< .001 36.7 < .001 30.9 < .001 43.7 .02 < .001 0.92 < .001 .49 25.2 ... 24.1 MacRisk (n = 1136) 43.4 36.5 56.6 ... SCAP (n = 400) 11.0 34.2 17.0 47.6 MacMandate (n = 1010) 19.3 ... 27.5 42.8 CATIE (n = 1459) 15.0 37.4 19.2 Age, y < .001 .46 ... ... < .001 32.8 37.3 40.7 42.5 ‡ 40 (n = 2110) Sex 14.0 33.3 20.0 45.1 Male (n = 2677) 22.8 Female (n = 1797) 25.5 Race/ethnicity White (n = 2297) .01 33.2 42.4 .16 24.3 .84 31.0 35.4 .05 40.5 30.7 .22 52.1 .03 32.1 .4 38.6 Black (n = 1683) 24.6 39.4 30.3 46.8 Hispanic (n = 317) 19.2 26.8 24.0 51.5 Other (n = 172) Primary diagnosis Schizophrenia (n = 2833) 20.9 54.5 < .001 16.1 32.6 .19 35.8 41.7 < .001 22.9 ... 43.7 Bipolar disorder (n = 428) 27.3 32.7 37.6 ... Major depression (n = 82... Purchase answer to see full attachment