Protecting the unprotected: Responding to a survey of violence while homeless

BACKGROUND: Individuals experiencing homelessness in the United States suffer from similar diseases and disorders as the general population but often times at significantly higher rates and with poorer control. The experience of violence while homeless is one factor contributing to the increased vulnerability to illness and mortality; physical assault on individuals experiencing homelessness has potential to cause serious physical and psychological injuries, extend homelessness, and result in expensive medical bills. METHODS: In 2010, the National Consumer Advisory Board - currently and formerly homeless individuals - surveyed homeless individuals in five different cities across the US to explore types of violent attacks experienced while homeless and success in receiving assistance. RESULTS: Median length of homelessness was 1.75 years for the 516 participants. Half of participants had been victim to an attack while homeless. Commonly reported injuries from most recent attacks were bruises (56%), mental trauma (31%), sexual assault (14%), head injury (13%) and broken bones (13%); 14% not injured. Thirty percent knew attacker - friend (41%), intimate partner (16%) and family member (6%). Forty percent sought help, specifically from emergency rooms (57%), police (31%), friends and family (9%), and local health centers (16%). Thirty percent unable to pay medical bills and 49% continue suffering consequences. CONCLUSIONS: Homeless individuals are at an increased risk for violence and require added protective services. RECOMMENDATIONS: Increase screening for violence and trauma victims; improve mental health services; assist application process for victim compensation; conduct educational programs for law enforcement to improve understanding of homelessness; provide housing.