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Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey.

https://arctichealth.org/en/permalink/ahliterature131318
Source
Open Med. 2011;5(2):e94-e103
Publication Type
Article
Date
2011
Author
Erika Khandor
Kate Mason
Catharine Chambers
Kate Rossiter
Laura Cowan
Stephen W Hwang
Author Affiliation
Toronto Public Health, Toronto, Ontario, Canada.
Source
Open Med. 2011;5(2):e94-e103
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chronic Disease - epidemiology
Communication Barriers
Cost of Illness
Family Practice - statistics & numerical data
Female
Health Care Costs
Health Services Accessibility - economics - statistics & numerical data
Health Status Disparities
Health Surveys
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Middle Aged
Ontario - epidemiology
Primary Health Care - economics - statistics & numerical data
Risk factors
Sexual Behavior - statistics & numerical data
Substance-Related Disorders - epidemiology
Abstract
Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of homeless adults in Toronto, Canada.
Homeless adults were recruited from shelter and meal programs in downtown Toronto between November 2006 and February 2007. Cross-sectional data were collected on demographic characteristics, health status, health determinants and access to health care. We used multivariable logistic regression analysis to investigate the association between having a family doctor as the usual source of health care (an indicator of access to primary care) and health status, proof of health insurance, and substance use after adjustment for demographic characteristics.
Of the 366 participants included in our study, 156 (43%) reported having a family doctor. After adjustment for potential confounders and covariates, we found that the odds of having a family doctor significantly decreased with every additional year spent homeless in the participant's lifetime (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.97). Having a family doctor was significantly associated with being lesbian, gay, bisexual or transgendered (adjusted OR 2.70, 95% CI 1.04-7.00), having a health card (proof of health insurance coverage in the province of Ontario) (adjusted OR 2.80, 95% CI 1.61-4.89) and having a chronic medical condition (adjusted OR 1.91, 95% CI 1.03-3.53).
Less than half of the homeless people in Toronto who participated in our study reported having a family doctor. Not having a family doctor was associated with key indicators of health care access and health status, including increasing duration of homelessness, lack of proof of health insurance coverage and having a chronic medical condition. Increased efforts are needed to address the barriers to appropriate health care and good health that persist in this population despite the provision of health insurance.
Notes
Cites: Arch Fam Med. 2000 Nov-Dec;9(10):1043-5111115206
Cites: JAMA. 2000 Apr 26;283(16):2152-710791509
Cites: JAMA. 2001 Jan 10;285(2):200-611176814
Cites: CMAJ. 2001 Jan 23;164(2):229-3311332321
Cites: Subst Use Misuse. 2001 May-Jun;36(6-7):807-2411697612
Cites: Am J Public Health. 2002 May;92(5):778-8411988447
Cites: Med Care. 2002 Jun;40(6):510-2012021677
Cites: Psychiatr Serv. 2002 Nov;53(11):1472-412407279
Cites: J Gen Intern Med. 2003 Nov;18(11):921-814687278
Cites: CMAJ. 2004 Apr 13;170(8):1243-715078846
Cites: JAMA. 2004 Aug 4;292(5):569-7415292082
Cites: Can Nurse. 1993 Jan;89(1):21-48425165
Cites: J Gen Intern Med. 1996 May;11(5):269-768725975
Cites: Psychiatr Serv. 1997 Mar;48(3):387-909057243
Cites: Am J Public Health. 1997 Feb;87(2):217-209103100
Cites: Addiction. 1997 Apr;92(4):437-459177065
Cites: J Gen Intern Med. 1998 Jun;13(6):389-979669568
Cites: Arch Fam Med. 1998 Jul-Aug;7(4):352-79682689
Cites: Subst Use Misuse. 1999 Mar-Apr;34(4-5):727-4610210102
Cites: Ann Fam Med. 2005 Mar-Apr;3(2):159-6615798043
Cites: Can J Public Health. 2005 Mar-Apr;96 Suppl 2:S23-916078553
Cites: J Gen Intern Med. 2006 Jan;21(1):71-716423128
Cites: Am Fam Physician. 2006 Jul 15;74(2):279-8616883925
Cites: Fam Pract. 2006 Dec;23(6):631-616799166
Cites: J Gen Intern Med. 2007 Jul;22(7):1011-717415619
Cites: Healthc Q. 2008;11(3):70-618536538
Cites: BMJ. 2009;339:b403619858533
Cites: Am J Public Health. 2010 Aug;100(8):1454-6120558789
Cites: CMAJ. 2000 Jul 25;163(2):170-110934979
Cites: Med Care. 1999 Dec;37(12):1282-9310599609
Cites: Health Serv Res. 2000 Feb;34(6):1273-30210654830
Cites: Arch Fam Med. 2000 Apr;9(4):333-810776361
Cites: Soc Psychiatry Psychiatr Epidemiol. 2000 Oct;35(10):444-5011127718
PubMed ID
21915240 View in PubMed
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Analyzing the impact of social factors on homelessness: a fuzzy cognitive map approach.

https://arctichealth.org/en/permalink/ahliterature107817
Source
BMC Med Inform Decis Mak. 2013;13:94
Publication Type
Article
Date
2013
Author
Vijay K Mago
Hilary K Morden
Charles Fritz
Tiankuang Wu
Sara Namazi
Parastoo Geranmayeh
Rakhi Chattopadhyay
Vahid Dabbaghian
Author Affiliation
The Modelling of Complex Social Systems (MoCSSy) Program, The IRMACS Centre, Simon Fraser University, Burnaby, Canada. vmago@sfu.ca.
Source
BMC Med Inform Decis Mak. 2013;13:94
Date
2013
Language
English
Publication Type
Article
Keywords
British Columbia - epidemiology
Fuzzy Logic
Geographic Mapping
Homeless Persons - psychology - statistics & numerical data
Humans
Models, Psychological
Models, Statistical
Socioeconomic Factors
Abstract
The forces which affect homelessness are complex and often interactive in nature. Social forces such as addictions, family breakdown, and mental illness are compounded by structural forces such as lack of available low-cost housing, poor economic conditions, and insufficient mental health services. Together these factors impact levels of homelessness through their dynamic relations. Historic models, which are static in nature, have only been marginally successful in capturing these relationships.
Fuzzy Logic (FL) and fuzzy cognitive maps (FCMs) are particularly suited to the modeling of complex social problems, such as homelessness, due to their inherent ability to model intricate, interactive systems often described in vague conceptual terms and then organize them into a specific, concrete form (i.e., the FCM) which can be readily understood by social scientists and others. Using FL we converted information, taken from recently published, peer reviewed articles, for a select group of factors related to homelessness and then calculated the strength of influence (weights) for pairs of factors. We then used these weighted relationships in a FCM to test the effects of increasing or decreasing individual or groups of factors. Results of these trials were explainable according to current empirical knowledge related to homelessness.
Prior graphic maps of homelessness have been of limited use due to the dynamic nature of the concepts related to homelessness. The FCM technique captures greater degrees of dynamism and complexity than static models, allowing relevant concepts to be manipulated and interacted. This, in turn, allows for a much more realistic picture of homelessness. Through network analysis of the FCM we determined that Education exerts the greatest force in the model and hence impacts the dynamism and complexity of a social problem such as homelessness.
The FCM built to model the complex social system of homelessness reasonably represented reality for the sample scenarios created. This confirmed that the model worked and that a search of peer reviewed, academic literature is a reasonable foundation upon which to build the model. Further, it was determined that the direction and strengths of relationships between concepts included in this map are a reasonable approximation of their action in reality. However, dynamic models are not without their limitations and must be acknowledged as inherently exploratory.
Notes
Cites: Am J Public Health. 2000 Dec;90(12):1939-4111111273
Cites: Am J Public Health. 2002 Feb;92(2):220-711818295
Cites: Addiction. 2003 Jul;98(7):901-1112814496
Cites: Neuropsychopharmacology. 2004 Aug;29(8):1558-7215173844
Cites: Am J Public Health. 1989 Jul;79(7):821-22660602
Cites: Int J Law Psychiatry. 1991;14(4):377-861791105
Cites: Drug Alcohol Depend. 1996 Sep;42(1):11-208889399
Cites: J Subst Abuse Treat. 1996 Jul-Aug;13(4):341-89076652
Cites: Am J Psychiatry. 1998 Feb;155(2):239-439464204
Cites: Am J Psychiatry. 1998 Aug;155(8):1092-69699699
Cites: Qual Health Res. 1999 Sep;9(5):602-1910558370
Cites: J Gerontol B Psychol Sci Soc Sci. 2005 May;60(3):S152-915860792
Cites: J Adolesc. 2005 Apr;28(2):185-9915878042
Cites: Psychiatr Serv. 2005 Jul;56(7):840-616020817
Cites: Am J Public Health. 2005 Oct;95(10):1747-5216186453
Cites: J Interpers Violence. 2006 Oct;21(10):1385-9316940403
Cites: Soc Sci Med. 2007 Feb;64(3):562-7617084952
Cites: Lancet. 2007 Jul 28;370(9584):319-2817662880
Cites: Alcohol Clin Exp Res. 2007 Sep;31(9):1545-5117635420
Cites: BMC Public Health. 2009;9:319128448
Cites: Psychiatr Serv. 2009 Apr;60(4):465-7219339321
Cites: Daedalus. 2010;139(3):8-1921032946
Cites: J Health Care Poor Underserved. 2010 Nov;21(4):1234-4921099075
Cites: Womens Health Issues. 2011 Jul-Aug;21(4 Suppl):S203-921724142
Cites: BMC Med Inform Decis Mak. 2012;12:9822947265
Cites: J Health Psychol. 2007 Sep;12(5):696-70817855456
Cites: Psychiatr Serv. 2008 Feb;59(2):170-718245159
Cites: Cochrane Database Syst Rev. 2008;(1):CD00108818253984
Cites: Obstet Gynecol. 2008 Nov;112(5):970-818978095
PubMed ID
23971944 View in PubMed
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An examination of the relationship of homelessness to mental disorder, criminal behaviour, and health care in a pretrial jail population.

https://arctichealth.org/en/permalink/ahliterature211183
Source
Can J Psychiatry. 1996 Sep;41(7):435-40
Publication Type
Article
Date
Sep-1996
Author
P A Zapf
R. Roesch
S D Hart
Author Affiliation
Simon Fraser University, Burnaby, British Columbia.
Source
Can J Psychiatry. 1996 Sep;41(7):435-40
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Crime - psychology - statistics & numerical data
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Mental Disorders - diagnosis - epidemiology - psychology
Patient Acceptance of Health Care - statistics & numerical data
Patient Care Team - utilization
Personality Assessment
Prisoners - psychology - statistics & numerical data
Psychotic Disorders - diagnosis - epidemiology - psychology
Violence - psychology - statistics & numerical data
Abstract
To examine the prevalence of homelessness and its relationship to mental disorder, criminal behaviour, and health care.
Interview and file data were collected for 790 male admissions to a large, pretrial jail facility over a 12-month period.
A significant relationship was found between homelessness and severe mental disorder as well as between homelessness and prior psychiatric history. There were no significant differences found between the homeless and the nonhomeless on the types of crimes for which they were incarcerated or on contact with health care services within the past year.
The findings indicate the need for a link between the jail and community services for homeless individuals.
Notes
Erratum In: Can J Psychiatry 1997 Mar;42(2):212
PubMed ID
8884032 View in PubMed
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The association between homelessness and suicidal ideation and behaviors: results of a cross-sectional survey.

https://arctichealth.org/en/permalink/ahliterature187229
Source
Suicide Life Threat Behav. 2002;32(4):418-27
Publication Type
Article
Date
2002
Author
Rahel Eynan
John Langley
George Tolomiczenko
Anne E Rhodes
Paul Links
Donald Wasylenki
Paula Goering
Author Affiliation
St. Michael's Hospital, Toronto, Ontario, Canada. eynanr@smh.toronto.on.ca
Source
Suicide Life Threat Behav. 2002;32(4):418-27
Date
2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Cross-Sectional Studies
Female
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Mental Disorders - epidemiology - prevention & control
Middle Aged
Ontario - epidemiology
Risk
Sex Factors
Suicide - prevention & control - psychology - statistics & numerical data
Suicide, Attempted - prevention & control - psychology - statistics & numerical data
Abstract
This study was carried out with three goals: (1) to determine the prevalence of suicidal ideation and suicide attempts among the homeless; (2) to determine what aspects of homelessness predict suicidality, and (3) to determine which aspects remain predictive after controlling for key covariates, such as mental illness. A sample of 330 homeless adults were interviewed. Sixty-one percent of the study sample reported suicidal ideation and 34% had attempted suicide. Fifty-six percent of the men and 78% of the women reported prior suicidal ideation, while 28 percent of the men and 57% of the women had attempted suicide. Childhood homelessness of at least 1 week without family members and periods of homelessness longer than 6 months were found to be associated with suicidal ideation. Psychiatric diagnoses were also associated with suicidality in this sample.
PubMed ID
12501966 View in PubMed
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Collaborative mental health care for the homeless: the role of psychiatry in positive housing and mental health outcomes.

https://arctichealth.org/en/permalink/ahliterature158705
Source
Can J Psychiatry. 2008 Jan;53(1):61-7
Publication Type
Article
Date
Jan-2008
Author
Vicky Stergiopoulos
Carolyn S Dewa
Katherine Rouleau
Shawn Yoder
Nancy Chau
Author Affiliation
St Michael's Hospital, Toronto, Ontario. stergiopoulosv@smh.toronto.on.ca
Source
Can J Psychiatry. 2008 Jan;53(1):61-7
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Mental Disorders - epidemiology - therapy
Mental Health Services - utilization
Middle Aged
Patient Compliance - statistics & numerical data
Public Housing - statistics & numerical data
Treatment Outcome
Abstract
Factors associated with positive outcomes for homeless men referred to a shelter-based collaborative mental health care team were examined.
A chart review of 73 clients referred over 12 months was completed. Two outcome measures were examined, clinical status and housing status, 6 months after their referral to the program.
Among the referred clients, the prevalence of severe and persistent mental illness and substance use disorders was 76.5% and 48.5%, respectively. At 6 months, 24 clients (35.3%) had improved clinically, and 33 (48.5%) were housed. Logistic regression identified 2 factors associated with clinical improvement: the number of visits with a psychiatrist and treatment adherence. The same 2 factors were associated with higher odds of housing, and presence of substance use disorder was associated with lower odds of housing at 6-month follow-up.
Care by a mental health specialist is positively associated with improved outcomes. Strategies to improve treatment adherence, access to mental health specialists, and innovative approaches to treatment of substance use disorders should be considered for this population. Having a psychiatrist as a member of a shelter-based collaborative care team is one possible way of addressing the complex physical and mental health needs of homeless individuals.
PubMed ID
18286873 View in PubMed
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Comparing the housing trajectories of different classes within a diverse homeless population.

https://arctichealth.org/en/permalink/ahliterature134643
Source
Am J Community Psychol. 2012 Mar;49(1-2):142-55
Publication Type
Article
Date
Mar-2012
Author
Tim Aubry
Fran Klodawsky
Daniel Coulombe
Author Affiliation
School of Psychology & Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, K1N 6N5, Canada. taubry@uottawa.ca
Source
Am J Community Psychol. 2012 Mar;49(1-2):142-55
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada
Female
Health status
Homeless Persons - psychology - statistics & numerical data
Housing - statistics & numerical data
Humans
Longitudinal Studies
Male
Mental disorders
Middle Aged
Substance-Related Disorders
Abstract
The paper presents findings from a longitudinal study identifying different classes of homeless individuals in a mid-size Canadian city based on health-related characteristics and comparing the housing trajectories of these classes 2 years later. Using data collected through in-person interviews with a sample of 329 single persons who have experienced homelessness, the paper presents results of a latent class analysis. Results found four distinct latent classes characterized by different levels of severity of health problems--i.e., a class of individuals who are "Higher Functioning" (28.7%), a second class with "Substance Abuse Problems" (27.1%), a third class with "Mental Health Substance Abuse Problems" (22.6%), and a fourth class with "Complex Physical and Mental Health Problems" (21.6%) that included having diminished physical functioning, multiple chronic physical health conditions, mental health difficulties, and in some cases substance abuse problems. Follow-up interviews with 197 of these individuals (59.9%) 2 years later showed the class of individuals with substance abuse problems experiencing the greatest difficulty in exiting homelessness and achieving housing stability. Implications of these findings for social policy development and program planning are discussed.
PubMed ID
21557093 View in PubMed
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Copenhagen Community Psychiatric Project (CCPP): characteristics and treatment of homeless patients in the psychiatric services after introduction of community mental health centres.

https://arctichealth.org/en/permalink/ahliterature10955
Source
Soc Psychiatry Psychiatr Epidemiol. 1997 Oct;32(7):369-78
Publication Type
Article
Date
Oct-1997
Author
M. Nordentoft
H C Knudsen
B. Jessen-Petersen
A. Krasnik
H. Saelan
A M Brodersen
P. Treufeldt
P. Løppenthin
I. Sahl
P. Ostergård
Author Affiliation
Psychiatric Department E, Bispebjerg Hospital, Copenhagen NV, Denmark.
Source
Soc Psychiatry Psychiatr Epidemiol. 1997 Oct;32(7):369-78
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Community Mental Health Centers - trends
Comorbidity
Cross-Sectional Studies
Day Care - trends
Denmark - epidemiology
Diagnosis, Dual (Psychiatry)
Female
Forecasting
Health Services Accessibility - trends
Health Services Needs and Demand - trends
Homeless Persons - psychology - statistics & numerical data
Humans
Incidence
Male
Medical Indigency - trends
Middle Aged
Research Support, Non-U.S. Gov't
Schizophrenia - epidemiology - rehabilitation
Substance-Related Disorders - epidemiology - rehabilitation
Urban Population - statistics & numerical data
Abstract
The main purpose of the study was to describe the characteristics of homeless psychiatric patients, and to compare the treatment they are offered to that offered to domiciled patients by the psychiatric services. Another purpose was to analyse the prevalence of homelessness among psychiatric patients before and after the introduction of community mental health centres in Copenhagen. Cross-sectional studies were conducted in two intervention and two control districts before and after introduction of the new treatment modalities. In 1991, 80 of 1008 patients (8%) were homeless. Male sex, young age, living on general welfare, schizophrenia and alcohol or substance abuse were the factors that most markedly differentiated homeless from domiciled patients. Compared with the treatment of domiciled patients, the homeless were more likely to be offered no further treatment after consultation in a psychiatric emergency and, if admitted, they were more likely to be placed in locked wards, given compulsory medication, and medicated with depot neuroleptics. The homeless were also less likely to be offered psychotherapy and consultation with a social worker. Schizophrenia and alcohol or substance abuse characterised the majority of the patients discharged homeless. In the intervention districts, the number of homeless patients in contact with the psychiatric services was found to increase at the same rate as the number of all patients in contact with the psychiatric services. In the control districts, no changes in prevalence of homeless patients or other patients in contact with the psychiatric services occurred. It is concluded that homeless psychiatric patients comprise a difficult patient group, with problems of schizophrenia, substance abuse and lack of motivation for treatment. It is recommended that special efforts be made to create housing facilities that fit the needs of different types of homeless patients, and that the homeless mentally ill are assisted in obtaining and maintaining an acceptable housing situation.
PubMed ID
9383967 View in PubMed
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Daily substance use and mental health symptoms among a cohort of homeless adults in Vancouver, British Columbia.

https://arctichealth.org/en/permalink/ahliterature119460
Source
J Urban Health. 2013 Aug;90(4):740-6
Publication Type
Article
Date
Aug-2013
Author
Anita Palepu
Michelle Patterson
Verena Strehlau
Akm Moniruzzamen
Jason Tan de Bibiana
James Frankish
Michael Krausz
Julian Somers
Author Affiliation
Centre for Health Evaluation and Outcome Sciences, Department of Medicine, University of British Columbia, 588B-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. anita@hivnet.ubc.ca
Source
J Urban Health. 2013 Aug;90(4):740-6
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
British Columbia - epidemiology
Female
Homeless Persons - psychology - statistics & numerical data
Humans
Linear Models
Male
Mental Disorders - epidemiology - psychology
Middle Aged
Psychiatric Status Rating Scales
Sex Factors
Substance-Related Disorders - epidemiology - psychology
Young Adult
Abstract
Substance use can be a barrier to stable housing for homeless persons with mental disorders. We examined DSM-IV symptoms among homeless adults (N?=?497), comparing those who reported daily substance use (DSU) with non-daily substance users. Multivariable linear regression modeling was used to test the independent association between DSU and symptoms using the Colorado Symptom Index total score. DSU was independently associated with higher symptoms (beta?=?3.67, 95 % CI 1.55-5.77) adjusting for homelessness history, age, gender, ethnicity, education, marital status, and mental disorder sub-type (adjusted R (2)?=?0.24). We observed a higher prevalence of DSU in our sample than has been previously reported in a Housing First intervention. DSU was also independently associated with more DSM-IV symptomatology. We have an opportunity to observe this cohort longitudinally and examine if there are changes in substance use based on treatment assignment and commensurate changes in housing stability, community integration, health status, and quality of life.
Notes
Cites: Addict Behav. 1982;7(3):231-427180617
Cites: Scand J Public Health. 2011 Mar;39(2):121-721247970
Cites: Addiction. 1998 Dec;93(12):1857-679926574
Cites: J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-579881538
Cites: Womens Health Issues. 2011 Sep-Oct;21(5):383-921703865
Cites: Addiction. 2003 Jul;98(7):901-1112814496
Cites: Milbank Q. 2009 Jun;87(2):495-53419523126
Cites: PLoS One. 2010;5(7):e1169720657732
Cites: J Subst Abuse Treat. 2000 Dec;19(4):395-40111166504
Cites: Ment Health Serv Res. 2001 Sep;3(3):141-5311718206
Cites: JAMA. 2009 Apr 1;301(13):1349-5719336710
PubMed ID
23099626 View in PubMed
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Developing and testing an intervention to prevent homelessness among individuals discharged from psychiatric wards to shelters and 'No Fixed Address'.

https://arctichealth.org/en/permalink/ahliterature155328
Source
J Psychiatr Ment Health Nurs. 2008 Sep;15(7):569-75
Publication Type
Article
Date
Sep-2008
Author
C. Forchuk
S K MacClure
M. Van Beers
C. Smith
R. Csiernik
J. Hoch
E. Jensen
Author Affiliation
Faculty of Health Sciences, University of Western Ontario, London, ON, Canada. cforchuk@uwo.ca
Source
J Psychiatr Ment Health Nurs. 2008 Sep;15(7):569-75
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aftercare - organization & administration
Attitude to Health
Chi-Square Distribution
Community Mental Health Services - organization & administration
Female
Follow-Up Studies
Homeless Persons - psychology - statistics & numerical data
Hospitals, Psychiatric
Humans
Male
Mental Disorders - psychology - rehabilitation
Middle Aged
Ontario
Patient Discharge
Pilot Projects
Program Development
Program Evaluation
Public Housing
Questionnaires
Social Support
Vulnerable Populations
Abstract
Shelter data in a recent study revealed discharges from psychiatric facilities to shelters or the street occurred at least 194 times in 2002 in London, Ontario, Canada. This problem must be addressed to reduce the disastrous effects of such discharge, including re-hospitalization and prolonged homelessness. An intervention was developed and tested to prevent homelessness associated with discharge directly to no fixed address. A total of 14 participants at-risk of being discharged without housing were enrolled, with half randomized into the intervention group. The intervention group was provided with immediate assistance in accessing housing and assistance in paying their first and last month's rent. The control group received usual care. Data was collected from participants prior to discharge, at 31 and 6-months post-discharge. All the individuals in the intervention group maintained housing after 3 and 6 months. All but one individual in the control group remained homeless after 3 and 6 months. The exception joined the sex trade to avoid homelessness. The results of this pilot were so dramatic that randomizing to the control group was discontinued. Discussions are underway to routinely implement the intervention. Systemic improvements can prevent homelessness for individuals being discharged from psychiatric wards.
PubMed ID
18768009 View in PubMed
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48 records – page 1 of 5.