Preventing Psychiatric Discharge to Homelessness
Publication: Canadian Journal of Community Mental Health
29 October 2013
Abstract
The present study assessed the effects of an intervention that was designed to provide on-site, predischarge housing assistance for psychiatric clients. Participants included clients from acute (n = 219) and tertiary (n = 32) care hospital sites. Data were collected from hospital and shelter databases. Results revealed that in the majority of cases, the intervention reduced the number of individuals discharged to homelessness or no fixed address. In addition, the costs of implementing and maintaining the intervention were less than the increased medical costs associated with homelessness and housing individuals in shelters.
Résumé
La présente étude a évalué les effets d'une intervention qui a été conçu pour fournir aux clients et clientes psychiatriques de l'aide au logement sur-place avant le congé. Les participants et participantes comprenaient des clients et clientes des sites hospitaliers de soins actifs (n = 219) et de soins tertiaires (n = 32). Les données ont été recueillies des bases de données des hôpitaux et des abris. Les résultats ont révélé que dans la majorité des cas, l'intervention a réduit le nombre d'individus rejetés dans le sans-abrisme ou sans domicile fixe. En outre, les coûts de la mise en oeuvre et du maintien de l'intervention étaient moins que l'augmentation des coûts médicaux liés aux personnes sans-abri et au logement dans les abris.
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References
Backer T. E., Howard E. A., and Moran G. E. The role of effective discharge planning in preventing homelessness Journal of Primary Prevention 2007 28 229 -243
Benbow S. Societal abuse in the lives of individuals with mental illness Canadian Nurse 2009 105 30 -32
Bonin J., Fournier L., and Blais R. Predictors of mental health service utilization by people using resources for homeless people in Canada Psychiatric Services 2007 58 7 936 -941
Bonin J., Fournier L., and Blais R. A typology of mentally disordered users of resources for homeless people: Towards better planning of mental health services Administration and Policy in Mental Health and Mental Health Services Research 2009 36 4 223 -235
Carling P. J. Housing and supports for persons with mental illness: Emerging approaches to research and practice Hospital and Community Psychiatry 1993 44 439 -449
Chilvers R., Macdonald G. M., and Hayes A. A. Supported housing for people with severe mental disorders Cochrane Database of Systematic Reviews, Issue 4 2006 CD 000453 Art. No.:
Draine J., Salzer M., Culhane D., and Hadley T. Role of social disadvantage in crime, joblessness and homelessness among persons with serious mental illness Psychiatric Services 2002 53 565 -573
Drake R. E. and Wallach M. A. Homelessness and mental illness: A story of failure Psychiatric Services 1999 50 589
Drury L. From homeless to housed: Caring for people in transition Journal of Community Health Nursing 2008 25 2 91 -105
Eynan R., Langley J., Tolomiczenko G., Rhodes A. E., Links P., Wasylenki D., and Goering P. The association between homelessness and suicidal ideation and behaviours: Results of a cross-sectional survey Suicide and Life-Threatening Behavior 2002 32 418 -427
Fischer S. N., Shinn M., Shrout P., and Tsemberis S. Homelessness, mental illness, and criminal activity: Examining patterns over time American Journal of Community Psychology 2008 42 3-4 251 -265
Forchuk C. Some psychiatric survivors can't survive the system Canadian Nurse 2008 104 4
Forchuk C., Brown S., Schofield R., and Jensen E. Perceptions of health and health service utilization among homeless and housed psychiatric consumer/survivors Journal of Psychiatric & Mental Health Nursing 2008 15 399 -407
Forchuk C., Joplin L., Schofield R., Csiernik R., Gorlick C., and Turner K. Housing, income support and mental health: Points of disconnection Health Research Policy Systems 2007 5 14
Forchuk C., MacClure S. K., Van Beers M., Smith C., Csiernik R., Hoch J., and Jensen E. Developing and testing an intervention to prevent homelessness among individuals discharged from psychiatric wards to shelters and “No Fixed Address.” Journal of Psychiatric and Mental Health Nursing 2008 15 7 569 -75
Forchuk C., Nelson G., and Hall G. B. “It's important to be proud of the place you live in”: Housing problems and preferences of psychiatric survivors Perspectives in Psychiatric Care 2006 42 42 -52
Forchuk C., Russell G., Kingston-MacClure S., Turner K., and Dill S. From psychiatric ward to the streets and shelters Journal of Psychiatric and Mental Health Nursing 2006 13 3 301 -308
Forchuk C., Ward-Griffin C., Csiernik R., and Turner K. Surviving the tornado: Psychiatric survivor experiences of getting, losing and keeping housing Psychiatric Services 2006 57 558 -62
Goering P., Tolomiczenko G., Sheldon T., Boydell K., and Wasylenki D. Characteristics of persons who are homeless for the first time Psychiatric Services 2002 53 1472 -1474
Goldfinger S. M., Schutt R. K., Tolomiczenko G. S., Seidman L., Penk W. E., Turner W., and Caplan B. Housing placement and subsequent days homeless among formerly homeless adults with mental illness Psychiatric Services 1999 50 674 -679
Hunt I. M., Kapur N., Webb R., Robinson J., Burns J., Shaw J., and Appleby L. Suicide in recently discharged psychiatric patients: A case-control study Psychological Medicine 2009 39 443 -449
Institute of Health Economics. (2010). The cost of mental health and substance abuse services in Canada. Retrieved fromhttp://www.ihe.ca/publications/library/2010/the-cost-of-mental-health-and-substance-abuse-services-in-canada/
Kertesz S. G. and Weiner S. J. Housing the chronically homeless: High hopes, complex realities Journal of the American Medical Association 2009 301 1822 -1824
Kirkpatrick H. and Byrne C. A narrative inquiry: Moving on from homelessness for individuals with a major mental illness Journal of Psychiatric and Mental Health Nursing 2009 16 68 -75
Koegel, P., Burnam, M. A., & Baumohl, J. (1996). The causes of homelessness. In J. Baumohl (Ed.), Homelessness in America (pp. 24-34). Phoenix, Arizona: Oryx.
Kuno E., Rothbard A. B., Avery J., and Culhane D. Homelessness among persons with serious mental illness in an enhanced community-based mental health system Psychiatric Services 2000 51 1012 -1016
Kyle T. and Dunn J. Effects of housing circumstances on health, quality of life and healthcare use for people with severe mental illness: A review Health and Social Care in the Community 2008 16 1 -15
Lauber C., Lay B., and Rossler W. Homeless people at disadvantage in mental health services European Archives of Psychiatry and Clinical Neuroscience 2006 256 138 -145
Lennon M. C., McAllister W., Kuang L., and Herman D. B. Capturing intervention effects over time: Reanalysis of a critical time intervention for homeless mentally ill men American Journal of Public Health 2005 95 760 -766
London Ontario Community and Protective Services Committee Meeting. (2008). Provincial increase to maximum per diem rate for emergency shelters. Retrieved from: http://council.london.ca/meetings/Archives/Agendas/Community%20and%20Protective%20Services%20Agendas/CPSC%20Agendas%202008/2008-11-10%20Agenda/Item%207.pdf
McChesney K. Y. Family homelessness: A systematic problem Journal of Social Issues 1990 46 191 -205
Mojtabai R. Perceived reasons for loss of housing and continued homelessness among homeless persons with mental illness Psychiatric Services 2005 56 172 -178
Morrell-Bellai T., Goering P. N., and Boydell K. M. Becoming and remaining homeless: A qualitative investigation Issues in Mental Health Nursing 2000 21 6 581 -604
Nelson G., Aubry T., and LaFrance A. A review of the literature on the effectiveness of housing and support, assertive community treatment and intensive case management interventions for persons with mental illness who have been homeless American Journal of Orthopsychiatry 2007 77 350 -361
Nelson G., Clarke J., Febbraro A., and Hatzipantelis M. A narrative approach to the evaluation of supportive housing: Stories of homeless people who have experienced serious mental illness Psychiatric Rehabilitation Journal 2005 29 2 98 -104
O'Connell J. J. Dying in the shadows: The challenge of providing health care for homeless people Canadian Medical Association Journal 2004 170 1251 -1252
O'Toole T. P., Gibbon J. L., Hanusa B. H., and Fine M. J. Utilization of health care services among subgroups of urban homeless and housed poor, Journal of Health Politics Policy and Law 1999 24 91 -114
Padgett D. K., Gulcur L., and Tsemberis S. Housing First services for people who are homeless with co-occurring serious mental illness and substance abuse Research on Social Work Practice 2006 16 74 -83
Padgett D., Stanhope V., Henwood B., and Stefancic A. Substance use outcomes among homeless clients with serious mental illness: Comparing Housing First with Treatment First programs Community Mental Health Journal 2011 47 227 -32
Pearson C., Montgomery A. E., and Locke G. Housing stability among homeless individuals with serious mental illness participating in Housing First programs Journal of Community Psychology 2009 37 404 -417
Piat M., Lesage A., Boyer R., Dorvil H., Couture A., Grenier G., and Bloom D. Housing for persons with serious mental illness: Consumer and service provider preferences Psychiatric Services 2008 59 1011 -1017
Robertson, M. (1992). The prevalence of mental disorder among homeless people. In R. Jahiel (Ed.), Homelessness: A prevention-oriented approach (pp. 57-87). Baltimore, MD: Johns Hopkins University Press.
Shern D. L., Felton C. J., Hough R. L., Lehman A. F., Goldfinger S., Valencia E., and Wood P. A. Housing outcomes for homeless adults with mental illness: Results from the second-round McKinney program Psychiatric Services 1997 48 239 -241
Stein J. A. and Gelberg L. Comparability and representativeness of clinical homeless, community homeless, and domiciled clinic samples: Physical and mental health, substance use, and health services utilization Health Psychology 1997 16 155 -162
Steinhaus D. A., Harley D. A., and Rogers J. Homelessness and people with affective disorders and other mental illnesses Journal of Applied Rehabilitation Counseling 2004 35 36 -40
Sullivan G., Burnam K. P., and Koegel P. Pathways to homelessness among the mentally ill Social Psychiatry Psychiatric Epidemiology 2000 35 444 -450
Tsai J., Bond G. R., Salyers M. P., Godfrey J. L., and Davis K. E. Housing preferences and choices among adults with mental illness and substance use disorders: A qualitative study Community Mental Health Journal 2010 46 381 -388
Tsemberis S. and Eisenberg R. F. Pathways to housing: Supported housing for street dwelling homeless individuals with psychiatric disabilities Psychiatric Services 2000 51 487 -493
Weinreb L., Goldberg R., and Perloff J. Health characteristics and medical service use patterns of sheltered homeless and low-income housed mothers Journal of General Internal Medicine 1998 13 389 -397
Wilton R. Putting policy into practice? Poverty and people with serious mental illness Social Science and Medicine 2004 58 25 -39
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Canadian Journal of Community Mental Health
Volume 32 • Number 3 • September 2013
Pages: 17 - 28
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Version of record online: 29 October 2013
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ForchukCheryl, GodinMike, HochJeffrey S., Kingston-MacClureShani, Jeng (Mo)Momodou S., PuddyLiz, VannRebecca, and JensenElsabeth. 2013. Preventing Psychiatric Discharge to Homelessness. Canadian Journal of Community Mental Health.
32(3): 17-28. https://doi.org/10.7870/cjcmh-2013-028
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