Abstract
BackgroundAlthough a growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. This quasi-experimental study compared the outcomes of two shelter-based collaborative mental health care models for men experiencing homelessness and mental illness: (1) an integrated multidisciplinary collaborative care (IMCC) model and (2) a less resource intensive shifted outpatient collaborative care (SOCC) model.MethodsIn total 142 participants, 70 from IMCC and 72 from SOCC were enrolled and followed for 12 months. Outcome measures included community functioning, residential stability, and health service use. Multivariate regression models were used to compare study arms with respect to change in community functioning, residential stability, and health service use outcomes over time and to identify baseline demographic, clinical or homelessness variables associated with observed changes in these domains.ResultsWe observed improvements in both programs over time on measures of community functioning, residential stability, hospitalizations, emergency department visits and community physician visits, with no significant differences between groups over time on these outcome measures.ConclusionsOur findings suggest that shelter-based collaborative mental health care models may be effective for individuals experiencing homelessness and mental illness. Future studies should seek to confirm these findings and examine the cost effectiveness of collaborative care models for this population.
Highlights
A growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations
142 male participants were recruited to the study: 70 from the integrated multidisciplinary collaborative care (IMCC) program, and 72 from shifted outpatient collaborative care (SOCC) program
There was no evidence that receiving less resource intensive SOCC compared to IMCC services was associated with significantly different outcomes over the study period in terms of residential stability or health service use
Summary
A growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. Individuals facing homelessness experience chronic medical conditions [7, 8], neurocognitive impairment [9, 10], and have higher mortality rates than people who are housed [11,12,13]. They face several barriers to accessing health services and appropriate disease management [11, 14, 15], and often rely on emergency department visits or inpatient hospitalizations for their health care [16,17,18,19]
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