Taking it to the Street: A Psychiatric Outreach Service in Canada

Farrell, Susan; Huff, James L.; Middlebro, Alison; Walsh, Russ

doi:10.1007/s10597-005-6430-7

Cited by 18 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Engagement in primary care reduced the likelihood of reporting unmet physical health care need but was not associated with a decreased likelihood of unmet mental health care need. The development and evaluation of efficacious models for delivering concurrent treatment services (for addiction and mental illness) that are accessible to the homeless population are urgently needed [46].…”

Section: Discussionmentioning

confidence: 99%

Substance Use and Access to Health Care and Addiction Treatment among Homeless and Vulnerably Housed Persons in Three Canadian Cities

et al. 2013

View full text Add to dashboard Cite

IntroductionWe examined the prevalence of substance use disorders among homeless and vulnerably housed persons in three Canadian cities and its association with unmet health care needs and access to addiction treatment using baseline data from the Health and Housing in Transition Study.MethodsIn 2009, 1191 homeless and vulnerably housed persons were recruited in Vancouver, Toronto, and Ottawa, Canada. Interviewer administered questionnaires collected data on socio-demographics, housing history, chronic health conditions, mental health diagnoses, problematic drug use (DAST-10≥6), problematic alcohol use (AUDIT≥20), unmet physical and mental health care needs, addiction treatment in the past 12 months. Three multiple logistic regression models were fit to examine the independent association of substance use with unmet physical health care need, unmet mental health care need, and addiction treatment.ResultsSubstance use was highly prevalent, with over half (53%) screening positive for the DAST-10 and 38% screening positive for the AUDIT. Problematic drug use was 29%, problematic alcohol use was lower at 16% and 7% had both problematic drug and alcohol use. In multiple regression models for unmet need, we found that problematic drug use was independently associated with unmet physical (adjusted odds ratio [AOR] 1.95; 95% confidence interval [CI] 1.43–2.64) and unmet mental (AOR 3.06; 95% CI 2.17–4.30) health care needs. Problematic alcohol use was not associated with unmet health care needs. Among those with problematic substance use, problematic drug use was associated with a greater likelihood of accessing addiction treatment compared to those with problematic alcohol use alone (AOR 2.32; 95% CI 1.18–4.54).ConclusionsProblematic drug use among homeless and vulnerably housed individuals was associated with having unmet health care needs and accessing addiction treatment. Strategies to provide comprehensive health services including addiction treatment should be developed and integrated within community supported models of care.

show abstract

Section: Discussionmentioning

confidence: 99%

Substance Use and Access to Health Care and Addiction Treatment among Homeless and Vulnerably Housed Persons in Three Canadian Cities

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Many homeless women experience barriers to accessing the health care system (Gelberg, Browner, Lejano, & Arangua, 2004;Lewis, Andersen, & Gelberg, 2003;Lim, Andersen, Leake, Cunningham, & Gelberg, 2002), and among women with children, prioritization of their children's needs, fear of losing custody of their children, and meeting basic family needs may function as additional deterrents for seeking mental health care (Tam, Zlotnick, & Bradley, 2008;Weinreb, Nicholson, Williams, & Anthes, 2007). The use of alternative models of care -for example, the psychiatric outreach model described by Farrell et al (2005), which offers flexible, open-ended outreach services to individuals considered "hard to serve" -may help reduce some of these barriers to accessing care and ensure improved access to mental health care services among this population.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Poor Mental Health Status Among Homeless Women With and Without Dependent Children

Chambers

Chiu

Scott

et al. 2013

Community Ment Health J

View full text Add to dashboard Cite

The purpose of this study was to estimate the prevalence of mental health problems among a representative sample of homeless women with and without dependent children and determine if the effects of risk factors for mental health are modified by the presence of dependent children. Homeless women (n=522) were recruited in 2004-2005 from shelters and meal programs in Toronto, Canada. Linear and logistic regression was performed to identify factors associated with mental health status. Poor mental health was associated with low perceived access to social support, physical/sexual assault in the past 12 months, presence of a chronic health condition, and presence of a drug use problem in the past month. Efforts to improve mental health in this population will need to address the associated problems of victimization, substance abuse, and lack of social supports.

show abstract

“…These features appear to be uncommon in street outreach programmes (Farrell et al . ). In some ways, MDOT is similar to ACT, but it lacks critical features such as a shared caseload and out of hours accessibility.…”

Section: Discussionmentioning

confidence: 97%

“…While it is essentially an intensive case management programme, it is also multidisciplinary, with nursing and psychiatric expertise. These features appear to be uncommon in street outreach programmes (Farrell et al 2005). In some ways, MDOT is similar to ACT, but it lacks critical features such as a shared caseload and out of hours accessibility.…”

Section: What the Study Adds To The International Evidencementioning

confidence: 99%

Housing outcomes and predictors of success: the role of hospitalization in street outreach

Lettner

Doan

Miettinen³

2016

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

Multidisciplinary street outreach teams successfully house long-standing homeless clients (>12 months without a permanent address) with serious mental illness and/or substance abuse. Hospitalization can be utilized as a complimentary intervention, particularly for those with psychosis, in the continuum of housing first initiatives, and can contribute to securing housing for those with persistent psychotic disorders. Implications for nursing practice Community mental health nurses are uniquely positioned to translate care between hospital and community settings, ensuring timely assessment, intervention and treatment of clients who are historically difficult to engage.

show abstract

Taking it to the Street: A Psychiatric Outreach Service in Canada

Cited by 18 publications

References 19 publications

Substance Use and Access to Health Care and Addiction Treatment among Homeless and Vulnerably Housed Persons in Three Canadian Cities

Substance Use and Access to Health Care and Addiction Treatment among Homeless and Vulnerably Housed Persons in Three Canadian Cities

Factors Associated with Poor Mental Health Status Among Homeless Women With and Without Dependent Children

Housing outcomes and predictors of success: the role of hospitalization in street outreach

Contact Info

Product

Resources

About