Homeless HIV+ persons with persistent mental illness and substance use disorders need services, but are hard to reach and enrol into treatment. Connecting them to services is a major challenge of the AIDS epidemic. This report describes characteristics of homeless HIV+ substance abusers who responded to outreach and enrolled in integrated treatment services. The target population was urban, homeless, HIV+ individuals with substance dependence and/or mental illness diagnoses. Health and physical functioning were measured using a refinement of the Medical Outcomes Study Health Survey. Questions based on the PRIME-MD measured subjects’ mental health status. Outreach occurred at shelters, soup kitchens, and on the streets. The outreach team consisted of a nurse, substance abuse counsellor, and a formerly homeless person. Outreach contacted 3,059 individuals; 1,446 entered the clinic, 110 of 206 eligible candidates enrolled in the study, and 82.7% of study participants completed 12-month follow-up interviews. Enrolees exhibited 5th percentile composite health scores. They reported heavy street drug use and unmet service needs particularly for housing and financial assistance. Outreach successfully recruited targeted individuals into treatment. They stayed in treatment and demonstrated improvements on measures of physical and mental health 12-months later.
Homeless HIV+ persons with persistent mental illness and substance use disorders need services, but are hard to reach and enrol into treatment. Connecting them to services is a major challenge of the AIDS epidemic. This report describes characteristics of homeless HIV+ substance abusers who responded to outreach and enrolled in integrated treatment services. The target population was urban, homeless, HIV+ individuals with substance dependence and/or mental illness diagnoses. Health and physical functioning were measured using a refinement of the Medical Outcomes Study Health Survey. Questions based on the PRIME-MD measured subjects’ mental health status. Outreach occurred at shelters, soup kitchens, and on the streets. The outreach team consisted of a nurse, substance abuse counsellor, and a formerly homeless person. Outreach contacted 3,059 individuals; 1,446 entered the clinic, 110 of 206 eligible candidates enrolled in the study, and 82.7% of study participants completed 12-month follow-up interviews. Enrolees exhibited 5th percentile composite health scores. They reported heavy street drug use and unmet service needs particularly for housing and financial assistance. Outreach successfully recruited targeted individuals into treatment. They stayed in treatment and demonstrated improvements on measures of physical and mental health 12-months later.
Subject terms:
HIV AIDS, homeless people, mental health problems, outreach services, substance misuse, unmet need, urban areas, community health care;
Mental Health Review, 3(3), September 1998, pp.30-32.
Publisher:
Pier Professional
Describes the work of HART (Homeless Assessment and Resettlement Team), which was set up in 1994 to provide a health and social care service to people in the London Borough of Hackney, who were both homeless and mentally ill and whose needs were not being met by existing services.
Describes the work of HART (Homeless Assessment and Resettlement Team), which was set up in 1994 to provide a health and social care service to people in the London Borough of Hackney, who were both homeless and mentally ill and whose needs were not being met by existing services.
Subject terms:
homeless people, homelessness, interagency cooperation, mental health problems, mental health services, needs, social care provision, urban areas;
British Journal of Psychiatry, 173, November 1998, pp.376-384.
Publisher:
Cambridge University Press
Best available evidence from public records, interviews, case notes, keyworkers and general practitioners were assembled to establish: which subjects initially identified as having psychotic illnesses had died; care currently received by subjects originally selected for interview; and rates of major adverse events and of admission for these individuals. Concludes that rates of adverse events and 'slipping through the net' are relatively low among individuals receiving community-based services, whether intensive or standard care.
Best available evidence from public records, interviews, case notes, keyworkers and general practitioners were assembled to establish: which subjects initially identified as having psychotic illnesses had died; care currently received by subjects originally selected for interview; and rates of major adverse events and of admission for these individuals. Concludes that rates of adverse events and 'slipping through the net' are relatively low among individuals receiving community-based services, whether intensive or standard care.
Subject terms:
homeless people, homelessness, mental health problems, severe mental health problems, social policy, suicide, unmet need, urban areas, violence, black and minority ethnic people, community care, community mental health services, death, evaluation;
immigrants, homeless people, homelessness, housing, inner cities, learning disabilities, legal aid, local authorities, local government, local government finance, mental health problems, NHS, mothers, offenders, older people, physical disabilities, probation, poverty, pre-school children, punishment, social services, social work, social care provision, urban areas, welfare state, young people, after care, alcohol misuse, benefits, central government, children, community health care, drug misuse, education, employment, family planning, financing, Gypsies, health care;