Community Mental Health Journal, 41(6), December 2005, pp.737-746.
Publisher:
Springer
This paper describes a model of flexible psychiatric outreach service in Canada designed to meet the needs of persons who are homeless or marginally housed and have mental illness. The activities of the Psychiatric Outreach Team of the Royal Ottawa Hospital for individual clients and the community agencies who serve them are profiled, followed by a demographic and mental and physical health profile of the clients seen in the past year. The differences from other models of service and the benefits and limitations of this unique multidisciplinary team are discussed, with implications for future service development for this vulnerable population.
This paper describes a model of flexible psychiatric outreach service in Canada designed to meet the needs of persons who are homeless or marginally housed and have mental illness. The activities of the Psychiatric Outreach Team of the Royal Ottawa Hospital for individual clients and the community agencies who serve them are profiled, followed by a demographic and mental and physical health profile of the clients seen in the past year. The differences from other models of service and the benefits and limitations of this unique multidisciplinary team are discussed, with implications for future service development for this vulnerable population.
Subject terms:
homeless people, homelessness, mental health problems, models, outreach services, teams, community mental health services;
ANDVIG Ellen Sofie, SAELOR Knut Tore, OGUNDIPE Esther
Journal article citation:
Advances in Dual Diagnosis, 11(1), 2018, pp.4-15.
Publisher:
Emerald
Purpose: Little is known about how harm reduction is practiced in Norwegian housing first (HF) projects. The purpose of this paper is to explore, describe, and interpret how providers apply a harm reduction approach within a housing project focused on individuals who are homeless with co-morbid substance use and mental health problems. Design/methodology/approach: This qualitative study was part of a larger evaluation study of a three-year HF project in a Norwegian municipality. Data were collected using four multi-stage focus groups with five providers working in the HF project. Focus group interviews were transcribed verbatim and analysed using thematic analysis. Findings: Analysis resulted in three main themes: “Letting the service user sit in the driver’s seat,” “We don’t follow service provision contracts, we do everything,” and “Collaborating with the local community.” Research limitations/implications: There is a need to develop increased knowledge about service users’ experiences within the harm reduction approach. Practical implications: To practice effective harm reduction, treatment providers must have open authorisations and the opportunity to exercise professional judgement. Harm reduction practice must also focus on social, political, and economic factors influencing users’ everyday lives. Originality/value: The paper contributes to the knowledge base on harm reduction within HF practice that differs from a traditional model wherein clients are expected to abstain from substance use. It highlights important preconditions for challenges practitioners might encounter at both individual and service system levels.
(Publisher abstract)
Purpose: Little is known about how harm reduction is practiced in Norwegian housing first (HF) projects. The purpose of this paper is to explore, describe, and interpret how providers apply a harm reduction approach within a housing project focused on individuals who are homeless with co-morbid substance use and mental health problems. Design/methodology/approach: This qualitative study was part of a larger evaluation study of a three-year HF project in a Norwegian municipality. Data were collected using four multi-stage focus groups with five providers working in the HF project. Focus group interviews were transcribed verbatim and analysed using thematic analysis. Findings: Analysis resulted in three main themes: “Letting the service user sit in the driver’s seat,” “We don’t follow service provision contracts, we do everything,” and “Collaborating with the local community.” Research limitations/implications: There is a need to develop increased knowledge about service users’ experiences within the harm reduction approach. Practical implications: To practice effective harm reduction, treatment providers must have open authorisations and the opportunity to exercise professional judgement. Harm reduction practice must also focus on social, political, and economic factors influencing users’ everyday lives. Originality/value: The paper contributes to the knowledge base on harm reduction within HF practice that differs from a traditional model wherein clients are expected to abstain from substance use. It highlights important preconditions for challenges practitioners might encounter at both individual and service system levels.
(Publisher abstract)
While recognition of the importance of the mental health of young people is improving, access to services largely relies on a degree of stability, such as a permanent address or a regular school. But what about the less rooted?. An innovative mental health project in the East Midlands is engaging young people who are homeless, have offended or who are looked after, and has become a beacon NHS service.
While recognition of the importance of the mental health of young people is improving, access to services largely relies on a degree of stability, such as a permanent address or a regular school. But what about the less rooted?. An innovative mental health project in the East Midlands is engaging young people who are homeless, have offended or who are looked after, and has become a beacon NHS service.
Subject terms:
homeless people, homelessness, local authorities, mental health problems, NHS, quality assurance, social worker-service user relationships, young people, access to services;
Purpose: The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding. Design/methodology/approach: This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures. Findings: Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care. Originality/value: The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts
(Publisher abstract)
Purpose: The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding. Design/methodology/approach: This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures. Findings: Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care. Originality/value: The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts
(Publisher abstract)
Subject terms:
outcomes, homelessness, service provision, mental health services, mental health problems, person-centred care, joint working, housing, integrated services, service development, hospital discharge;