Impact on the use and cost of other services following intervention by an inpatient pathway homelessness team in an acute mental health hospital

Abstract

Background

Mental illness in people experiencing homelessness is common and a key reason for attendance at emergency departments and admission to hospital.

Aims

This paper describes how the KHP Pathway homeless team impacted use and cost of health and wider services. The Pathway model had never been adopted by a mental health hospital, and there had never been an economic analysis to evaluate service use before and after intervention.

Method

Service use was measured using an adapted version of the Client Service Receipt Inventory (CSRI) with a simple before and after design at admission, 3 months and 6 months after discharge from hospital.

Results

During the first 3-month follow-up, over half the participants saw a GP, with an increase in the proportion seeing a psychiatrist, social worker and a mental health nurse. Attendance at emergency departments was substantially lower than at baseline. The mean total service cost was £818 at base line and £414 at 3 months.

Conclusions

The adapted version of the CSRI demonstrates that patients seen by the Pathway Homelessness Team were supported to use community and scheduled health and care services. The service overcomes barriers, frequently experienced by people experiencing homelessness, in accessing support and community healthcare in the UK.

Keywords:

• Homeless
• inclusion health
• exclusion
• pathway
• service use
• service evaluation
• in-patient
• Inclusion Health Groups

Acknowledgments

The authors acknowledge support from the Guy’s and St. Thomas’ and Maudsley charities, and to KCL and the Institute of Psychiatry in funding and supporting the pilot Pathway Homelessness Team at the South London and Maudsley NHS Foundation Trust, and the aligned service evaluation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was funded as part of pilot funding from the Guy’s and St. Thomas’ and Maudsley Charities of the King’s Health Partners Pathway Homeless Team at the South London and Maudsley (SLaM) between December 2014 and December 2017.