Coordination of Care for Homeless Individuals with Comorbid Severe Mental Disorders and Substance-Related Disorders

ABSTRACT

Psychiatric symptoms and alcohol and drug use disorders are often diagnosed in individuals who frequent shelters and programs for homelessness. Services are often provided in a fragmented, uncoordinated manner. This study evaluates a care coordination program in dual-diagnosis patients by comparing data on 50 patients treated with standard methods and 50 patients enrolled in the care coordination program. Clinical outcomes were measured with the Hamilton Depression Scale, Positive and Negative Syndrome scale, BASIS-32, service utilization, and alcohol use. We found that care coordination is a relatively low intensity but promising intervention that may improve clinical outcomes of homeless dual-diagnosis patients.

KEYWORDS:

• Homeless
• dual diagnosis
• care
• coordination
• mental illness

Results of the study were previously presented in preliminary form at the American Psychiatric Association 53rd Institute on Psychiatric Services, October 2001 and the American Psychiatric Association 54th Institute on Psychiatric Services, October 2002.

The authors wish to acknowledge the encouragement and support of Elliot J. Sussman, MD, President and CEO, Lehigh Valley Hospital and Health Network. This research was funded by the Dorothy Rider Pool Health Care Trust.

Notes

∗Values are presented as: Mean ± Standard Deviation.

∗Values are presented as: Count (Percent).

∗No significant Baseline difference for Control versus Treatment group for the three month test (p = 0.067). However, a significant difference at Baseline, Control versus Treatment group for the Six month test (p = 0.017).

∗There were no Baseline differences between Control or Treatment groups.

∗There were no Baseline differences between Treatment and Control groups for either the Three Month or the Six Month data.