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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
David E. Pollio, PhD, School of Social Work, Washington University, One Brookings Dr., Box 1196, St. Louis, MO 63130-4899, (314) 935-7516, depollio@gwbmail.wustl.edu, Carol S. North, MD, MPE, School of Medicine, Washington University, Department of Psychiatry, 660 S Euclid, CB 8134, Renard Building, Room 2210, St. Louis, MO 63110, and Karin M. Eyrich, MSW, MPE, George Warren Brown School of Social Work, Washington University, One Brookings Drive, CB 1196, St. Louis, MO 63130.
Previous research has documented extensive service use among homeless populations, with higher rates associated with achievement of housing. Research in this population has been hampered by cross-sectional designs, self report methods of service use documentation, inattention to subgroups (e.g., mentally ill, substance abusing), and data collection limited to a single agency or service sector. Distinguishing diagnostic subgroups in longitudinal studies across entire service systems may uncover important differences meriting attention of service providers. The current study examined service use patterns among a randomly selected sample of 397 homeless people in St. Louis, MO. The Diagnostic Interview Schedule and Composite International Diagnostic Interview/Substance Abuse Module provided psychiatric diagnoses. Data on service use by study participants over 12 months were collected through MIS (where available) or attendance rolls of all metropolitan area agencies serving the homeless, including health, mental health, and addiction treatment facilities. Service units were categorized into shelter, substance abuse and mental health treatment (inpatient and outpatient separately for both). Kruskal-Wallis tests identified differences in rates of service use for mental illness (depression, mania, schizophrenia) and substance abuse/dependence (cocaine, cannabis, opioids) diagnoses. Shelter utilization was significantly lower among those with substance abuse and mental illness; substance abuse was associated with greater inpatient and outpatient addiction services use and other psychiatric disorders with greater outpatient mental health services use. Findings echo previous reports that diagnoses are related to service needs. Yet, because diagnoses also impact shelter use negatively, this suggests the need for specialized shelter and outreach services.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.