Integrated healthcare for homeless individuals: A biopsychosocial model that works

The traditional system of providing parallel or sequential approaches to the care of those with co-occurring disorders is both expensive and ineffective. We believe the important missing link in the discussion is that of primary healthcare, the addition of which results in a biopsychosocial approach to overall health. Penobscot Community Health Care has developed an integrated, easily accessible, low-barrier, on-demand medical/mental health/substance abuse delivery program that addresses the biopsychosocial needs of homeless individuals.

This program is based on a team-centered approach focused on integration of healthcare for those who are homeless and involves: a) implementation of an evidence-based, integrated system of medical, mental health and substance abuse treatment; b) strengthening linkages between public and private organizations; and c) addressing issues of cultural barriers in access to care.

In this model, all team members are co-located, which facilitates communication both with and concerning the patient. All providers share a single electronic medical record (EMR) that enables full knowledge of the status of an individual in all aspects of care, improves team awareness, patient safety and quality assurance.

We also seek to advance the cause of putting knowledge into practice by enabling replication of this approach by other community health centers/FQHCs across the country. This service model addresses the issues of low-barrier access to care in a method that will is economically transferable and can become independent of shifting altruistic funding or volunteerism.