260822 Assessing health status and exploring health needs in women with experiences of homelessness and serious mental illness

Monday, October 29, 2012

Lara Weinstein, MD, MPH , Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA
Marianna Lanoue, PhD , Department of Family and Community Medicine, Thomas Jefferson Univeristy, Philadelphia, PA
Elizabeth Collins, MS , Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA
Women with experiences of chronic homelessness and serious mental illness (SMI) represent a distinct and highly marginalized subgroup of homeless individuals, whose needs maybe different from men experiencing chronic homelessness, and from women experiencing short-term family homelessness. Housing First (HF) is an evidence-based practice that works to end chronic homelessness for individuals with SMI. HF provides a unique opportunity to address health needs of individuals as they transition from homelessness to supportive housing. The purpose of this mixed methods study was to provide preliminary information regarding the health status and health needs of women in a HF program that also provides on-site integrated health care. Demographic, health condition, and health care quality information was reviewed for all 123 individuals in the program and differences between men and women were examined. Among the program participants, 9 women agreed to in-depth individual interviews regarding health, access to healthcare, sense of control over healthcare decision-making, and program support. Quantitative findings showed equally high levels of chronic disease and substance use, as well as high levels of receipt of recommended quality measures in both women and men. Emergent qualitative themes include: the impact of ongoing pain on health, the importance of housing in order to effectively self-manage chronic illness, and a high sense of personal control over one's own health. These findings highlight the high level of multi-morbidity in this population and the potential for supportive housing to effectively address the health needs and values of women with experiences of homelessness and SMI.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health or related research

Learning Objectives:
Review baseline physical and mental health status in women and men entering a Housing First program and compare to normative standards when available Compare differences in receipt of recommended health quality measurements between women and men in a Housing First program. Describe the lived experience of women with experiences of homelessness and SMI in the areas of health, self-management, and personal control Discuss critical areas of health service planning to effectively meet the needs of women with experiences of homelessness and serious mental illness

Keywords: Mental Health, Homelessness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a family physician researcher whose work concentrates on improving systems of health care for individuals with experiences of homelessness and serious mental illness through community-academic partnerships. I conceptualized and led the team that carried out this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.