Can shelter-based interventions improve treatment engagement in homeless individuals with psychiatric and/or substance misuse disorders? A randomized controlled trial
Can shelter-based interventions improve treatment engagement in homeless individuals with psychiatric and/or substance misuse disorders? A randomized controlled trial
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DOI：
10.1097/01.mlr.0000170402.35730.ea
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发表时间：
2005-08-01
期刊：
影响因子：
3
通讯作者：
Weinberger, M
中科院分区：
文献类型：
--
作者：
Bradford, DW;Gaynes, BN;Weinberger, M
背景：高比例的无家可归者患有精神疾病和物质使用障碍。这些人中很少有人进行持续治疗，尽管他们可能从中受益。帮助这一人群进行治疗的基于庇护所的干预措施尚未得到严格的研究。目标：我们试图评估以庇护所为基础的干预措施的有效性，包括精神病社会工作者的密集外展，以及每周提供精神病医生的连续护理，以吸引无家可归者研究设计：这是一个随机对照试验。主题：共102个人被称为一个庇护所为基础的精神病clinic.Measures：主要结果的措施是第一次预约出席社区精神卫生中心（CMHC）。第二个结果的措施出席了第二次和第三次CMHC任命，参与药物滥用计划，就业和住房状况在庇护所退出。接受干预的个人更有可能参加>= 1次CMHC预约（64.7%vs37.3%，P = 0.006）和参加药物滥用项目（51.4%vs12.5%，P = 0.0006）。有一种趋势是更有可能参加2 CMHC访问（33.3%对17.7%，P = 0.083），但没有显着差异，参加3次访问，被雇用，或housing.Conclusions：基于住房的干预措施，提高治疗参与无家可归的人群精神和物质使用问题的承诺。进一步的研究应解决如何在最初的CMHC任命之后促进护理，并使用更广泛的结果指标来澄清关键计划组成部分。
Background: High proportions of homeless individuals have mental illness and substance use disorders. Few of these individuals engage in consistent treatment, although they are likely to benefit from it. Shelter-based interventions to help this population engage in treatment have not been studied in a rigorous manner.Objectives: We sought to evaluate the effectiveness of a shelter-based intervention, including intensive outreach by a psychiatric social worker and availability of weekly psychiatrist visits with continuity of care to engage homeless individuals with psychiatric and substance use problems.Research Design: This was a randomized controlled trial.Subjects: A total of 102 individuals were referred to a shelter-based psychiatric clinic.Measures: The primary outcome measure was first appointment attendance at a community mental health center (CMHC). Second-ary outcome measures were attendance at second and third CMHC appointments, participation in a substance abuse program, and employment and housing status at shelter exit.Results: Individuals receiving the intervention were more likely to attend >= 1 CMHC appointment (64.7% versus 37.3%, P = 0.006) and to participate in a substance abuse program (51.4% versus 12.5%, P = 0.0006) than those in the control group. There was a trend towards being more likely to attend 2 CMHC visits (33.3% versus 17.7%, P = 0.083), but no significant differences in attending 3 visits, being employed, or having housing.Conclusions: Shelter-based interventions hold promise for improving treatment engagement in homeless populations with psychiatric and substance use problems. Further study should address how to foster care beyond an initial CMHC appointment and clarify key program components using a wider range of outcome measures.