Accommodation History and Continuity of Care in Patients with Psychosis

Holmes, Alex; Hodge, Mark; Bradley, Gail; Bluhm, Alan; Hodges, Jane; Didio, Louisa; Markulev, Natasha

doi:10.1080/j.1440-1614.2005.01540.x

Cited by 14 publications

(12 citation statements)

References 8 publications

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“…[109] The relevance of socioeconomic context was later highlighted in the management of specific health problems including diabetes, [32, 69, 110] rheumatoid arthritis, [61, 63] and psychosis. [62] The specific socioeconomic context of vulnerable housing is a particular challenge: ‘Lack of stable housing can affect a patient’s ability to store and take medications, to care for wounds properly, and to abstain from or limit physical activity during recuperation.’ [68] It was said that acknowledging patients’ socioeconomic contexts could enable improved treatment planning [11, 58, 59, 64, 66] and shared decision-making. [16, 58, 60] It could also improve the effectiveness [65] and outcomes of healthcare, [67] while reducing costs [38] and improving patient satisfaction.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of reasons for and against asking patients about their socioeconomic contexts

Moscrop

Ziébland

Roberts

et al. 2019

Int J Equity Health

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Background People’s social and economic circumstances are important determinants of their health, health experiences, healthcare access, and healthcare outcomes. However, patients’ socioeconomic circumstances are rarely asked about or documented in healthcare settings. We conducted a systematic review of published reasons for why patients’ socioeconomic contexts (including education, employment, occupation, housing, income, or wealth) should, or should not , be enquired about. Methods Systematic review of literature published up to and including 2016. A structured literature search using databases of medicine and nursing (pubmed, embase, global health), ethics (Ethicsweb), social sciences (Web of Science), and psychology (PsychINFO) was followed by a ‘snowball’ search. Eligible publications contained one or more reasons for: asking patients about socioeconomic circumstances; collecting patients’ socioeconomic information; ‘screening’ patients for adverse socioeconomic circumstances; or linking other sources of individual socioeconomic data to patients’ healthcare records. Two authors conducted the screening: the first screened all references, the second author screened a 20% sample with inter-rater reliability statistically confirmed. ‘Reason data’ was extracted from eligible publications by two authors, then analysed and organised. Results We identified 138 eligible publications. Most offered reasons for why patients’ should be asked about their socioeconomic circumstances. Reasons included potential improvements in: individual healthcare outcomes; healthcare service monitoring and provision; population health research and policies. Many authors also expressed concerns for improving equity in health. Eight publications suggested patients should not be asked about their socioeconomic circumstances, due to: potential harms; professional boundaries; and the information obtained being inaccurate or unnecessary. Conclusions This first summary of literature on the subject found many published reasons for why patients’ social and economic circumstances should be enquired about in healthcare settings. These reasons include potential benefits at the levels of individuals, health service provision, and population, as well as the potential to improve healthcare equity. Cautions and caveats include concerns about the clinician’s role in responding to patients’ social problems; the perceived importance of social health determinants compared with biomedical factors; the use of average population data from geographic areas to infer the socioeconomic experience of individuals. Actual evidence of outcomes is lacking: our review suggests hypotheses that can be tested in future research.

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Section: Resultsmentioning

confidence: 99%

A systematic review of reasons for and against asking patients about their socioeconomic contexts

Moscrop

Ziébland

Roberts

et al. 2019

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…Periods of homelessness are common in patients attending community clinics. 18 The capacity to access and work with homeless people may be required for many urban mental health services, practices which may be measured using these PIs.…”

Section: Discussionmentioning

confidence: 99%

Developing performance indicators for homeless outreach psychiatric services

Holmes

Bradley²,

Carslie

et al. 2014

Australas Psychiatry

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“…A previous study found that men with a psychosis, who experienced homelessness in the previous year, had a mean of 4.1 accommodation settings as compared with 1.8 in those who had not experienced homelessness (Holmes et al . 2005b).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…A minority of homeless people with a psychosis remain so long term. In Melbourne, Australia, 13% of homeless men engaged by outreach mental health service had been homeless for more than 12 months (Holmes et al 2005b). In New York, approximately 10% of shelter entrants had long-term homelessness, defined as: 'continuous homelessness for a year or more or having at least 4 episodes of homelessness in the past three years' (Kuhn & Culhane 1998).…”

Section: Introductionmentioning

confidence: 99%

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Long‐term homelessness in men with a psychosis: Limitation of services

Burns

Robins

Hodge³

et al. 2009

Int J Mental Health Nurs

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A proportion of persistently homeless men with psychosis are unable to function in the community, despite intensive outreach. The present study aimed to (i) develop a method to measure the number of homeless clients with a psychosis who are unable to maintain basic levels of function, despite the application of intensive community treatment; and (ii) determine if the proportion of these men had increased in an Australian inner urban setting over a 5-year period. Criteria were developed and validated to define this group. A review of records of clients engaged in homeless settings was conducted in order to compare the proportion of men with these features in 2000 and 2005. In 2005, 23% met the criterion of long-term homelessness with poor function, despite intensive outreach, as compared with 17% in 2000 (P = 0.62). The 2005 cohort was more likely to have attempted intensive community psychiatric treatment (P = 0.04). We conclude that a proportion of homeless men with a psychosis in Australia do not achieve basic function, despite access to intensive outreach. The proportion of these men did not change between 2000 and 2005. These men require additional specialized services, including access to long-term supported housing.

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Accommodation History and Continuity of Care in Patients with Psychosis

Abstract: A history of homelessness is common in patients with psychosis using inner urban mental health services and is associated with poorer engagement with psychiatric services.

Cited by 14 publications

References 8 publications

A systematic review of reasons for and against asking patients about their socioeconomic contexts

A systematic review of reasons for and against asking patients about their socioeconomic contexts

Developing performance indicators for homeless outreach psychiatric services

Long‐term homelessness in men with a psychosis: Limitation of services

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