Broadening Perspectives on Mobile Medical Outreach to Homeless People

Abstract

Using data collected by Project Renewal's mobile medical services to homeless people in New York City, this paper discusses a tension between an emergency medicine model of outreach and that of primary care. In the former model, clinicians evaluate clients on the basis of presenting complaints and refer them, as necessary, for specialized treatment. The latter is a broader model of comprehensive outreach and/or treatment, where clinicians screen clients and assess them for various conditions offering ongoing evaluation and treatment on site. The model of outreach is applicable for some homeless clients, but the prevalence and overlap of physical complaints, infectious diseases, substance abuse, and psychiatric symptoms among homeless people in New York City has resulted in an evolution toward broader approaches to outreach in this population. Improvements in diagnostic testing and increasingly portable medical technology may make the mobile delivery of medical care to homeless persons increasingly feasible.

Taking it to the Street: A Psychiatric Outreach Service in Canada

“…A search of articles over the past decade from Medline, PsychLit, and CINAHL reveal that most articles outlined the conceptual and clinical issues involved in working with the population (Morse et al, 1996), and the clinical characteristics and unique service needs of the population, rather than innovative models of service to meet those needs (Gou, Biedel, Johnsen, & Dyches, 2001;Lam & Rosencheck, 1999;Nuttbrock, Rosenblum, Magura, & McQuistion, 2003;Rosenblum, Nuttbrock, McQuinstion, Magrua, & Joseph, 2002). The few models described for persons who are homeless with mental illness include community information fairs, where agencies serving the homeless provide a single day program where homeless people can access various services at a downtown location close to domiciliary services (Wuenschel, 1997) or mobile primary health care teams (Plescia, Watts, Neibacher & Strelnick, 1997).…”

Implementation of a mobile health clinic framework for Hepatitis C virus screening and treatment: a descriptive study

“… 4 Key beneficiaries include those living in rural and low-income areas, homeless people, migrant and immigrant workers, minority groups, and those who are underinsured or unlinked to primary care. 4 , 5 , 6 , 7 , 8 , 9 , 10 However, HCV is rarely addressed in MHCs. Effective protocols are needed for screening and understanding of the utility of MHCs for provision of treatment among populations with barriers to care.…”