A Shelter-Based Model of Mental Health Care for the Homeless

Abstract

The focus of this presentation is on a shelter-based model of psychiatric care for homeless adults that aims to help participants achieve psychiatric stability and reduce risk behaviors that can lead to HIV. The presentation will include: 1) an overview of the model; 2) data on mental health, risk behaviors, and substance abuse among the population; and 3) pilot study results on a motivational interviewing HIV prevention intervention.

Proposal Summary

Introduction: Many individuals who are homeless are living with or at-risk for HIV infection. One of the known risk factors for risky behaviors that can lead to HIV infection among the homeless is untreated mental illness and substance abuse. The aim of this proposal is to present a model of shelter-based psychiatric care for homeless individuals who are living in shelters, on the streets, or are marginally-housed. The main goal of the program is to help program clients achieve stability of their psychiatric symptoms. In addition, the program aims to help reduce risky behaviors and provide linkages to permanent housing that can reduce the risk of HIV transmission. The model is based on motivational interviewing (MI) principles and includes the following components: 1) Comprehensive assessment of client’s mental health and substance abuse problems; 2) Individual counseling focused on mental health and risk behaviors; 3) Psychiatric evaluation and medication management; and 4) Case management and referral for additional services, including health care, substance-abuse treatment, and housing assistance. Methods: The Homeless Opportunities and Treatment (HOT) Project, is a shelter-based psychiatric clinic that provides care to adults age 18 and older in Forsyth County, NC. The clinic is staffed by mental health providers and physicians and also serves as a teaching clinic for students. As part of our overall MI approach, we also conducted an HIV prevention pilot study using MI. Results: To date, the clinic model has proven to be a method of successfully engaging and treating homeless adults with mental illness. The presentation will include: 1) an overview of the conceptual and treatment model; 2) data on the mental health, risk behaviors, and substance abuse needs of the population; and 3) pilot study results from a MI HIV prevention intervention. Data from the program provide a picture of the clinical needs of this population and demonstrate the potential effectiveness of this model of care. Pilot study results indicate that MI interventions as part of a targeted approach to HIV prevention must culturally sensitive and may benefit from integration into an overall model of care.

Relevance And Significance

This proposal focuses on an innovative prevention and intervention strategy with homeless adults that uses mental health treatment as a means of risk reduction for a population at-risk for or living with HIV. The project is housed in medical center that serves a geographic area that consists primarily of rural counties with limited resources.

Session Format

Workshop

Keywords

Mental health, Substance abuse, Homeless adults, Shelter-based care, Prevention

Location

Room 216

Publication Type and Release Option

Presentation (Open Access)

This document is currently not available here.

Share

COinS
 
Sep 12th, 10:30 AM Sep 12th, 11:45 AM

A Shelter-Based Model of Mental Health Care for the Homeless

Room 216

The focus of this presentation is on a shelter-based model of psychiatric care for homeless adults that aims to help participants achieve psychiatric stability and reduce risk behaviors that can lead to HIV. The presentation will include: 1) an overview of the model; 2) data on mental health, risk behaviors, and substance abuse among the population; and 3) pilot study results on a motivational interviewing HIV prevention intervention.