Accommodation History and Continuity of Care in Patients with Psychosis

• Published in: Australian and New Zealand journal of psychiatry 2005-03, Vol.39 (3), p.175-179
• Main Authors: Holmes, Alex C.N., Hodge, Mark A., Bradley, Gail, Bluhm, Alan, Hodges, Jane, Didio, Louisa, Markulev, Natasha
• Format: Article
• Language: English
• Subjects: Accommodation; Adult; Australia; Biological and medical sciences; Case Management - statistics & numerical data; Chronic Disease; Community treatment. Ambulatory treatment. Home care; Continuing care; Continuity of Patient Care - statistics & numerical data; Female; Homeless Persons - psychology; Homeless Persons - statistics & numerical data; Homelessness; Humans; Male; Medical sciences; Middle Aged; Patients; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychotic Disorders - epidemiology; Psychotic Disorders - rehabilitation; Public Housing - statistics & numerical data; Statistics as Topic; Treatment Outcome; Treatments; Utilization Review; Western Australia
• ISSN: 0004-8674; 1440-1614
• DOI: 10.1080/j.1440-1614.2005.01540.x

Objectives: The objective of this study was to determine the relationship between accommodation history and management outcome in patients with psychosis. Method: Demographic information, diagnosis and an accommodation history were taken from patients with psychosis accepted for case management by the Inner West Area Mental Health Service over a 12-month period. The patients were followed up 2 years later to determine their continuity of care and discharge outcome. Results: One hundred 42 patients completed the assessments. Forty-eight percent of patients had spent at least 1 day in a homeless setting in the previous 12 months. Twentytwo percent of patients had long-term (between 2 and 12 months) and six percent chronic (more than 12 months) homelessness. The duration of previous homelessness was significantly inversely correlated with the length of engagement with the service, continuity of psychiatric care at discharge or likelihood of transfer to primary care. Previous interstate mobility was significantly associated with discontinuity of care at discharge. Conclusions: 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.