Health Care Integration for Formerly Homeless People With Serious Mental Illness

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Abstract
Objective: The primary objective of this study was to evaluate medical health and health care in a program of integrated primary and behavioral health care for people with experiences of homelessness and mental illness. Methods: Using a retrospective chart review, we examined health status and rates of health care quality indicators in a group of 123 Housing First participants with histories of chronic homelessness and diagnoses of serious mental illness, including a subgroup of 43 participants who received integrated medical and behavioral health care. Results: In addition to having serious mental illness, participants had high rates of comorbid chronic disease and risk behavior: 76% had at least one chronic disease, 59% had two or more chronic diseases, 6.5% had HIV, and 83% used tobacco. The integrated care program subgroup had relatively high rates of documentation of some health care quality indicators: 62% with body mass index, 73% with blood pressure, 77% with tobacco use history, 87% with substance use history. Conclusions: Our study confirms that people with experiences of homelessness and serious mental illness also have serious medical comorbidities and documents the feasibility of providing on-site integrated primary care and health screenings in supportive housing programs.

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