Assessing the Mental Health Service Needs of the Homeless: A Level-of-Care Approach

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Abstract
Objective A level-of-care needs assessment was undertaken at Ontario’s largest shelter to establish homeless clients’ mental health service needs and identify service gaps. Methods A level-of-care planning model was applied to data on 356 men. Assessments included the Colorado Client Assessment Record and a Service Needs and Use Questionnaire. Results Among the clients, 32% (N=105) were recommended for weekly support, 38% (N=125) for Intensive Case Management or Assertive Community Treatment, and 9% (N=29) for 24-hour supervision in a residential care facility. Despite on-site health services, half the men did not have their level of service need met. Conclusion The wide range of unmet specialized mental health needs suggests that interventions of different structure and service intensity may be required for this population. A level-of-care planning model may be a helpful tool for ensuring homeless clients are matched to appropriate services and supports.