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首页> 外文期刊>Medical care >Can Shelter-Based Interventions Improve Treatment Engagement in Homeless Individuals With Psychiatric and/or Substance Misuse Disorders?: A Randomized Controlled Trial.
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Can Shelter-Based Interventions Improve Treatment Engagement in Homeless Individuals With Psychiatric and/or Substance Misuse Disorders?: A Randomized Controlled Trial.

机译：基于庇护所的干预措施能否改善患有精神病和/或药物滥用障碍的无家可归者的治疗参与度：一项随机对照试验。

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BACKGROUND:: High proportions of homeless individuals have mental illness and substance use disorders. Few of these individuals engage in consistent treatment, although they are likely to benefit from it. Shelter-based interventions to help this population engage in treatment have not been studied in a rigorous manner. OBJECTIVES:: We sought to evaluate the effectiveness of a shelter-based intervention, including intensive outreach by a psychiatric social worker and availability of weekly psychiatrist visits with continuity of care to engage homeless individuals with psychiatric and substance use problems. RESEARCH DESIGN:: This was a randomized controlled trial. SUBJECTS:: A total of 102 individuals were referred to a shelter-based psychiatric clinic. MEASURES:: The primary outcome measure was first appointment attendance at a community mental health center (CMHC). Secondary outcome measures were attendance at second and third CMHC appointments, participation in a substance abuse program, and employment and housing status at shelter exit. RESULTS:: Individuals receiving the intervention were more likely to attend >/=1 CMHC appointment (64.7% versus 37.3%, P = 0.006) and to participate in a substance abuse program (51.4% versus 12.5%, P = 0.0006) than those in the control group. There was a trend towards being more likely to attend 2 CMHC visits (33.3% versus 17.7%, P = 0.083), but no significant differences in attending 3 visits, being employed, or having housing. CONCLUSIONS:: Shelter-based interventions hold promise for improving treatment engagement in homeless populations with psychiatric and substance use problems. Further study should address how to foster care beyond an initial CMHC appointment and clarify key program components using a wider range of outcome measures.
机译：背景：高比例的无家可归者患有精神疾病和药物滥用疾病。尽管他们很可能会从中受益，但很少有人坚持治疗。尚未严格研究过以庇护所为基础的干预措施，以帮助该人群进行治疗。目标：：我们试图评估基于庇护所的干预措施的有效性，包括精神科社会工作者的密集外展活动以及每周提供精神科医师就诊的时间以及连续性护理，以使无家可归者有精神病和药物滥用问题。研究设计：这是一项随机对照试验。受试者：总共102个人被转介到庇护所的精神病诊所。措施：：主要结局指标是在社区心理健康中心（CMHC）的首次就诊出席率。次要结果指标包括第二次和第三次CMHC任命，参加药物滥用计划以及避难所出口处的就业和住房状况。结果：与这些人相比，接受干预的个体更有可能参加> / = 1 CMHC任命（64.7％对37.3％，P = 0.006）和参加药物滥用计划（51.4％对12.5％，P = 0.0006）。在对照组中。趋势是更有可能参加2次CMHC访问（33.3％对17.7％，P = 0.083），但是参加3次访问，被雇用或有住房的人之间没有显着差异。结论：基于庇护的干预措施有望改善患有精神病和药物滥用问题的无家可归人群的治疗参与度。进一步的研究应探讨如何在最初的CMHC任命后促进护理，并使用更广泛的结果指标来阐明关键的计划组成部分。

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