A Model for Health Intervention Regarding the National Strategy for Homeless People Integration – Health Care Pilot Project for Homeless People with Mental Illness

European Research Conference, Budapest, 17th September 2010UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN THE NEW

EUROPEAN CONTEXT

ENHR

Pilot project for the treatment of homeless people

Paula Domingos

National Mental Health Coordination Body – Portugal


EUROPEAN CONTEXTENHR

1st Stage: Argument and research - 2009• Field work• Bibliographic review2nd Stage: Assessment of the access to mental health care• Development and administration of a questionnaire to health

professionals working in the area3rd Stage: Implementation and monitoring of the project– 2010

1st Stage: Argument and research - 2009• Field work• Bibliographic review2nd Stage: Assessment of the access to mental health care• Development and administration of a questionnaire to health

professionals working in the area3rd Stage: Implementation and monitoring of the project– 2010

Pilot project for the treatment of homeless people

CARE FOR VULNERABLE GROUPSHomeless people



Outcome from the field workOutcome from the field work

Incidence of mental health diseases:

a) Alcoholism

b) Drug addiction

c) Psychotic disorders

Well Known institutions that were contacted: CML/Departamento de Acção Social:ERASA, Associação Médicos do Mundo, Comunidade Vida e Paz, Novos Rostos Novos Desafios.

1st Stage1st Stage




Scope- Thoroughly analysing the access to mental health care.

Aims- To identify difficulties areas for the homeless when accessing mental health care services, by the technical teams. - To know about the procedures which connect mental health and the social sector.

Scope- Thoroughly analysing the access to mental health care.

Aims- To identify difficulties areas for the homeless when accessing mental health care services, by the technical teams. - To know about the procedures which connect mental health and the social sector.

Administration of the Questionnaire on the Assessment to Mental Health Care by homeless people to professionals in the catchment area

Administration of the Questionnaire on the Assessment to Mental Health Care by homeless people to professionals in the catchment area

2nd Stage




Access to Mental Health Care Services

2nd Stage: Outcome

Number of People

Average Standard deviation

Street team 1 0,79 1,1

Temporary accomodation centre 2 0,82 1,1

Social assistance 5 1,90 2,3


Table 1 – Homeless people referenced, in average per week



Table 2 – Difficulties by Type of ServiceTable 2 – Difficulties by Type of Service

Type of ServiceDifficulties

Administrative Relational Communication

Emergency 3.1 2.7 3.1

Outpatient services 2.8 2.3 2.9

Primary health care centre

2.6 2.1 2.8


2nd Stage: Outcome



Partnership Protocol between the National Mental Health Coordination Body and the Psychiatric Hospital Centre in Lisbon (CHPL)

Partnership Protocol between the National Mental Health Coordination Body and the Psychiatric Hospital Centre in Lisbon (CHPL)

Scope: • To ensure the access of homeless people to mental

health care services, at regional level. Objectives:• To ensure psychiatric and psychological follow-up of

homeless people coming from the referral of case managers, street teams and other institutions that provide support.

• To help the training of professionals that work in the Lisbon Platform.

3rd Stage




Negative aspects:

1.Difficulties in accessing the mental health care services provided bythe health care system;2.Inability by the traditional psychiatric services to respond to thehealth care needs of homeless people.

Positive aspects:The collaboration with the Psychiatry Hospital Centre in Lisbon, whichhas the know-how and experience of providing mental health carehomeless people.

3rd Stage


Partnership Protocol between the National Mental Health Coordination body and the Psychiatry Hospital Centre in Lisbon (CHPL)




Protocol requirements:

Referral procedures• Entrance/access by homeless people in the CHPL through the

mental health clinical team and the required signalling/referral form, to the care of the CHPL (the form is part of the National Strategy for the Integration of Homeless People);

• The referral of homeless people to the CHPL is done by the case managers.

3rd Stage







Providing mental health care:

The provision of mental health care services takes place in

ambulatory care.

• Emergency services - using the psychiatric emergency of the HCC.

• The medication cost is shared by national health care.

3rd Stage









Managing information:

• Information about the health situation of the homeless person (clinical situation) will be sent to the case manager through the return form.

• When possible, the information will be sent in the following formats:

a) email;

b) fax.


3rd Stage



Partnership Protocol between the National Mental Health Coordination bodyand the Psychiatry Hospital Centre in Lisbon (CHPL)

Partnership Protocol between the National Mental Health Coordination bodyand the Psychiatry Hospital Centre in Lisbon (CHPL)


Providing mental health care:

The provision for mental health care follows the partnership model as set out in the Plan of the National Strategy for the Integration of Homeless People.


3rd Stage



Referral entitiesPartner organisations

STREET TEAM

AMI – Fundação de Assistência Média Internacional

Centro de apoio ao sem abrigo

Centro social do exercito de salvação

CML

Comunidade Vida e Paz

Legião Boa Vontade

Médicos do Mundo

Movimento ao Serviço da Vida

Novos Rostos novos Desafios

Santa Casa da Misericórdia de Lisboa

VITAE – associação de Solidariedade e Desenvolvimento Internacional

Desafio Jovem

TEMPORARY ACCOMODATION CENTRE

AMI – Fundação de Assistência Média Internacional

Associação dos Albergues Nocturnos de Lisboa

Centro Social do Exercito de Salvação


VITAE – Associação de Solidariedade e Desenvolvimento Internacional

ATELIER Associação Crescer na Maior


ASSISTANCE Santa Casa da Misericórdia de Lisboa




Thanks for your attention!

NATIONAL MENTAL HEALTH COORDINATION BODY,

PORTUGAL

[email protected]


Health & Medicine

A Model for Health Intervention Regarding the National Strategy for Homeless People Integration – Health Care Pilot Project for Homeless People with Mental Illness