Up from the streets: A follow-up study of people referred to a specialist team for the homeless mentally ill

Abstract

Background: In 1991 the START team was formed as part of the UK government's homeless mentally ill initiative to reduce homelessness and increase access to mental health services for this marginalised group. Aims: To identify the characteristics of homeless clients who were `lost' after referral on to statutory health and social services departments. Method: A retrospective case note review of a consecutive series of a hundred homeless people with mental health problems referred to a specialist team. Follow-up was 4 years after initial contact. Their last known address or caseworker was used to gain information regarding their housing status, and whether they were in contact with mental health services. Results: There was no evidence that loss of contact with mental health services related to age, forensic history or substance misuse. Clients referred to the team on more than one occasion were marginally more likely to remain in contact with services. Ten percent of the sample had returned to the homeless circuit, 49% were resettled to more permanent accommodation. Forty-three percent were not in contact with services while 55% were still in contact 4 years later. Conclusion: This study supports the suggestion that with specialist intervention and support, people with mental health problems who are homeless can live a more settled existence.