Preventing Homelessness through Mental Health Discharge Planning

Transcription

1 Preventing Homelessness through Mental Health Discharge Planning P R O M I S I N G P R A C T I C E S A N D C O M M U N I T Y P A R T N E R S H I P S I N B R I T I S H C O L U M B I A

2 Discharge Planning and Preventing Homelessness Confirmed link between homelessness and mental illness (Krausz, 2011) Individuals with complex mental health needs function best when they have a high degree of support in housing and through community-based mental health services Discharge planning represents an important point of intervention in preventing homeless, identifying clients at risk and reducing re-admission rates

3 Purpose To identify effective policies, practices and resource requirements in British Columbia for discharging residents and patients from mental health facilities, in partnership with community service providers, in order to prevent homelessness

4 Methods Advisory Committee 4 case study facilities selected 2 rural (Kootenay Boundary Regional Hospital, St. Mary s Hospital) 2 urban (Lions Gate Hospital, Burnaby Centre for Mental Health and Addiction) Literature review Key informant interviews Cross case analysis

5 Case Study Communities: Vancouver Facility: Burnaby Centre for Mental Health and Addiction 100-bed provincial facility for individuals with both substance use issue and mental illness Total homeless counted (2014): 1,798 Population: 603,502 Average monthly rent: $1,089

6 Case Study Communities: North Shore Vancouver Facility: Lions Gate Hospital 26 bed Acute Psychiatric Inpatient Unit Total homeless counted (2014): 119 Population: 175,302 Average monthly rent: $1,126-$1,558

7 Case Study Communities: Trail Facility: Kootenay-Boundary Regional Hospital 12-bed Acute Psychiatric Inpatient Unit Individuals who accessed the Extreme Weather Shelter ( ): 25 Population: 7,681 Average monthly rent : $646

8 Case Study Communities: Sunshine Coast Facility: St. Mary s Hospital 6-bed Psychiatric Inpatient Unit Shelter nights open ( ): 126 Number of stays ( ): 758 Population: 28,618 Average monthly rent: $986

9 Treatment from Intake to Discharge Emergency Acute Unit Discharge

10 Characteristics of Successful Discharge Clients show clear, positive change during treatment Long-term treatment plan is in place Client has a strong support network in place

11 Barriers to Successful Discharge Clients with concurrent disorders Clients with behavioral problems Clients living in poverty, experiencing negative peer influence

12 Best Practices: Literature Review Begin discharge planning as early as possible Inter-disciplinary discharge teams Discharge planning has a home Adapted to patient needs Long-term focus Culturally sensitive All partners buy in to the process

13 Best Practices: Literature Review (Cont d) Existing housing for individuals with mental illness Existing community support services Information sharing between health care providers and housing/community service agencies Peer support programs in place during treatment and after discharge

14 Best Practices: Case Studies Discharge planning started at admission Housing resources exist Long-term focus Culturally sensitive Adapted to patient needs

15 Institutional Barriers Facility resources and time, and volume of clients More acute in urban areas Lack of affordable, appropriate housing Particularly acute in rural areas Lack of community service resources Particularly acute in rural areas Community service agencies are not formally integrated into discharge planning No peer involvement in discharge planning

16 Opportunities for Strengthening Discharge Planning Formalize partnerships with community service agencies Develop formal peer support resources during treatment and discharge Provide facility staff training on concurrent disorders and hard to house individuals (emergency room) Strengthen available housing resources and community services

17 Thank you Contact: Research available in three volumes (overview, case studies, literature review):

18 Questions How are these best practices currently being applied by other organizations? Are there best practices that they are aware of that are not included? What steps can be taken to implement best practices outside of the case studies from the panel? In your experience, how are the main facets of discharge planning affected by accessibility to/availability of mental health services and/or housing options in your community? Are there implications for discharge planning best practices beyond the mental health and criminal justice systems? What are some ways to engage with some of these larger institutions collaboratively?