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Sectioning on the street – futility or utility?

  • Philip Timms (a1) and Jennifer Perry (a1)
Abstract
Aims and method

A service evaluation was undertaken to examine outcomes in patients who were street homeless (‘rough sleepers’) and who were compulsorily admitted to hospital under the Mental Health Act 1983. The data were collected from the patients' case notes.

Results

At 1-year follow-up, patients had positive outcomes in areas such as accommodation status, registration with a general practitioner and engagement with the clinical team.

Clinical implications

The study shows that the intervention of a Mental Health Act assessment and compulsory hospital admission in homeless people on the street is associated with positive outcomes at 1 year.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Jennifer Perry (jenperry@doctors.org.uk)
Footnotes
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Declaration of interests

P.T. is consultant psychiatrist for the START team. J.P. worked in the START team for a 6 month period (2013–2014).

Footnotes
References
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1 Chamberlain, C, Johnson, G, Theobald, J. Homelessness in Melbourne: Confronting the Challenge. RMIT Publishing, 2007.
2 Craig, TKJ, Timms, PW. Homelessness and schizophrenia. In Schizophrenia (eds Hirsch, SR, Weinberger, DR): pp. 664–84. Blackwell Science, 1995.
3 World Health Organization. International Classification of Diseases (ICD-10). WHO.
4 Office of Population Censuses and Surveys. OPCS Survey of Psychiatric Morbidity among Homeless People. UK Data Archive, 1994. Available at http://dx.doi.org/10.5255/UKDA-SN-3642-1 (accessed 11 July 2015).
5 Rees, S. Mental Ill Health in the Adult Single Homeless Population: A Review of the Literature. Crisis & Public Health Resource Unit, 2009 (http://www.crisis.org.uk/data/files/publications/Mental%20health%20literature%20review.pdf).
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7 Thomas, B. An Analysis of the Mortality of Homeless People in Early Twenty-First Century England. Crisis & The University of Sheffield, 2012 (http://www.crisis.org.uk/data/files/publications/Homelessness%20kills%20-%20Executive%20Summary.pdf).
8 Department for Communities and Local Government. Rough Sleeping Statistics England – Autumn 2013, Official Statistics. DCLG, 2014.
9 CHAIN. Rough Sleeping in London: CHAIN Annual Report, Greater London, April 2014–March 2015. Greater London Authority, 2015.
10 Coldwell, CM, Bender, WS. The effectiveness of assertive community treatment for homeless populations with severe mental illness: a meta-analysis. Am J Psychiatry 2007; 164: 393–9.
11 Kim, MM, Swanson, JW, Swartz, MS, Bradford, DW, Mustillo, SA, Elbogen, EB. Healthcare barriers among severely mentally ill homeless adults: evidence from the five-site health and risk study. Adm Policy Ment Health 2007; 34: 363–75.
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13 Kahn, MW, Duckworth, SD. Needing treatment, wanting nothing: ethical dilemmas in the treatment of the homeless mentally ill. Harv Rev Psychiatry 1998; 5: 274–80.
14 Timms, P, Borrell, T. Doing the right thing – ethical and practical dilemmas in working with homeless mentally ill people. J Ment Health 2001; 10: 419–26.
15 Graham, ZC, Salton-Cox, FS, White, PD. The outcome of rough sleepers with mental health problems admitted to a psychiatric ward. Psychiatr Bull 1999; 23: 164–6.
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
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Sectioning on the street – futility or utility?

  • Philip Timms (a1) and Jennifer Perry (a1)
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