The increasing awareness that serious mental disorder is common among men residing in homeless hostels has acted as a fillip towards providing new services for this disadvantaged group. Conventional psychiatry frequently fails to meet their needs, not least because of the formality and inaccessibility of the contact. Detailed psychiatric history taking, for example, is often perceived as a barrier to communication with no intrinsic benefit for the homeless. Indeed psychiatrists often appear distant to hostel staff. The Salvation Army have gone so far as to suggest to the House of Commons Social Services Committee that community psychiatric nurses are effective because of their ability to mediate with consultant psychiatrists.
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