Community Mental Health Journal

, Volume 26, Issue 5, pp 463-480

First online:

Some clinical approaches to the homeless mentally ill

  • Ezra SusserAffiliated withStatistical Sciences and Epidemiology Division, Nathan Kline Institute for Psychiatric ResearchDepartment of Psychiatry, New York University School of Medicine
  • , Stephen M. GoldfingerAffiliated withMass. Mental Health CenterDepartment of Psychiatry, Harvard Medical School
  • , Andrea WhiteAffiliated withColumbia University Community Services

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Clinicians who work with homeless people are likely to encounter a very broad spectrum of mental disorders and residential patterns. As with any other patient population, the particulars of clinical interventions must be guided by the specific constellations of biological, psychological, and social needs. However, for individuals who not only suffer from serious psychiatric disorders, but are also homeless, effective approaches may require significant modifications of traditional techniques and changes in the prioritization, timing, and framing of specific interventions. In this article we will focus on people who are severely and persistently mentally ill and who have been sleeping for months or years in shelters or in public spaces such as parks, streets, and bus terminals.