Original Paper

Administration and Policy in Mental Health and Mental Health Services Research

, Volume 34, Issue 4, pp 363-375

Healthcare Barriers among Severely Mentally Ill Homeless Adults: Evidence from the Five-site Health and Risk Study

  • Mimi M. KimAffiliated withServices Effectiveness Research Program in the Department of Psychiatry & Behavioral Sciences, Duke University Medical Center Email author 
  • , Jeffrey W. SwansonAffiliated withServices Effectiveness Research Program in the Department of Psychiatry & Behavioral Sciences, Duke University Medical Center
  • , Marvin S. SwartzAffiliated withServices Effectiveness Research Program in the Department of Psychiatry & Behavioral Sciences, Duke University Medical Center
  • , Daniel W. BradfordAffiliated withVA Center for Health Services Research in Primary Care
  • , Sarah A. MustilloAffiliated withServices Effectiveness Research Program in the Department of Psychiatry & Behavioral Sciences, Duke University Medical Center
  • , Eric B. ElbogenAffiliated withServices Effectiveness Research Program in the Department of Psychiatry & Behavioral Sciences, Duke University Medical Center

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Abstract

Few studies have examined barriers to physical and mental healthcare among homeless mentally adults. Methods This study examined physical and mental healthcare barriers reported by 154 recently homeless mentally ill persons. Results Practical concerns (e.g. transportation and cost) were key components of barriers to accessing general medical care among uninsured men with poorer overall mental health, PTSD, and STD infections. Perceived stigma was an important component of mental healthcare barriers reported most frequently by those with greater psychiatric symptoms. Conclusion Focusing on individual characteristics underlying barriers to healthcare may lead to better interventions for improving access to needed care.

Keywords

Mental illness Homelessness Physical healthcare