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Typology of Currently or Formerly Homeless Individuals Based on Their Use of Health and Social Services

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Abstract

This study identified profiles among 455 currently or formerly homeless individuals in Quebec (Canada), based on health and social service use. Using latent class analysis, four profiles were identified that grouped individuals with: (1) few health problems, and using few case managers and family doctors, but with high frequency of psychiatric consultations, emergency department (ED) visits and hospitalizations; (2) chronic physical illnesses, having case managers and family doctors, but low frequency of ED visits and hospitalizations; (3) moderate health problems and little service use; and (4) multiple and complex health problems and high frequency of service use. These profiles suggest the following recommendations to more adequately meet patient needs: regarding Class 1, improved outreach services, more ED liaison nurses and peer navigation; Class 2: more family doctors and case managers; Class 3: higher family doctors; and Class 4: more assertive or intensive case management, harm reduction and permanent housing resources.

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References

  • Adair, C. E., Streiner, D. L., Barnhart, R., Kopp, B., Veldhuizen, S., Patterson, M., et al. (2017). Outcome trajectories among homeless individuals with mental disorders in a multisite randomised controlled trial of housing first. Canadian Journal of Psychiatry, 62(1), 30–39.

    PubMed  Google Scholar 

  • Akaike, H. (1987). Factor analysis and AIC. Psychometrika, 52(3), 317–322.

    Google Scholar 

  • Altena, A. M., Beijersbergen, M. D., Vermunt, J. K., & Wolf, J. (2018). Subgroups of Dutch homeless young adults based on risk- and protective factors for quality of life: Results of a latent class analysis. Health and Social Care in the Community, 26(4), e587–e597.

    PubMed  Google Scholar 

  • Althaus, F., Paroz, S., Hugli, O., Ghali, W. A., Daeppen, J. B., Peytremann-Bridevaux, I., et al. (2011). Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Annals of Emergency Medicine, 58(1), 41–52.

    PubMed  Google Scholar 

  • Amato, S., Nobay, F., Amato, D. P., Abar, B., & Adler, D. (2019). Sick and unsheltered: Homelessness as a major risk factor for emergency care utilization. American Journal of Emergency Medicine, 37(3), 415–420.

    Google Scholar 

  • Aubry, T., Farrell, S., Hwang, S. W., & Calhoun, M. (2013). Identifying the patterns of emergency shelter stays of single individuals in Canadian cities of different sizes. Housing Studies, 28(6), 910–927.

    Google Scholar 

  • Aubry, T., Klodawsky, F., & Coulombe, D. (2012). Comparing the housing trajectories of different classes within a diverse homeless population. American Journal of Community Psychology, 49(1–2), 142–155.

    PubMed  Google Scholar 

  • Bharel, M., Lin, W. C., Zhang, J., O’Connell, E., Taube, R., & Clark, R. E. (2013). Health care utilization patterns of homeless individuals in Boston: Preparing for Medicaid expansion under the Affordable Care Act. American Journal of Public Health, 103(Suppl 2), S311–317.

    PubMed  PubMed Central  Google Scholar 

  • Bohn, M. J., Babor, T. F., & Kranzler, H. R. (1995). The alcohol use disorders identification test (AUDIT): Validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol, 56(4), 423–432.

    CAS  PubMed  Google Scholar 

  • Bonin, J. P., Fournier, L., & Blais, R. (2009). A typology of mentally disordered users of resources for homeless people: Towards better planning of mental health services. Administration and Policy in Mental Health, 36(4), 223–235.

    PubMed  Google Scholar 

  • Brown, M., Chodzen, G., Mihelicova, M., & Collins, K. (2017). Applying a time-patterned typology of homelessness among individuals with mental illness. American Journal of Community Psychology, 59(3–4), 306–315.

    PubMed  Google Scholar 

  • Brown, R. T., & Steinman, M. A. (2013). Characteristics of emergency department visits by older versus younger homeless adults in the United States. American Journal of Public Health, 103(6), 1046–1051.

    PubMed  PubMed Central  Google Scholar 

  • Busch-Geertsema, V., Culhane, D., & Fitzpatrick, S. (2016). Developing a global framework for conceptualising and measuring homelessness. Habitat International, 55, 124–132.

    Google Scholar 

  • Byrne, T., & Culhane, D. P. (2015). Testing alternative definitions of chronic homelessness. Psychiatric Services, 66(9), 996–999.

    PubMed  Google Scholar 

  • Byrne, T., Fargo, J. D., Montgomery, A. E., Roberts, C. B., Culhane, D. P., & Kane, V. (2015). Screening for homelessness in the Veterans Health Administration: Monitoring housing stability through repeat screening. Public Health Report, 130(6), 684–692.

    Google Scholar 

  • Caron, J., Mercier, C., & Tempier, R. (1997). Validation of satisfaction with life domains scale in Quebec. Santé mentale au Québec, 22(2), 195–217.

    CAS  PubMed  Google Scholar 

  • Celeux, G., & Soromenho, G. (1996). An entropy criterion for assessing the number of clusters in a mixture model. Journal of Classification, 13(2), 195–212.

    Google Scholar 

  • Chambers, C., Chiu, S., Katic, M., Kiss, A., Redelmeier, D. A., Levinson, W., et al. (2013). High utilizers of emergency health services in a population-based cohort of homeless adults. American Journal of Public Health, 103(S2), 5302–5310.

    Google Scholar 

  • Council of Economic Advisers. (2019). The state of homelessness, September 2019. Washington, DC: Council of Economic Advisers.

    Google Scholar 

  • D’Amore, J., Hung, O., Chiang, W., & Goldfrank, L. (2001). The epidemiology of the homeless population and its impact on an urban emergency department. Academic Emergency Medicine, 8(11), 1051–1055.

    PubMed  Google Scholar 

  • Doran, K. M., Rahai, N., McCormack, R. P., Milian, J., Shelley, D., Rotrosen, J., et al. (2018). Substance use and homelessness among emergency department patients. Drug and Alcohol Dependence, 188, 328–333.

    PubMed  PubMed Central  Google Scholar 

  • Fitzpatrick-Lewis, D., Ganann, R., Krishnaratne, S., Ciliska, D., Kouyoumdjian, F., & Hwang, S. W. (2011). Effectiveness of interventions to improve the health and housing status of homeless people: A rapid systematic review. BMC Public Health, 11, 638.

    PubMed  PubMed Central  Google Scholar 

  • Fleury, M. J., Grenier, G., Bamvita, J. M., & Ferland, F. (2020). Typology of patients who use emergency departments for mental and substance use disorders. BJPsych Open, 6(4), e59.

    PubMed  PubMed Central  Google Scholar 

  • Fok, M. L., Chang, C. K., Broadbent, M., Stewart, R., & Moran, P. (2019). General hospital admission rates in people diagnosed with personality disorder. Acta Psychiatrica Scandinavica, 139(3), 248–255.

    PubMed  Google Scholar 

  • Fuehrlein, B. S., Cowell, A. J., Pollio, D., Cupps, L., Balfour, M. E., & North, C. S. (2015). A prospective study of the associations among housing status and costs of services in a homeless population. Psychiatric Services, 66(1), 27–32.

    PubMed  Google Scholar 

  • Gaetz, S., Barr, C., Friesen, A., Harris, B., Hill, C., Kovacs-Burns, K., et al. (2012). Canadian definition of homelessness. Toronto: Canadian Observatory on Homelessness Press.

    Google Scholar 

  • Gaetz, S., Scott, F., & Gulliver, T. E. (2013). Housing first in Canada: Supporting communities to end homelessness. Toronto: Canadian Homelessness Research Network Press.

    Google Scholar 

  • Gelberg, L., Andersen, R. M., & Leake, B. D. (2000). The behavioral model for vulnerable populations: Application to medical care use and outcomes for homeless people. Health Services Research, 34(6), 1273–1302.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gentil, L., Grenier, G., Bamvita, J. M., Dorvil, H., & Fleury, M. J. (2018). Profiles of quality of life in a homeless population. Réseau de recherche en santé des populations du Quebec. Paper presented at the Regroupement stratégique santé mentale, Webinar, Montréal.

  • Gentil, L., Grenier, G., Bamvita, J. M., Dorvil, H., & Fleury, M. J. (2019). Profiles of quality of live in a homeless population. Frontiers of Psychiatry. https://doi.org/10.3389/fpsyt.2019.00010.

    Article  Google Scholar 

  • Gentil, L., Grenier, G., Bamvita, J. M., & Fleury, M. J. (2020). Satisfaction with health and community services among homeless and formerly homeless individuals in Quebec, Canada. Health and Social Care in the Community, 28(1), 22–33.

    PubMed  Google Scholar 

  • Gilmer, T. P., Stefancic, A., Ettner, S. L., Manning, W. G., & Tsemberis, S. (2010). Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness. Archives of General Psychiatry, 67(6), 645–652.

    PubMed  Google Scholar 

  • Goodman, L. A. (1974). Exploratory latent structure analysis using both identifiable and unidentifiable models. Biometrika, 61, 215–231.

    Google Scholar 

  • Hagernaars, J. A., & McCutcheon, A. L. (2009). Applied latent class analysis. Cambridge: Cambridge University Press.

    Google Scholar 

  • Han, B., & Wells, B. L. (2003). Inappropriate emergency department visits and use of the Health Care for the Homeless Program services by Homeless adults in the northeastern United States. Journal of Public Health Management and Practice, 9(6), 530–537.

    PubMed  Google Scholar 

  • Holtyn, A. F., Jarvis, B. P., Subramaniam, S., Wong, C. J., Fingerhood, M., Bigelow, G. E., et al. (2017). An intensive assessment of alcohol use and emergency department utilization in homeless alcohol-dependent adults. Drug and Alcohol Dependence, 178, 28–31.

    PubMed  PubMed Central  Google Scholar 

  • Hwang, S. W., Aubry, T., Palepu, A. S. F., Nisenbaum, R., Hubley, A. M., et al. (2011a). The health and housing in transition study: A longitudinal study of the health of homeless and vulnerably housed adults in three Canadian cities. International Journal of Public Health, 56(6), 609–623.

    CAS  PubMed  Google Scholar 

  • Hwang, S. W., Chambers, C., Chiu, S., Katic, M., Kiss, A., Redelmeier, D. A., et al. (2013). A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance. American Journal of Public Health, 103(SUPPL. 2), S294–S301.

    PubMed  PubMed Central  Google Scholar 

  • Hwang, S. W., Gogosis, E., Chambers, C., Dunn, J. R., Hoch, J. S., & Aubry, T. (2011b). Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program. Journal of Urban Health, 88(6), 1076–1090.

    PubMed  PubMed Central  Google Scholar 

  • Jego, M., Abcaya, J., Stefan, D. E., Calvet-Montredon, C., & Gentile, S. (2018). Improving Health Care Management in primary care for homeless people: A literature review. International Journal of Environmental Research and Public Health, 15(2), 309.

    PubMed Central  Google Scholar 

  • Johnstone, M., Jetten, J., Dingle, G. A., Parsell, C., & Walter, Z. C. (2015). Discrimination and well-being amongst the homeless: The role of multiple group membership. Frontiers in Psychology, 6, 739.

    PubMed  PubMed Central  Google Scholar 

  • Kaduszkiewicz, H., Bochon, B., van den Bussche, H., Hansmann-Wiest, J., & van der Leeden, C. (2017). The medical treatment of homeless people. Deutsches Ärzteblatt International, 114(40), 673–679.

    PubMed  PubMed Central  Google Scholar 

  • Khandor, E., Mason, K., Chambers, C., Rossiter, K., Cowan, L., & Hwang, S. W. (2011). Access to primary health care among homeless adults in Toronto, Canada: Results from the Street Health survey. Open Medicine, 5(2), e94–e103.

    PubMed  PubMed Central  Google Scholar 

  • Kreindler, S. A., & Coodin, S. (2010). Housing histories of assertive community treatment clients: Program impacts and factors associated with residential stability. Canadian Journal of Psychiatry, 55(3), 150–156.

    PubMed  Google Scholar 

  • Ku, B. S., Scott, K. C., Kertesz, S. G., & Pitts, S. R. (2010). Factors associated with use of urban emergency departments by the U.S. homeless population. Public Health Reports, 125(3), 398–405.

    PubMed  PubMed Central  Google Scholar 

  • Kuhn, R., & Culhane, D. P. (1998). Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: Results from the analysis of administrative data. American Journal of Community Psychology, 26(2), 207–232.

    CAS  PubMed  Google Scholar 

  • Kushel, M. B., Gupta, R., Gee, L., & Haas, J. S. (2006). Housing instability and food insecurity as barriers to health care among low-income Americans. Journal of General Internal Medicine, 21(1), 71–77.

    PubMed  PubMed Central  Google Scholar 

  • Kushel, M. B., Perry, S., Bangsberg, D., Clark, R., & Moss, A. R. (2002). Emergency department use among the homeless and marginally housed: Results from a community-based study. American Journal of Public Health, 92(5), 778–784.

    PubMed  PubMed Central  Google Scholar 

  • Kushel, M. B., Vittinghoff, E., & Haas, J. S. (2001). Factors associated with the health care utilization of homeless persons. Journal of the American Medical Association, 285(2), 200–206.

    CAS  PubMed  Google Scholar 

  • Lam, J. A., & Rosenheck, R. A. (2000). Correlates of improvement in quality of life among homeless persons with serious mental illness. Psychiatric Services, 51(1), 116–118.

    CAS  PubMed  Google Scholar 

  • Lanza, S. T., Collins, L. M., Lemmon, D. R., & Schafer, J. L. (2007). PROC LCA: A SAS procedure for latent class analysis. Structural Equation Modeling, 14(4), 671–694.

    PubMed  PubMed Central  Google Scholar 

  • Latimer, E., McGregor, J., Méthot, C., & Smith, A. (2015). Je compte Mtl 2015. Dénombrement des personnes en situation d’itinérance à Montréal le 24 mars 2015. Montréal, QC: Ville de Montréal.

    Google Scholar 

  • Lazarsfeld, P. F., & Henry, N. W. (1968). Latent structure analysis. Boston, MA: Hougton Miffilin.

    Google Scholar 

  • Lewis, J. H., Andersen, R. M., & Gelberg, L. (2003). Health care for homeless women. Journal of General Internal Medicine, 18(11), 921–928.

    PubMed  PubMed Central  Google Scholar 

  • Lin, W. C., Bharel, M., Zhang, J., O’Connell, E., & Clark, R. E. (2015). Frequent emergency department visits and hospitalizations among homeless people with medicaid: Implications for medicaid expansion. American Journal of Public Health, 105(Suppl 5), S716–722.

    PubMed  PubMed Central  Google Scholar 

  • Mackelprang, J. L., Harpin, S. B., Grubenhoff, J. A., & Rivara, F. P. (2014). Adverse outcomes among homeless adolescents and young adults who report a history of traumatic brain injury. American Journal of Public Health, 104(10), 1986–1992.

    PubMed  PubMed Central  Google Scholar 

  • Mackelprang, J. L., Qiu, Q., & Rivara, F. P. (2015). Predictors of emergency department visits and inpatient admissions among homeless and unstably housed adolescents and young adults. Medical Care, 53(12), 1010–1017.

    PubMed  PubMed Central  Google Scholar 

  • Miner, J. R., Westgard, B., Olives, T. D., Patel, R., & Biros, M. (2013). Hunger and food insecurity among patients in an Urban Emergency Department. Western Journal of Emergency Medicine, 14(3), 253–262.

    PubMed Central  Google Scholar 

  • Ministère de la Santé et des Services Sociaux. (2018). Plan d’action interministériel en dépendance 2018–2028. Prévenir, réduire et traiter les conséquences associées à la consommation de substances psychoactives, à la pratique de jeux de hasard et d’argent et à l’utilisation d’Internet. Québec: Gouvernement du Québec.

    Google Scholar 

  • Mitchell, M. S., Leon, C. L. K., Byrne, T. H., Lin, W. C., & Bharel, M. (2017). Cost of health care utilization among homeless frequent emergency department users. Psychological Services, 14(2), 193–202.

    PubMed  Google Scholar 

  • Morris, D. M., & Gordon, J. A. (2006). The role of the emergency department in the care of homeless and disadvantaged populations. Emergency Medicine Clinics of North America, 24(4), 839–848.

    PubMed  Google Scholar 

  • Munoz, M., Panadero, S., Santos, E. P., & Quiroga, M. A. (2005). Role of stressful life events in homelessness: An intragroup analysis. American Journal of Community Psychology, 35(1–2), 35–47.

    PubMed  Google Scholar 

  • Pascual, J. C., Malagòn, A., Arcega, J. M., Gines, J. M., Navinés, R., Gurrea, A., et al. (2008). Utilization of psychiatric emergency services by homeless persons in Spain. General Hospital Psychiatry, 30, 14–19.

    PubMed  Google Scholar 

  • Pearson, D. A., Bruggman, A. R., & Haukoos, J. S. (2007). Out-of-hospital and emergency department utilization by adult homeless patients. Annals of Emergency Medicine, 50(6), 646–652.

    PubMed  Google Scholar 

  • Pleace, N., Baptista, I., & Knutagård, M. (2019). Housing first in Europe. An overview of implementation, strategy and fidelity. Brussel, Belgium: Housing First Europe Hub.

    Google Scholar 

  • Poulin, S. R., Maguire, M., Metraux, S., & Culhane, D. P. (2010). Service use and costs for persons experiencing chronic homelessness in Philadelphia: A population-based study. Psychiatric Services, 61(11), 1093–1098.

    PubMed  Google Scholar 

  • Quinn, K., Dickson-Gomez, J., Nowicki, K., Johnson, A. K., & Bendixen, A. V. (2018). Supportive housing for chronically homeless individuals: Challenges and opportunities for providers in Chicago, USA. Health and Social Care in the Community, 26(1), e31–e38.

    PubMed  Google Scholar 

  • Richard-Lepouriel, H., Weber, K., Baertschi, M., DiGiorgio, S., Sarasin, F., & Canuto, A. (2015). Predictors of recurrent use of psychiatric emergency services. Psychiatric Services, 66(5), 521–526.

    PubMed  Google Scholar 

  • Robbins, P. C., Callahan, L., & Monahan, J. (2009). Perceived coercion to treatment and housing satisfaction in housing-first and supportive housing programs. Psychatric Services, 60(9), 1251–1253.

    Google Scholar 

  • Rodriguez, R. M., Fortman, J., Chee, C., Ng, V., & Poon, D. (2009). Food, shelter and safety needs motivating homeless persons’ visits to an urban emergency department. Annals of Emergency Medicine, 53(5), 598–602.

    PubMed  Google Scholar 

  • Sadowski, L. S., Kee, R. A., VanderWeele, T. J., & Buchanan, D. (2009). Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: A randomized trial. Journal of the American Medical Association, 301(17), 1771–1778.

    CAS  PubMed  Google Scholar 

  • Salhi, B. A., White, M. H., Pitts, S. R., & Wright, D. W. (2018). Homelessness and emergency medicine: A review of the literature. Academic Emergency Medicine, 25(5), 577–593.

    PubMed  Google Scholar 

  • Salit, S. A., Kuhn, E. M., Hartz, A. J., Vu, J. M., & Mosso, A. L. (1998). Hospitalization costs associated with homelessness in New York City. New England Journal of Medicine, 338(24), 1734–1740.

    CAS  Google Scholar 

  • Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl 20), 22–33.

    Google Scholar 

  • Skinner, H. A. (1982). The drug abuse screening test. Addictive Behaviors, 7(4), 363–371.

    CAS  PubMed  Google Scholar 

  • Statistics Canada. (2016). Canadian Community Health Survey (CCHS).

  • Stenius-Ayoade, A., Haaramo, P., Erkkila, E., Marola, N., Nousiainen, K., Wahlbeck, K., et al. (2017). Mental disorders and the use of primary health care services among homeless shelter users in the Helsinki metropolitan area, Finland. BMC Health Services Research, 17(1), 428.

    PubMed  PubMed Central  Google Scholar 

  • Sullivan, G., Burnam, A., Koegel, P., & Hollenberg, J. (2000). Quality of life of homeless persons with mental illness: Results from the course-of-homelessness study. Psychiatric Services, 51(9), 1135–1141.

    CAS  PubMed  Google Scholar 

  • Tsai, J., Kasprow, W. J., & Rosenheck, R. A. (2013). Latent homeless risk profiles of a national sample of homeless veterans and their relation to program referral and admission patterns. American Journal of Public Health, 103(Suppl 2), S239–247.

    PubMed  PubMed Central  Google Scholar 

  • Tsai, J., & Rosenheck, R. A. (2013). Risk factors for ED use among homeless veterans. American Journal of Emergency Medicine, 31(5), 855–858.

    Google Scholar 

  • Üstü, B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., et al. (2010). Developing the World Health Organization Disability Assessment Schedule 2.0. Bulletin of the World Health Organization, 88, 815–823.

    Google Scholar 

  • van der Plas, A. G., Hoek, H. W., van Hoeken, D., Valencia, E., & van Hemert, A. M. (2012). Perceptions of quality of life and disability in homeless persons with schizophrenia and persons with schizophrenia living in non-institutional housing. International Journal of Social Psychiatry, 58(6), 629–634.

    Google Scholar 

  • Wooden, M. D., Air, T. M., Schrader, G. D., Wieland, B., & Goldney, R. D. (2009). Frequent attenders with mental disorders at a general hospital emergency department. Emergency Medicine Australasia, 21(3), 191–195.

    PubMed  Google Scholar 

  • Woollcott, M. (2008). Access to primary care services for homeless mentally ill people. Nursing Standard, 22(35), 40–44.

    PubMed  Google Scholar 

  • Zimmerman, M., Rothschild, L., & Chelminski, I. (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients. American Journal of Psychiatry, 162(10), 1911–1918.

    Google Scholar 

  • Zlotnick, C., & Zerger, S. (2009). Survey findings on characteristics and health status of clients treated by the federally funded (US) Health Care for the Homeless Programs. Health and Social Care in the Community, 17(1), 18–26.

    PubMed  Google Scholar 

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Acknowledgements

We thank the individuals who participated in the research as well as the research team, including key decision-makers and the organizational staff who assisted us with recruitment. We are also grateful to Judith Sabetti for editorial assistance.

Funding

This study was funded by Social Sciences and Humanities Research Council of Canada (Grant No. Project # 435-2016-0761)

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Authors and Affiliations

  1. Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd., Montreal, QC, H4H1R3, Canada

    Marie-Josée Fleury, Guy Grenier, Zhirong Cao & Xiangfei Meng

  2. Department of Psychiatry, McGill University, Montréal, QC, Canada

    Marie-Josée Fleury & Xiangfei Meng

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  1. Marie-Josée Fleury
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  2. Guy Grenier
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  3. Zhirong Cao
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  4. Xiangfei Meng
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection were performed by research agents, and analysis by ZC under the supervision of MJF. GG, ZC and MJF wrote the first draft of the manuscript, which was commented on and revised by XM. All authors read and approved the final manuscript.

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Correspondence to Marie-Josée Fleury.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments on comparable ethical standards. The study was approved by the ethics committee of the Douglas Hospital Research Centre.

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All patients had to sign a consent form before participation in the study.

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Fleury, MJ., Grenier, G., Cao, Z. et al. Typology of Currently or Formerly Homeless Individuals Based on Their Use of Health and Social Services. Community Ment Health J 57, 948–959 (2021). https://doi.org/10.1007/s10597-020-00693-6

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