October 31, 2022
The ICES study underscores factors related to elevated healthcare use such as mental illness and substance use that can inform interventions for EDs as the point of contact. It shows the rates of inpatient, emergency and physician visits were higher for homeless participants with a mental illness compared to a general cohort of homeless adults. However, the study finds healthcare use isn't the same for all groups who experience homelessness. It found that during the one-year follow-up:
- Compared to the general homeless cohort, people in the cohort with a mental illness had higher rates of inpatient (27% vs 14%), emergency (63% vs 53%) and physician services (90% vs 76%);
- Black participants were less likely to visit a primary care physician than white participants and were also less likely to use ED services or be admitted to a non-psychiatric inpatient unit; and
- Factors such as problematic alcohol and drug use, criminal behaviour and victimization were all associated with higher rates of ED use in both cohorts.
The researchers conclude interventions need to take a trauma-informed and layered approach to care to reduce the risk of re-traumatization. They add that, for those using less services, alternative approaches may be needed.