Forchuk C, MacClure S K, Van Beers M, Smith C, Csiernik R, Hoch J, Jensen E
Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.
J Psychiatr Ment Health Nurs. 2008 Sep;15(7):569-75. doi: 10.1111/j.1365-2850.2008.01266.x.
Shelter data in a recent study revealed discharges from psychiatric facilities to shelters or the street occurred at least 194 times in 2002 in London, Ontario, Canada. This problem must be addressed to reduce the disastrous effects of such discharge, including re-hospitalization and prolonged homelessness. An intervention was developed and tested to prevent homelessness associated with discharge directly to no fixed address. A total of 14 participants at-risk of being discharged without housing were enrolled, with half randomized into the intervention group. The intervention group was provided with immediate assistance in accessing housing and assistance in paying their first and last month's rent. The control group received usual care. Data was collected from participants prior to discharge, at 31 and 6-months post-discharge. All the individuals in the intervention group maintained housing after 3 and 6 months. All but one individual in the control group remained homeless after 3 and 6 months. The exception joined the sex trade to avoid homelessness. The results of this pilot were so dramatic that randomizing to the control group was discontinued. Discussions are underway to routinely implement the intervention. Systemic improvements can prevent homelessness for individuals being discharged from psychiatric wards.
近期一项研究中的收容所数据显示，2002年在加拿大安大略省伦敦市，从精神病院出院后前往收容所或流落街头的情况至少发生了194次。必须解决这个问题，以减少此类出院带来的灾难性影响，包括再次住院和长期无家可归。为此开发并测试了一种干预措施，以防止与直接出院至无固定住址相关的无家可归情况。共有14名面临无住房出院风险的参与者被纳入研究，其中一半被随机分配到干预组。干预组在获得住房方面得到了即时援助，并获得了支付首月和末月房租的帮助。对照组接受常规护理。在出院前、出院后31天和6个月时从参与者那里收集数据。干预组的所有个体在3个月和6个月后都保住了住房。对照组除一人外，所有个体在3个月和6个月后仍无家可归。该例外者为避免无家可归而加入了性交易行业。这项试点研究的结果非常显著，以至于停止了随机分配到对照组的做法。目前正在进行讨论，以便常规实施该干预措施。系统性改进可以防止从精神病病房出院的个体无家可归。
