Stergiopoulos Vicky, Kerman Nick, Reid Nadine
Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Adm Policy Ment Health. 2025 Mar;52(2):285-288. doi: 10.1007/s10488-024-01418-7. Epub 2024 Oct 9.
In recent years, there has been increased support for the use of coercive policies to address the seemingly intractable problem of homelessness among people with mental disorders in North America. Although these policy approaches respond to a critical issue, rising rates of unsheltered homelessness, low service engagement and concerns about disruptive behaviors in public settings, they are unlikely on their own to be successful. To avoid coercive practices, there is an urgent need to consider alternative, person-centred approaches to promote service engagement among people experiencing homelessness and mental disorders, with input from those with lived experience and frontline homeless service providers. Three person-centred approaches are proposed for consideration: (1) cross-sectoral service delivery models, (2) peer-led services, and (3) financial incentives. These approaches merit further study to support voluntary treatment engagement and exits from homelessness among people with mental and substance use disorders and safeguard the human rights of this population.
近年来，在北美，使用强制性政策来解决精神疾病患者中看似棘手的无家可归问题得到了更多支持。尽管这些政策措施回应了一个关键问题，即无家可归者露宿街头的比率不断上升、服务参与度低以及对公共场所破坏性行为的担忧，但仅靠它们自身不太可能取得成功。为避免强制做法，迫切需要考虑以个人为中心的替代方法，以促进无家可归且患有精神疾病的人参与服务，并吸纳有实际生活经历者和一线无家可归服务提供者的意见。现提出三种以个人为中心的方法供考虑：（1）跨部门服务提供模式，（2）同伴主导的服务，以及（3）经济激励措施。这些方法值得进一步研究，以支持患有精神疾病和物质使用障碍的人自愿接受治疗并摆脱无家可归状态，并保障这一人群的人权。
