Client and site characteristics as barriers to service use by homeless persons with serious mental illness.

Clients entering the Access to Community Care and Effective Services and Supports (ACCESS) program for homeless mentally ill persons in 18 U.S. communities identified barriers to service use. The most frequent barrier was not knowing where to go for a service (encountered by 32.4 percent of the 1,828 clients). It was followed by not being able to afford it (29.5 percent); experiencing too much confusion, hassle, or waiting to obtain it (27.1 percent); and having been previously denied the service (16.5 percent). Differences in the program site (that is, the 18 communities) explained two to three times more of the variance in encountering barriers use than did individual client characteristics.