MENTAL-HEALTH-SERVICE USE AMONG HOMELESS AND NEVER-HOMELESS MEN WITH SCHIZOPHRENIA

Objective: The study compared patterns of previous mental health servi ce use among 100 homeless men with schizophrenia and 100 men with schi zophrenia who had never been homeless and explored whether differences in use of services were related to severity of illness. Methods: Subj ects were recruited from shelters, clinics, and inpatient psychiatric programs in New York City. Clinical interviewers used standardized res earch instruments to collect data on psychiatric treatment history, me ntal health service use within the past 12 months, adequacy of dischar ge planning from the most recent psychiatric hospitalization, positive and negative symptom levels, and presence of concurrent substance abu se and antisocial personality disorder: Results and conclusions: Homel ess subjects and never-homeless subjects had similar treatment histori es and recent patterns of inpatient, outpatient, and emergency service use. However, the homeless men were more likely to have been discharg ed from their most recent psychiatric hospitalization against medical advice and to have less adequate discharge planning for living arrange ments, aftercare, and finances. Inadequacies in discharge planning wer e most apparent among homeless men with triple disorders of schizophre nia, substance abuse, and antisocial personality disorder.