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Psychiatric morbidity and health service use among attendees at a winter shelter

PO28, Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, email: m.hayward{at}iop.kcl.ac.uk

Declaration of interest

M.H. worked as an unpaid volunteer in the Crisis Open Christmas medical service.

AIMS AND METHOD

Homelessness is associated with raised psychiatric morbidity. Case records for 597 consecutive attendees at a winter shelter medical service were retrospectively reviewed to assess routine recording of psychiatric morbidity and to examine associations between current psychiatric symptoms and health service use.

RESULTS

Previous psychiatric morbidity was recorded in 36.0% of attendees, including 20.4% with comorbid substance misuse. Current psychiatric morbidity was recorded in 31.3% of attendees, and was associated with reduced total medication prescription, increased referral to other services and increased re-presentation to the shelter medical service.

CLINICAL IMPLICATIONS

Psychiatric morbidity was frequently recorded in this population. Current psychiatric symptoms were associated with increased health service use. Improved training of shelter staff should be instituted to increase engagement with mainstream mental health services.