ABSTRACT
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.
Subject(s)
Aftercare/organization & administration , Community Mental Health Services/organization & administration , Ill-Housed Persons , Mental Disorders/rehabilitation , Patient Discharge , Adolescent , Adult , Attitude to Health , Chi-Square Distribution , Female , Follow-Up Studies , Ill-Housed Persons/psychology , Ill-Housed Persons/statistics & numerical data , Hospitals, Psychiatric , Humans , Male , Mental Disorders/psychology , Middle Aged , Ontario , Pilot Projects , Program Development , Program Evaluation , Public Housing , Social Support , Surveys and Questionnaires , Vulnerable PopulationsABSTRACT
1. Occupational health nurses can use their skills and knowledge of core nursing principles to become key players within their organization is EAPs. 2. The five stages of EAP intervention are recognition, documentation, approaching the employee, offering assistance, and ongoing monitoring of health. 3. Occupational health nurses must be able to recognize not only direct changes in physical health, but also changes in work performance, social interaction, and mental health. 4. If an employee's health continues to deteriorate, even after intervention, occupational health nurses must be willing to confront employees with detailed information regarding the medical, psycho-social, and employment consequences of unchanged behavior.
