Psychiatric admission for homeless people: the impact of a specialist community mental health team

Considerable problems have been encountered In providing care to homeless people with mental health problems (Health Advisory Service, 1995). In many instances mainstream services have failed to adapt to meet the needs of people who are often not registered with a GP and who regularly move between catchment areas. In districts with high levels of homelessness, specialist community teams have been estab lished (Craig et al, 1995). The service in Birming ham has been demonstrated to be effective in targeting a transient population with severe psychiatric morbidity not in contact with main stream services (Commander et al, 1997). How ever, with few exceptions (Whiteley, 1955; Berry & Orwin, 1966; Herzberg, 1987) little attention has been paid to the provision of in-patient care to homeless people in the UK. This study evaluates the impact of a specialist community mental health team (CMHT) for homeless people on admissions of people of no fixed abode (NFA) to psychiatric hospitals in Birmingham. It compares admissions before and after the introduction of the service with respect to both the number and characteristics of those admitted as well as the admission pathways and discharge arrangements. The study