{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:49:43Z","timestamp":1791229783729,"version":"4.1.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001784","name":"Victoria University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001784","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Psychiatr Q"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    People experiencing homelessness (PEH) face significant barriers to healthcare access. This study explores the socio-demographic and clinical characteristics, as well as health-seeking behaviour, of PEH presenting to two major Australian metropolitan Emergency Departments (EDs).\u00a0A quantitative observational study was conducted using administrative and clinical data from ED records for all PEH presentations during 2023. Data were analysed using SPSS (v30) and R (4.5.1).\u00a0Of the 541 cases initially screened, 310 met inclusion criteria, with mean age of 42.4 years (SD\u2009=\u200914.0), and mean ED length of stay (LOS) of 8.48\u00a0h (SD\u2009=\u20098.34\u00a0h). Disposition status was significantly associated with triage acuity, self-harm history, substance use, chronic disease, suicidal intent, and emergency psychiatry review. Patients with self-harm or substance use histories were more likely to have follow-up arranged (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001 and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.006 respectively). Younger patients were more often referred to mental health facilities (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002).\u00a0This cohort demonstrated a wide range of psychosocial and clinical needs, including documented self-harm, mental health conditions, substance use, and chronic disease, with suicidal intent recorded in one in five presentations. Disposition outcomes varied substantially, and patients triaged as \u2018not urgent\u2019 showed the highest rate of leaving against medical advice (45.2%), suggesting perceived acuity may influence care engagement. Differences across age, sex, and ED length of stay further highlight the diversity of presentations. Collectively, these findings reinforce the need for flexible and responsive care pathways that account for the heterogeneity and complexity of this population.\n                  <\/jats:p>","DOI":"10.1007\/s11126-026-10263-w","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:11:50Z","timestamp":1771481510000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding Healthcare-Seeking Patterns of People Experiencing Homelessness: A Quantitative Multi-Centre Analysis of Emergency Department Utilisation"],"prefix":"10.1007","author":[{"given":"Abdi","family":"Osman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahar","family":"Bhowmik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Rachele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Gilmartin-Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakma","family":"Gunarathne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Braitberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"10263_CR1","unstructured":"United Nations Human Rights. Homelessness and human rights: Special Rapporteur on the right to adequate housing. 2025. Contract No.: (A\/HRC\/43\/43, para.30)."},{"key":"10263_CR2","unstructured":"Australian Bureau of Statistics. Homelessness operational groups (OPGP): Census of Population and Housing: Census dictionary. 2021."},{"key":"10263_CR3","unstructured":"Pawson H, Parsell C, Clarke A, Moore J, Hartley C, Aminpour F et al. Australian homelessness monitor 2024."},{"key":"10263_CR4","unstructured":"Australian Institute of Health and Welfare. Homelessness and homelessness services. Australian Institute of Health and Welfare,; 2023."},{"key":"10263_CR5","unstructured":"Council to Homeless Persons. Data and demographics: Homelessness facts, stats, and insights."},{"issue":"1","key":"10263_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14023-w","volume":"22","author":"W Lutchmun","year":"2022","unstructured":"Lutchmun W, Gach J, Borup C, Froeschl G. Chronic diseases and multi-morbidity in persons experiencing homelessness: results from a cross-sectional study conducted at three humanitarian clinics in Germany in 2020. BMC Public Health. 2022;22(1):1597.","journal-title":"BMC Public Health"},{"issue":"8","key":"10263_CR7","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1136\/jech-2021-216439","volume":"76","author":"KM Leifheit","year":"2022","unstructured":"Leifheit KM, Schwartz GL, Pollack CE, Linton SL. Building health equity through housing policies: critical reflections and future directions for research. J Epidemiol Community Health. 2022;76(8):759\u201363.","journal-title":"J Epidemiol Community Health"},{"key":"10263_CR8","unstructured":"O\u2019donnell M, Varker T, Cash R, Armstrong R, Di Censo l, Zanatta P et al. The trauma and homelessness initiative. Australian centre for posttraumatic mental health in collaboration with sacred heart mission, mind Australia, inner south community health and vincentcare victoria. 2014."},{"key":"10263_CR9","unstructured":"Australian Human Rights Commission. Homelessness is a Human Rights Issue. 2008. Available from: https:\/\/humanrights.gov.au\/our-work\/rights-and-freedoms\/publications\/homelessness-human-rights-issue"},{"key":"10263_CR10","unstructured":"Australian Institute of Health. and Welfare. Health of people experiencing homelessness. 2021."},{"issue":"9953","key":"10263_CR11","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/S0140-6736(14)61132-6","volume":"384","author":"S Fazel","year":"2014","unstructured":"Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. 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Gerontologist. 2017;57(4):757\u201366.","journal-title":"Gerontologist"}],"container-title":["Psychiatric Quarterly"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11126-026-10263-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11126-026-10263-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11126-026-10263-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:11:57Z","timestamp":1771481517000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11126-026-10263-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":34,"alternative-id":["10263"],"URL":"https:\/\/doi.org\/10.1007\/s11126-026-10263-w","relation":{},"ISSN":["0033-2720","1573-6709"],"issn-type":[{"value":"0033-2720","type":"print"},{"value":"1573-6709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"assertion":[{"value":"8 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study obtained ethics approval from all participating sites as referenced in the methods section.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}