{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:06:00Z","timestamp":1770894360418,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T00:00:00Z","timestamp":1456185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychiatric Ment Health Nurs"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Accessible summary<\/jats:title><jats:sec><jats:title>What is known on the subject?<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Outreach services are often successful in engaging and housing street homeless individuals.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>People experiencing homelessness have greatly increased rates of mental illness and substance abuse.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge?<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Given the relative lack of research involving street homeless individuals, this ret\u2010rospective chart review examined factors associated with successful housing by a multidisciplinary street outreach team, including the use of hospitalization as an intervention within a housing first framework.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The majority of clients were successfully housed by the end of outreach team involvement.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>An admission to hospital was strongly associated with successful housing for those with a psychotic disorder.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>What are the implications for practice?<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Multidisciplinary outreach teams, specifically those with psychiatric and nursing support, successfully work with and house people experiencing street homeless\u2010ness and psychosis.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Mental health nurses embedded in the community are an essential link between inpatient and outpatient care for highly vulnerable street homeless individuals.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Housing\u2010first strategies have helped establish housing as a human right. However, endemic homelessness persists. Multidisciplinary outreach teams that include nursing, social and psychiatric services allow for integrative strategies to engage and support clients on their housing trajectory. The following retrospective review focused on the identification of demographic, clinical, and service characteristics that predicted the obtainment of housing, and explored the role of psychiatric hospitalization as an intervention, not an outcome measure, in contrast to previous studies. These have rarely focused on street homelessness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective chart review of 85 homeless, primarily rough\u2010sleeping, clients was conducted to determine housing outcomes and the factors associated with obtaining housing through care provided by a psychiatric street outreach team in Toronto, Canada. Demographics, homelessness duration, diagnosis, hospitalization and housing status were tracked during team involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 46% (36\/79) were housed during the study term. Securing housing at the end of treatment\/data collection was significantly enhanced by hospitalization (OR\u00a0=\u00a09.04, 95% CI [2.43, 33.59]). It was significantly diminished by psychosis (OR\u00a0=\u00a00.22, 95% CI [0.05, 0.95]) and prior homelessness &gt;36\u00a0months (OR\u00a0=\u00a00.10, 95% CI [0.02, 0.50]). Twenty\u2010three of 31 (74%) hospitalized clients with psychosis were subsequently housed, compared to 4 of 30 (13%) not hospitalized (Fisher's exact, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Multidisciplinary street outreach teams successfully house long\u2010standing homeless clients (&gt;12\u00a0months without a permanent address) with serious mental illness and\/or substance abuse. Hospitalization can be utilized as a complimentary intervention, particularly for those with psychosis, in the continuum of housing first initiatives, and can contribute to securing housing for those with persistent psychotic disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for nursing practice<\/jats:title><jats:p>Community mental health nurses are uniquely positioned to translate care between hospital and community settings, ensuring timely assessment, intervention and treatment of clients who are historically difficult to engage.<\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/jpm.12287","type":"journal-article","created":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T02:27:09Z","timestamp":1456453629000},"page":"98-107","source":"Crossref","is-referenced-by-count":15,"title":["Housing outcomes and predictors of success: the role of hospitalization in street outreach"],"prefix":"10.1111","volume":"23","author":[{"given":"B. H.","family":"Lettner","sequence":"first","affiliation":[{"name":"Department of Nursing University of Toronto Toronto"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. J.","family":"Doan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Toronto Toronto"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. W.","family":"Miettinen","sequence":"additional","affiliation":[{"name":"Department of Economics University of Toronto Toronto"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201400167"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.145.10.1273"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11469-012-9392-3"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.0.0216"},{"key":"e_1_2_7_6_1","first-page":"9","article-title":"Involuntary psychiatric hospitalization and risk management: the ethical considerations","volume":"11","author":"Christensen R.","year":"2011","journal-title":"Jefferson Journal of Psychiatry"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2007.164.3.393"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.62.2.pss6202_0171"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1976.01770060086012"},{"key":"e_1_2_7_10_1","unstructured":"FalvoN.(2009)Homelessness program response and an assessment of Toronto's Streets to Homes program. Canadian Policy Research Networks. Available at:http:\/\/cprn.org\/documents\/50981_EN.pdf(accessed 30 April 2014)."},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-005-6430-7"},{"key":"e_1_2_7_12_1","first-page":"e225","article-title":"The prevalence of mental disorders among the homeless in western countries: systematic review and meta\u2010regression analysis","volume":"5","author":"Fazel S.","year":"2008","journal-title":"Public Library of Science"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2002.02209.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2008.01266.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638230802053326"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61133-8"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4036"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-787"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-007-9046-y"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-011-0427-z"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1191\/0969733002ne480oa"},{"key":"e_1_2_7_22_1","first-page":"1","article-title":"Is deinstitutionalization a \u2018failed experiment\u2019? The ethics of re\u2010institutionalization","volume":"3","author":"Morrow M.","year":"2008","journal-title":"Journal of Ethics in Mental Health"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.12297"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1891\/cmaj.5.2.101.66284"},{"key":"e_1_2_7_25_1","unstructured":"Royal College of Psychiatrists(2014)Health of the Nation Outcome Scales. Available at:http:\/\/www.rcpsych.ac.uk\/crtu\/healthofthenation\/whatishonos.aspx(accessed 30 April 2014)."},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.12.1873"},{"key":"e_1_2_7_27_1","volume-title":"Stata Statistical Software: Release 13","author":"StataCorp","year":"2013"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.2753\/IMH0020-7411390101"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-167"},{"key":"e_1_2_7_30_1","unstructured":"Street Needs Assessment Results(2013)Toronto: Toronto Shelter Support & Housing Administration 2013. Available at:http:\/\/www.toronto.ca\/legdocs\/mmis\/2013\/cd\/bgrd\/backgroundfile-61365.pdf(accessed 30 April 2014)."},{"key":"e_1_2_7_31_1","first-page":"201","article-title":"Considering alternatives to the housing first model","volume":"6","author":"Tsai J.","year":"2012","journal-title":"European Journal of Homelessness"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.4.651"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-011-0414-4"}],"container-title":["Journal of Psychiatric and Mental Health Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpm.12287","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpm.12287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpm.12287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T03:21:09Z","timestamp":1696216869000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpm.12287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,23]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1111\/jpm.12287"],"URL":"https:\/\/doi.org\/10.1111\/jpm.12287","archive":["Portico"],"relation":{},"ISSN":["1351-0126","1365-2850"],"issn-type":[{"value":"1351-0126","type":"print"},{"value":"1365-2850","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,23]]}}}