A pair of recent studies found that people are more likely to seek emergency healthcare services just prior to becoming homeless. Such findings invite service providers to reexamine their approaches to homelessness prevention and diversion.
Homelessness and Medical Treatment
Focusing on veterans, one set of researchers found an increase in treatment for suicidal thoughts and attempts in the year prior to homelessness onset, with a sharp increase in the eight weeks prior to a person becoming homeless. The second study of shelter users in New York City found an increase in emergency department visits in the year preceding homelessness, also with a sharp increase in utilization in the weeks closest to becoming homeless.
Both sets of researchers matched homeless client data to medical records, building upon previous studies that relied on sometimes imperfect self-reports of people experiencing homelessness. The previous research, like that completed by Margot Kushel (2002) and Bella Schanzer (2007), noted similar patterns—increased use of hospital emergency departments in the year prior to becoming homeless. In fact, the study conducted in 2007 found that almost “80% of respondents sought out medical treatment in the year before becoming homeless.”
Looking Ahead: Systems Collaboration
The results of these studies suggest a need for collaboration between the healthcare system and the homeless response system. Hospitals, both veteran and civilian, are in the unique position to identify people in housing crisis, raising certain questions:
- Can medical records inform efforts to prioritize people for homelessness prevention and other services?
- Can emergency rooms refer patients who are homeless and at-risk of homelessness to Coordinated Entry Systems?
- Are some homeless consumer challenges best addressed in the healthcare system? How can emergency doctors better help direct people to the healthcare treatments needed to stabilize them?
- How can diversion better account for the physical and mental health challenges? In managing housing crises, should they also make referrals aimed at these medical needs that go hand-in-hand?
Such interventions could prevent and quickly resolve homelessness while also avoiding unnecessary suffering.