Summary: Researchers use geospatial indicators of mental health need and homelessness in Los Angeles County Service Planning Areas (SPAs) and a psychiatric sample of adults who were homeless to investigate 1) overlap between SPA level of mental health need and corresponding volume of involuntary psychiatric hospitalizations over time; 2) overlap between SPA level of unsheltered homelessness and corresponding volume of involuntary psychiatric hospitalizations over time; and 3) associations between SPA level of mental health need, SPA level of unsheltered homelessness, and initiation of a mental health conservatorship for grave disability.
A sample of 373 adults who were homeless and hospitalized on an involuntary psychiatric hold from 2016 to 2018 were linked to data from the Greater Los Angeles Homeless Count on unsheltered homelessness and from the 2012 California Health Interview Survey (CHIS) on need for mental health services and suicidality, using admission ZIP codes to link variables at the SPA level.
Findings: Results suggest a need for targeted mental health and housing services to reach areas of highest need in Los Angeles County. Regional unsheltered homelessness was associated with severe mental illness. Psychiatric admissions from areas with high levels of homelessness decreased. Psychiatric admissions from areas with high levels of mental health need increased. Mental health and housing services should be targeted to areas of highest need. Housing first approaches are essential to long-term mental illness stability.
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