A survey of the problems and needs of homeless consumers of acute psychiatric services.

Efforts to alter the repeated use costly hospital-based psychiatric services and the underuse of community mental health services by some homeless adults have yielded few successes. To better understand these failed efforts, the authors interviewed 112 self-identified homeless recidivists in San Francisco on several demographic variables, the problems they face in living in the community, and the resources they feel they need to be able to remain in the community. Most striking among the findings was the low priority respondents accorded to the psychiatric and social services currently offered by community mental health agencies; instead the respondents often blamed their inability to avoid readmissions on their lack of basic resources for survival. The authors discuss the relevance of the findings for mental health research, funding policies, and programming.