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Alicia Sands Lurry, 404/616-6389,
September 3, 2002


Emory Psychiatrists Develop Outreach Program For Metro Atlanta Homeless

In the first collaboration of its kind in metro Atlanta, Emory University School of Medicine and Grady Health System are working together through Central Fulton Community Mental Health Center to provide integrated psychiatric outreach services to the city's homeless who are severely mentally ill and in need of comprehensive mental health and medical services. The collaboration is made possible through a special appropriation of state funds from the Fulton Regional Board.

The program supports two Homeless Outreach Psychiatry Evaluation (HOPE) teams developed in part by Emory faculty members Rosalind Mance, M.D., medical director of Community Outreach Services and associate professor in the Department of Psychiatry and Behavioral Sciences, and Catherine Peters, M.D., assistant professor in the Department of Psychiatry and Behavioral Sciences. The goal of the program is to reduce homelessness, incarceration, and hospitalization and provide an integrated approach to treatment that focuses on community-based treatment and principles of prevention and rehabilitation.

As part of the outreach program, two teams of psychiatrists, nurses, case managers, substance abuse counselors, and social workers work closely with several community shelters, homeless service providers, the court and jail systems, and Grady mental health programs. The phase of client recruitment focuses on active outreach and engagement. The initial contact, as well as on-site intakes and evaluations, are completed where individuals live and are already receiving services: on the streets, in shelters, parks, and Georgia Regional Hospital. Some of the community agencies involved include St. Joseph's Mercy Care Services of Atlanta, as part of its Healthcare for the Homeless program; the Atlanta Day Shelter for Women and Children; Crossroads Ministries; and the Task Force for the Homeless.

The purpose of the HOPE teams, Dr. Peters notes, is to shift treatment of homeless individuals away from emergency room settings and hospitals and to prevent relapse. The ultimate goal of this treatment model is transition clients out of homelessness by providing a continuum of care, including psychiatric, medical, and case management services. The team provides psychiatric evaluation and medication management along with case management services including assistance with housing, income support, and vocational and legal issues. The teams, which currently work with 115 homeless individuals, work with clients for up to 24 months of treatment.

Clients are eligible for HOPE services if they meet criteria for homelessness and severe mental illness. Clients with dual diagnosis (those with a secondary diagnosis of alcohol or drug dependence) are also eligible for the program.

"The need for mental health treatment for the homeless is far bigger than one program can provide, but the goal is to use this integrated model of psychiatric and social services to address the needs of underserved homeless and mentally ill individuals in Atlanta," Dr. Mance said. "In addition, an essential need is for Atlanta to develop more specialized and supportive housing options for this population."

The Atlanta Trijurisdiction Continuum of Care's Year 2000 Gaps Analysis estimated that 5,775 homeless persons per night in Atlanta were substance abusers, seriously mentally ill, or dually diagnosed and in need of services. According to the 2001 Strategic Plan for Improved Services for the Homeless in Region 5, the existing service capacity for this group was 1,637 per day, leaving 4,240 people, or 73 percent, with unmet needs.

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