Accuracy of reported service use in a cohort of people who are chronically homeless and seriously mentally illReportar como inadecuado

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BMC Psychiatry

, 16:41

Social psychiatry, therapy and provision of mental health care


BackgroundSelf-reported service use is an integral feature of interventional research with people who are homeless and mentally ill. The objective of this study was to investigate the accuracy of self-reported involvement with major categories of publicly funded services health, justice, social welfare within this sub-population.

MethodsMeasures were administered pre-randomization in two randomized controlled trials, using timeline follow back with calendar aids for Health, Social, and Justice Service Use, compared to linked administrative data. Variables examined were: psychiatric admissions both extended stays of more than 6 months and two or more stays within 5 years; emergency department visits, general hospitalization and jail in the past 6 months; and income assistance in the past 1 month. Participants n = 433 met criteria for homelessness and a least one mental illness.

ResultsPrevalence adjusted and bias adjusted kappa PABAK values ranged between moderate and almost perfect for extended psychiatric hospital separations PABAK: 0.77; 95 % confidence interval CI = 0.71, 0.83, multiple psychiatric hospitalizations PABAK = 0.50, 95 % CI = 0.41, 0.59, emergency department visits PABAK: 0.77; 95 % CI = 0.71, 0.83, jail PABAK: 0.74; 95 % CI = 0.68, 0.81, and income assistance PABAK: 0.82; 95 % CI = 0.76, 0.87. Significant differences in under versus over reporting were also found.

ConclusionsPeople who are homeless and mentally ill reliably reported their overall use of health, justice, and income assistance services. Evidence of under-reporting and over-reporting of certain variables has implications for specific research questions.

ISRCTN registry: 57595077 Vancouver at Home Study: Housing First plus Assertive Community Treatment versus congregate housing plus supports versus treatment as usual; and 66721740 Vancouver at Home study: Housing First plus Intensive Case management versus treatment as usual.

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Autor: Julian M. Somers - Akm Moniruzzaman - Lauren Currie - Stefanie N. Rezansoff - Angela Russolillo - Milad Parpouchi


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