Addressing psychiatric needs for homeless-experienced patients: a pilot study for patient-centered solutions

Individuals experiencing homelessness face a disproportionate burden of psychiatric disorders, yet often receive inadequate mental health care. Community-based health centers, such as Boston Health Care for the Homeless Program (BHCHP), attempt to address this issue but do not often directly hear patients’ perspectives on care quality. This study aimed to assess patients’ psychiatric needs and inform patient-directed approaches to mental health care improvement for community-based organizations like BHCHP. Semi-structured interviews (n = 10) and one-page surveys (n = 10) were administered to homeless-experienced patients at BHCHP’s hospital-based clinic. Responses were qualitatively coded using thematic analysis. Participants reported positive impressions of therapy, although identified prolonged wait times for therapy as a barrier. While some expressed hesitance toward medications, many found them beneficial, particularly when combined with therapy. Participants also highlighted the importance of integrated services. Recommendations for improvement included increasing access to therapy, peer support, group sessions, emergency services, and a workforce with diverse skills. BHCHP and similar organizations may improve psychiatric care based on patient-directed suggestions, such as those described above. This study promotes a patient-centered approach towards quality improvement and encourages further research to address mental health care among vulnerable populations.