Subacute Inpatient Units for a Subset of People Experiencing Chronic Street Homelessness and Serious Mental Illness

This column describes a state-funded initiative that provides intensive inpatient care for individuals whose chronic homelessness appears to be driven by three factors: serious mental illness, the inability to be engaged in care even with repeated assertive outreach, and fulfillment of the criteria for involuntary admission (usually by virtue of grave disability). Stable housing and ongoing engagement in care are the key outcomes. For the initial cohort of patients with 6 months of follow-up data (N=51), 61% remained stably housed, and 71% remained engaged in care. Length of stay—expected to be approximately 6 months—has gradually increased. Lessons learned are discussed.