Presentation given by Teresa Caldas de Almeida and Paula Domingos, Portugal at a FEANTSA Research Conference on "Understanding Homelessness and Housing Exclusion in the New European Context", Budapest, Hungary, 2010

1. Pilot project for the
treatment
of homeless people
Paula Domingos
National Mental Health Coordination Body – Portugal
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN THE
ENHR
NEW EUROPEAN CONTEXT

2. CARE FOR VULNERABLE GROUPS
Homeless people
Pilot project for the treatment
of homeless people
1st Stage: Argument and research -- 2009
1st Stage: Argument and research 2009
•• Field work
Field work
•• Bibliographic review
Bibliographic review
2nd Stage: Assessment of the access to mental health care
2nd Stage: Assessment of the access to mental health care
•• Development and administration of a questionnaire to health
Development and administration of a questionnaire to health
professionals working in the area
professionals working in the area
3rd Stage: Implementation and monitoring of the project–
3rd Stage: Implementation and monitoring of the project–
2010
2010
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

3. CARE FOR VULNERABLE GROUPS
Homeless people
1st Stage
Outcome from the field work
Outcome from the field work
Incidence of mental health diseases:
a) Alcoholism
b) Drug addiction
c) Psychotic disorders
Well Known institutions that were contacted: CML/Departamento de Acç ão
Social:ERASA, Associaç ã Mé dicos do Mundo, Comunidade Vida e Paz,
o
Novos Rostos Novos Desafios.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

4. CARE FOR VULNERABLE GROUPS
Homeless people
2nd Stage
Administration of the Questionnaire on the Assessment to Mental Health
Care by homeless people to professionals in the catchment area
Scope
- Thoroughly analysing the access to mental health care.
Aims
- To identify difficulties areas for the homeless when
accessing mental health care services, by the technical
teams.
- To know about the procedures which connect mental
health and the social sector.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

5. CARE FOR VULNERABLE GROUPS
Homeless people
2nd Stage: Outcome
Access to Mental Health Care Services
Table 1 – Homeless people referenced, in average per
week
Number of Average Standard
People deviation
Street team 1 0,79 1,1
Temporary accomodation centre 2 0,82 1,1
Social assistance 5 1,90 2,3
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

6. CARE FOR VULNERABLE GROUPS
Homeless people
2nd Stage: Outcome
Table 2 – Difficulties by Type of Service
Difficulties
Type of Service
Administrative Relational Communication
Emergency 3.1 2.7 3.1
Outpatient services 2.8 2.3 2.9
Primary health care
centre 2.6 2.1 2.8
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

7. CARE FOR VULNERABLE GROUPS
Homeless people
3rd Stage
Partnership Protocol between the National Mental Health Coordination
Body and the Psychiatric Hospital Centre in Lisbon (CHPL)
Scope:
• To ensure the access of homeless people to mental
health care services, at regional level.
Objectives:
• To ensure psychiatric and psychological follow-up of
homeless people coming from the referral of case
managers, street teams and other institutions that provide
support.
• To help the training of professionals that work in the
Lisbon Platform.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

8. CARE FOR VULNERABLE GROUPS
Homeless people
3rd Stage
Partnership Protocol between the National Mental Health Coordination
body and the Psychiatry Hospital Centre in Lisbon (CHPL)
Negative aspects:
1.Difficulties in accessing the mental health care services provided by
the health care system;
2.Inability by the traditional psychiatric services to respond to the
health care needs of homeless people.
Positive aspects:
The collaboration with the Psychiatry Hospital Centre in Lisbon, which
has the know-how and experience of providing mental health care
homeless people.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

9. CARE FOR VULNERABLE GROUPS
Homeless people
3rd Stage
Partnership Protocol between the National Mental Health Coordination
body and the Psychiatry Hospital Centre in Lisbon (CHPL)
Protocol requirements:
Referral procedures
• Entrance/access by homeless people in the CHPL through the
mental health clinical team and the required signalling/referral
form, to the care of the CHPL (the form is part of the National
Strategy for the Integration of Homeless People);
• The referral of homeless people to the CHPL is done by the case
managers.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

10. CARE FOR VULNERABLE GROUPS
Homeless people
3rd Stage
Partnership Protocol between the National Mental Health Coordination
body
and the Psychiatry Hospital Centre in Lisbon (CHPL)
Protocol requirements:
Providing mental health care:
The provision of mental health care services takes place in
ambulatory care.
• Emergency services - using the psychiatric emergency
of the HCC.
• The medication cost is shared by national health care.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

11. CARE FOR VULNERABLE GROUPS
Homeless people
3rd Stage
Partnership Protocol between the National Mental Health Coordination body
Partnership Protocol between the National Mental Health Coordination body
and the Psychiatry Hospital Centre in Lisbon (CHPL)
and the Psychiatry Hospital Centre in Lisbon (CHPL)
Protocol requirements:
Managing information:
• Information about the health situation of the homeless
person (clinical situation) will be sent to the case
manager through the return form.
• When possible, the information will be sent in the
following formats:
a) email;
b) fax.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

12. CARE FOR VULNERABLE GROUPS
Homeless people
3rd Stage
Partnership Protocol between the National Mental Health Coordination body
Partnership Protocol between the National Mental Health Coordination body
and the Psychiatry Hospital Centre in Lisbon (CHPL)
and the Psychiatry Hospital Centre in Lisbon (CHPL)
Protocol requirements:
Providing mental health care:
The provision for mental health care follows the partnership
model as set out in the Plan of the National Strategy for the
Integration of Homeless People.
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

13. CARE FOR VULNERABLE GROUPS
Homeless people
Partner organisations
Referral entities AMI – Fundação de Assistência Média Internacional
Centro de apoio ao sem abrigo
Centro social do exercito de salvação
CML
Comunidade Vida e Paz
Legião Boa Vontade
STREET TEAM
Médicos do Mundo
Movimento ao Serviço da Vida
Novos Rostos novos Desafios
Santa Casa da Misericórdia de Lisboa
VITAE – associação de Solidariedade e Desenvolvimento Internacional
Desafio Jovem
TEMPORARY AMI – Fundação de Assistência Média Internacional
ACCOMODATION
CENTRE
Associação dos Albergues Nocturnos de Lisboa
Centro Social do Exercito de Salvação
Santa Casa da Misericórdia de Lisboa
VITAE – Associação de Solidariedade e Desenvolvimento
Internacional
ATELIER Associação Crescer na Maior
Santa Casa da Misericórdia de Lisboa
ASSISTANCE Santa Casa da Misericórdia de Lisboa
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT

14. CARE FOR VULNERABLE GROUPS
Homeless people
Thanks for your attention!
NATIONAL MENTAL HEALTH
COORDINATION BODY,
PORTUGAL
pauladomingos@acs.min-saude.pt
European Research Conference, Budapest, 17th September 2010
UNDERSTANDING HOMELESSNESS AND HOUSING EXCLUSION IN ENHR
THE NEW EUROPEAN CONTEXT