A New Kind of Homelessness for Individuals With Serious Mental Illness? The Need for a “Mental Health Home”


Thomas E. Smith, M.D. and Lloyd I. Sederer, M.D.

Funding Area

Integrating Mental Health and Substance Use Services


March 13, 2009

Integrating Mental Health and Substance Use Services

This April 2009 Psychiatric Services article discusses the adaptation of the medical home concept to the care for individuals with serious mental illness (SMI).

Medical home characteristics, such as access to and coordination of services, integration of primary and preventive care, adoption of recovery orientation and evidence-based practices, and family and community outreach, are ideal for the treatment of co-occurring disorders (COD). The authors cite individuals with COD as a target population for this kind of initiative.

Individuals with severe and persistent SMI, often with co-occurring substance use issues, are unable to access consumer- and family-oriented community care, resulting in repeated hospitalizations, incarceration, and homelessness. A mental health home will require mental health clinicians to function more like generalists, working with the entire individual and coordinating care among a range of behavioral and rehabilitation service providers. A clinical setting that provides services for individuals with SMI and adopts these principles can be thought of as a “mental health home.” A mental health home would not be a new type of service. Instead, existing clinics, assertive community treatment teams, psychiatric rehabilitation programs, and partial hospitalization or day treatment programs would become mental health homes by practicing a core set of principles outlined in the article.