Mental health needs assessment of individuals experiencing homelessness in Charleston, South Carolina

Context: More than 4,268 people were experiencing homelessness in South Carolina during the 2020 point in time count, with Charleston county ranked the 4th highest in the state for number of individuals experiencing homelessness. Mental health disorders often contribute to or result from housing insecurity.

Objective: The purpose of this quality improvement study was to determine mental health needs, and mental health services utilization patterns of people experiencing homelessness or housing insecurity (PEH) in Charleston, SC.

Study Design: Cross sectional survey, utilizing a 13 question paper survey

Setting: Drop-in resource center for PEH

Population Studied: 33 PEH accessing the resource center

Outcome Measures: 1. Demographics 2. Mental health needs 3. Access to mental health resources and 4. Preferences for accessing mental health services.

Results: Survey participants (n=33) ranged from 19 to 64 years old with 57.6% identifying as male and 51.5% identifying as Black. More than three quarters (81.3%) of those surveyed reported being diagnosed with at least one psychiatric disorder. Over half (56.3%) had been hospitalized for a psychiatric reason. Over two thirds (70.0%) were accessing some form of mental health service and 51.9% endorsed some difficulty accessing prescribed psychiatric medications. Cost and transportation were selected most often as barriers to access. Most participants (92.9%) were interested in receiving some form of mental health service and 62.5% said access to services would make it easier to get stable housing. Most (85.2%) were willing to access mental health services virtually, however, 50.0% of participants did not report access to an electronic device and most (74.1%) denoted preference for in person services

Conclusions: PEH have significant mental health needs and experience barriers to accessing mental health services. Resources directed at addressing these barriers are essential to improve the mental health of this vulnerable population and ameliorate housing instability.