Researchers: Wendel Abel, M. McCallum, Freddie W. Hickling
Department of Community Health and Psychiatry, University of the West Indies & Ministry of Health
Presented at the Faculty of Medical Sciences, 11th Annual Research Conference
Objective: Over the past 20 years the problem of homelessness in persons with severe and enduring mental illness has emerged as a major social and public health problem. This study seeks to evaluate the impact of two different community intervention programmes for the treatment of the homeless mentally ill in Jamaica.
Method: Two interventions that have been evaluated are the community treatment programme developed by the Westmoreland Association for Street People (WASP) and that developed by the Committee for the Upliftment of the Mentally Ill (CUMI). The WASP programme provided active administration of depot neuroleptic medication in the field, in addition to supportive and family intervention. The CUMI programme encouraged homeless people to voluntarily seek medication and supportive services at a prescribed location. The patients were followed for one year and the outcome date were reviewed retrospectively.
Results: Thirty-two persons were seen in the WASP programme and 54 persons seen in the CUMI programme. At the end of one year, 30 (94 per cent) persons from the WASP programme were reunited with their families at home compared with four (seven per cent) from the CUMI programme. At the end of one year, two (six per cent) persons from the WASP programme continued to live on the streets but they were still receiving regular, monthly depot medication. For the CUMI programme, 50 (93 per cent) persons were still living on the streets or were lost to follow-up.
Conclusions: The outcome of the patients in the WASP programme was far superior to that of patients in the CUMI programme.
