Clinical and social outcomes of homeless persons with mental illness receiving Care in Emergency Care and Recovery Centres (ECRCs) in Tamil Nadu, India: A descriptive study

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BACKGROUND: Homeless people with mental illness (HPWMI) are an ultra-vulnerable population with unmet clinical and social needs. To address this, the Government of Tamil Nadu, India, launched the Emergency Care and Recovery Centres (ECRCs) in 2019 to rescue, treat, and reintegrate HPWMI with their families. We conducted this study to evaluate the clinical and social outcomes of individuals admitted to ECRCs. METHODS: We conducted a descriptive analysis using case records for individuals admitted to 13 ECRCs between 1st January 2022 and 31st December 2022. Using simple random sampling, 250 records were selected from all admissions during this period. We retrospectively extracted social, demographic and clinical characteristics and treatment outcomes using data-extraction forms. The characteristics and outcome were summarized and reported as proportions. Ethical approval was obtained from the Institutional Human Ethics Committee of ICMR-NIE. FINDINGS: A total of 1619 individuals were admitted during the study period. We retrieved 250 case records. The majority were male (59%, 148/250) and were aged 26-50 years (75%, 162/217). Schizophrenia spectrum disorders were the most common psychiatric diagnosis (57%, 137/242). Physical comorbidities were present in 20% (49/250), with anaemia being the most frequent. Majority (71%, 135/190) showed weight gain at discharge, and 46% (84/184, 95%CI: 38-53) were reintegrated with families. INTERPRETATION: The ECRC program has the potential to improve clinical outcomes and social life of HPWMIs. Long-term care models are required for individuals who were not reintegrated with families after initial rehabilitation.

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