Amal Abdel-Baki1, Virginie Doré-Gauthier1, Isabelle-Sarah Lévesque1; 1CHU Montreal, Canada
Background: Psychosis is associated with homelessness and conversely homelessness increases psychosis risk, the young being at higher risk. In Montreal inner city early intervention service (EIS), 29% of the first episode psychosis (FEP) cohort experienced homelessness. Non-affective psychosis, male gender, lower education, drug abuse and cluster B personality disorder were associated with homelessness. Homeless participants had worse symptomatic and functional outcomes, longer hospitalisations and were more likely to use emergency services despite regular EIS services. The Centre Hospitalier de l’Université de Montréal created in 2012, an intensive assertive community intervention team (AICIT) offering specialized care for homeless FEP (HFEP), aiming to offer to this clientele, individualized treatment integrating specialized and intensive care for early psychosis, housing support as well as substance use disorder (SUD) and outreach interventions. Objectives: Explore the impact of the addition of an IACIT to an EIS. Methods: 2 years-longitudinal study comparing the outcome of HFEP followed by both the EIS and IACIT since 2012 to a historical cohort of HFEP followed only by the EIS between 2005 and 2011. Results: HFEP followed by the EIS+IACIT attained housing stability more quickly and spent less time hospitalised than HFEP followed only by the EIS (RR 2.38, p=0.017). HFEP with cocaine misuse were less likely to attain housing stability (RR 0.25, p=0.04). Symptomatic, functional and SUD outcomes between the two groups were similar. Conclusion: HFEP outcome may be improved by the addition of IACIT to EIS as they have special expertise in quitting homelessness in collaboration with community organisations.
