Breaking the cycle : evidence-based diversion for homeless individuals with mental illness

The resources and infrastructure in place to serve our nation’s homeless is spread thin. Issues of capacity, funding, and lack of individualized treatment plans create limited opportunities for individuals to escape their current, often cyclical circumstances. For many, this results in continuous interactions with the justice system and physical-behavioral health systems. This Professional Report seeks to examine the effectiveness of evidence-based diversion strategies used to keep individuals experiencing homelessness from cycling in and out of correctional facilities and unnecessary hospitalization, in both general and psychiatric settings. As a community, we have an ethical and moral responsibility to support homeless individuals suffering with mental illness who may require additional support. This report seeks to determine the most effective way to meet this obligation. Austin is rapidly changing its approach to solving homelessness, which has the potential to increase the number of unsheltered individuals experiencing homelessness, even if only for a brief amount of time. This can in turn lead to negative social determinants of health and an increased need for diversion from crisis settings. Individuals experiencing homelessness are unique—their needs, conditions, and mitigating circumstances are different. In order for successful diversion to take place, Austin must be robust in its approach. This report surveyed diversion strategies used nationwide in order to examine strategies and resources currently available in Austin and Travis County. Although Austin has a strong capacity for diversion, findings show there is room for improvement. Recommendations to improve Austin’s ability to divert homeless individuals with mental illness from unnecessary crisis system interactions include: increased outreach capacity; expansion of the Combined Transportation, Emergency, & Communications Center, Austin’s current central dispatch center; creation of a crisis stabilization unit; and 24/7 availability of Integral Care’s Expanded Mobile Crisis Outreach Team