Wednesday, March 2, 2016

Accuracy of Reported Service Use in a Cohort of People Who Are Chronically Homeless & Seriously Mentally Ill

Self-reported service use is an integral feature of interventional research with people who are homeless and mentally ill. The objective of this study was to investigate the accuracy of self-reported involvement with major categories of publicly funded services (health, justice, social welfare) within this sub-population.

Measures were administered pre-randomization in two randomized controlled trials, using timeline follow back with calendar aids for Health, Social, and Justice Service Use, compared to linked administrative data. Variables examined were: psychiatric admissions (both extended stays of more than 6 months and two or more stays within 5 years); emergency department visits, general hospitalization and jail in the past 6 months; and income assistance in the past 1 month. Participants (n = 433) met criteria for homelessness and a least one mental illness.

Prevalence adjusted and bias adjusted kappa (PABAK) values ranged between moderate and almost perfect for extended psychiatric hospital separations, multiple psychiatric hospitalizations, emergency department visits, jail, and income assistance. Significant differences in under versus over reporting were also found.

People who are homeless and mentally ill reliably reported their overall use of health, justice, and income assistance services. Evidence of under-reporting and over-reporting of certain variables has implications for specific research questions.

Full article at:

Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
Julian M. Somers,  ac.ufs@sremosj.

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