This study assessed the impact of inpatient mental health bed closures on access to mental health services among homeless individuals. During 1996, 26 percent of mental health inpatient beds in the Veterans Health Administration (VHA) were closed. We examined inpatient and outpatient service use among 45,083 veterans in VHA’s Health Care for Homeless Veterans (HCHV) program, a national homeless outreach effort, two years before and after these bed closures. Service use was compared at two different facility types: (1) those which closed 35% or more of mental health beds (high bed closure) and (2) those which closed only 4% of beds (low bed closure). Multiple regression analysis was used to assess the interaction of time of intake (pre- and post-1996) and site type (high- and low-bed closures), controlling for veteran characteristics at baseline. Homeless veterans at sites with high bed closures showed significantly greater reduction in use of any VHA mental health services and in use of VA inpatient care than did veterans at low bed closure sites. However, veterans at high bed closure sites also showed a greater increase in use of outpatient mental health services during the study period. Outcomes for veterans discharged from residential treatment during the study period were similar at each site type. We conclude that mental health bed closures reduced access to VHA health services for some homeless veterans, although among those who received services, the reduction in inpatient care appears to have been compensated with significant increases in the intensity of outpatient care.
Learning Objectives: N/A
Keywords: Access and Services, Veterans
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Department of Veterans Affairs
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.