Understanding homeless shelter users: Overlap with criminal justice and behavioral health systems

Background: Adults who use homeless shelters have a wide variety of characteristics and needs. In order to best identify people who incur high costs through multiple system use and who may benefit from supportive housing, Connecticut records for shelter users are regularly merged with other state administrative records. We sought to describe the nature of behavioral health problems among shelter users, and to examine the impact of interruptions in care on shelter use and criminal justice involvement. Methods: We matched and merged records of 26,000 individual adults who received services in Connecticut shelters during a 3-year period, 2010 – 2012, with administrative files from the CT Department of Mental Health & Addiction Services, and from the CT Department of Correction (which covers both jails and prisons). We measured overall rates to of overlap with each system, and between all three systems, and compared each type of user with individual characteristics and patterns of use, especially for individuals who discontinued service use. Results: Approximately 22% of homeless individuals also have records in the correctional system, and 57% have records in the behavioral health system. Shelter users in the behavioral health system have high rates of co-occurring disorders (75.0%), but are especially likely to engage in behavioral health treatment if they have been arrested. The population will be further described with respect to diagnostic categories, type of service use, and the relationship between service interruptions and use of shelters and jails.