Establishing behavioral health services in homeless shelters and using telehealth digital tools: best practices and guidelines

Purpose Homelessness is a growing concern across the globe that has multiplied during the pandemic. According to a recent report by the Department of Housing and Urban Development (HUD, 2018), 20% of the homeless population have a severe mental illness and 16% chronically used substances. This paper aims to address the effectiveness of in-shelter mental health services provided by qualified clinicians. Design/methodology/approach In this study, clients from a homeless shelter were provided in-shelter mental health intake and resources by predoctoral clinicians. Their pre- and postdistress scores were recorded to establish the effectiveness of the intervention. Findings Ninety-eight guests were provided services of which 51% reported co-occurring mental health and substance use diagnoses. There was a clinically significant difference in the pre- to postsession distress levels based on the ratings at the intake session. It was noted that making services accessible increased the ability to provide triage services, help with housing options and integrate care with other providers and decrease distress levels. Research limitations/implications The current program was implemented in only one shelter in Upstate New York, other similar settings need to be explored in different locations. Objective indicators will be analyzed in the future to establish the effectiveness of services. Practical implications This paper outlines a procedure that can guide and help future projects to establish clinical care at homeless shelters across the USA and globally. This paper provides examples of the intake form, list of resources and basic coping strategies that can aid other clinicians and researchers to establish similar programs. Social implications This paper sheds light on the mental health needs of an underserved and underrepresented population in the field of mental health - the homeless. The guidelines outlined in this paper can help set up more mental health clinics at homeless shelters and make mental health services more accessible, which can help prevent recurring homelessness. Originality/value This paper establishes guidelines for effective single session interventions that help decrease distress levels. This paper also establishes the need for in-shelter services to overcome barriers in mental health care for the homeless population.