Improving outcomes for people who are homeless and have severe mental illness in Africa (HOPE): Pilot study
Severe mental illness, including psychotic and affective conditions (e.g. bipolar disorder or severe depression) associated with disability
Contextualised complex intervention that focuses on (1) identification, initial engagement and assessment, (2) response to emergency needs, and (3) person-centred care planning, ongoing engagement and care co-ordination. The intervention primarily works with existing cadres of community, health and social care workers and comprises training, social contact interventions with people with lived experience to reduce stigma, referral pathways, decision support and proformas for information capture. In addition, each country will integrate peer support workers employed by the project who have lived experience of severe mental illness, with or without experience of homelessness.
Key inclusion criteria for qualitative interviews Person experiencing homelessness and severe mental illness (SMI) 1. Person who is homeless and present in the study locations at the time of pilot study. The definition of homelessness was operationalised in the HOPE formative work and includes people who spend the night unsheltered or in other places not intended for habitation (e.g. under bridges or unfinished buildings or in a forest). The study will include people who pay for a bed for the night on an ad hoc basis when they can afford it. 2. Identified as having probable SMI based on the assessments of community workers who have been trained by HOPE 3. Aged 16 years or above based on self-report or estimation. There is no upper age limit. 4. Willing and able to provide informed consent Provider 1. Care provider who attends training in HOPE interventions 2. Aged 18 years or above 3. Willing and able to provide written informed consent Implementation working group 1. Professionals, experts by lived experience and peer support workers involved in implementation working group 2. Aged 18 years or above 3. Willing and able to provide written informed consent
Person experiencing homelessness and SMI 1. People who do not meet the definition of homelessness because they spend their days on the streets, for example, to beg, but who have stable night-time accommodation 2. People who have substance use problems without any evidence of SMI 3. Children or adolescents younger than 16 years of age who have probable SMI. This group is excluded because of the different needs, interventions and service configurations for this age group. 4. Unwilling or unable to provide informed consent Provider 1. Unwilling or unable to provide written informed consent