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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0743

Navigating fragmented care: The role of social determinants in mental health service use among people experiencing homelessness in Skid Row

NAVIGATING FRAGMENTED CARE: THE ROLE OF SOCIAL DETERMINANTS IN MENTAL HEALTH SERVICE UTILIZATION AMONG PEOPLE EXPERIENCING HOMELESSNESS IN SKID ROW

Among people experiencing homelessness in Skid Row, 47.6% reported current mental health struggles; this group showed high levels of nonprescription drug use, low engagement in addiction treatment, and a crisis-driven, episodic pattern of care.

The study aimed to assess the role of social determinants of health (SDOH) in healthcare utilization and self-management behaviors among people experiencing homelessness in Skid Row. A cross-sectional survey of N = 163 Skid Row residents assessed mental health status, access to physical healthcare, patterns of prescription and nonprescription drug use, and treatment engagement; respondents reporting current mental health struggles (MHS) were compared with those who did not. Overall, 47.6% of participants reported current mental health struggles, and 89.7% of this group had a co-occurring physical illness. Nonprescription drug use was markedly higher among those reporting mental health struggles (past use: 63.2% versus 46.7%; current use: 26.5% versus 14.7%). Only 19.1% of this group were actively engaged in substance use treatment programs. Those reporting mental health struggles used physician services more frequently, and the time since their last visit was significantly shorter (4.06 versus 6.88 months); this pattern suggests crisis-driven, acute, and episodic care rather than consistent preventive care. In conclusion, the combination of high levels of self-medication and low engagement in addiction treatment reveals a substantial gap in accessible, stigma-free, integrated care models; overcoming healthcare fragmentation requires investment in equitable, continuous, and culturally responsive community-based services.

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