Shelter Service Utilization among Homeless Adults: Associations with Substance Use Disorder, Mental Health Diagnosis, and Dual Diagnosis



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Although substance use and mental health disorders among homeless adults remains a prevalent public health issue, accessing treatment and shelter services has proved challenging. Surveying 565 homeless adults from six-area shelters in Oklahoma City, OK, we examined the association between substance use disorder diagnosis, mental health diagnosis, dual diagnosis, and socio-demographic characteristics on the utilization of 13 types of shelter services. These associations were measured through covariate-adjusted logistic regression models. Among the services, receiving meals at a shelter, spending the night at a shelter, and meeting with a case manager were the most utilized. Participants with only a mental health diagnosis tended to utilize mental health counseling and a case manager, while participants with only a substance use disorder diagnosis tended to utilize substance abuse counseling and attending educational group meetings. Those with dual diagnosis were more likely to utilize eight of the 13 services. Participants without an official diagnosis were less likely to seek shelter services than those with an official mental health and/or substance use diagnosis. Age, gender, race/ethnicity, and marital status, were also associated with shelter service utilization. To meet the needs of this vulnerable population, shelters should consider providing more opportunities for a clinical diagnosis.