摘要：The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment. HEALTH PROVIDERS FACE significant challenges to provide comprehensive healthcare to homeless persons, as care is often fragmented and lacking in coordination and continuity between providers. Such lack of integration may be detrimental to health care of homeless persons who are prone to significant medical, mental health, and substance abuse comorbidities. 1 – 4 Health care needs of urban homeless persons are often addressed at emergency rooms, urgent care sites, and free-standing clinics. 5 , 6 Care at these clinics is often provided by medical or behavioral health providers, but rarely both. Research has demonstrated that a significant gap exists between the medical and behavioral health needs of homeless individuals and the provision of health services to meet that need. 7 Emerging community initiatives are designed to confront the many facets of homelessness, and significant resources have been allocated to assist local and regional efforts. 8 , 9 One national initiative provided 12 community-guided grants to increase integration between Health Care for the Homeless primary care clinics and community mental health agencies. The goal of this initiative was to discover unique and collaborative strategies for reducing the morbidity of homelessness.
