Date of Graduation

Spring 5-18-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Dr. Jo Loomis

Second Advisor

Dr. Joan Fraino



Background: Serious mental illness (SMI) and substance use disorder (SUD) are two common findings among the majority of those experiencing homelessness in the Stanislaus County.

Local Problem: Emergency shelters typically do not provide mental health services on-site, however, a collaboration between First Behavioral Health Urgent Care Center (FBH) and We Care Program Turlock (WCPT) was established to provide mental health services on-site.

Method: The WCPT case manager as part of a Doctor of Nursing Practice (DNP) quality improvement project implemented Assertive Outreach Model interventions to increase utilization of mental health services and established long-term relationships.

Interventions: Frequent contact with clients; screening for SMI and SUD; and conducting team meetings with key stakeholders were elements implemented within the workflow.

Measures: Client encounter data; number of screenings and referrals completed compared to prevalence of SMI/SUD in Stanislaus County, and semi-structured interviews from key stakeholders were collected between Fall 2021-2022.

Results: 103 individuals connected with the WCPT case manager; 55 of 103 individuals were screened positive for either SMI/SUD; and 75% of referred clients met with the mental health clinician. Key stakeholders believed that the project established consistency because “it ties things together so these guys don’t slip through the cracks.”

Conclusion: Assertive Outreach interventions in emergency shelters is a feasible option to promoting mental health service utilization.

Keywords: mental health, services, utilization, screening, homeless, shelter, assertive outreach, social support