Date of Submission

Fall 12-18-2022

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Jo Loomis

Second Advisor

Dr. Joan Fraino


Emergency shelters provide a unique location to offer easily accessible services for unhoused individuals experiencing mental distress and serious mental illness. Housing First interventions do not improve mental health or social integration. It is important to consider alternative approaches to providing care for homeless individuals. This integrated review was undertaken to evaluate existing evidence of interventions that improve mental health awareness and utilization of mental health services among unhoused populations living in shelters. Assertive outreach is an important strategy that was shown to improve effectiveness of mental health programs in shelters; reconnect individuals with family; and help with psychological integration. Screening, as a component of the assertive outreach strategy, has an enabling effect on the promotion of mental health awareness and utilization of mental health services. The process of screening individuals was informal and semi-structured; conducted by both clinical and shelter staff; but used validated screening instruments. Initiative taken by clinicians and outreach workers to seek out individuals about mental health changed the context of care. Incorporation of shelter staff helped to expand social networks, rather than establish traditional patient-provider relationships, which improved self-efficacy through social support. The synthesis of evidence recommends that a non-traditional approach to mental health care, which emphasizes outreach and social network building, be implemented within shelters to improve on-site utilization of mental health services.

Included in

Nursing Commons