| Summary: | Adults with experiences of homelessness, both those who have been homeless and those with housing insecurity, are more likely to suffer from higher rates of chronic illness and early mortality compared with those who are not homeless. Adults with experiences of homelessness experiences also have a higher mental health burden than the general population; about 20-25% of people who experience homelessness in the United States also have been diagnosed with serious mental illness (SMI). The VA National Psychosis Registry defines SMI as the presence of schizophrenia, other psychotic disorders, or bipolar disorder. Mental and behavioral health disorders threaten household stability, which, in turn, leads to poor community integration and engagement with medical care. Hence, both experiences of homelessness and mental illness are vulnerabilities that negatively impact health and receipt of health care. Individuals with experiences of homelessness and SMI would benefit greatly from longitudinal medical care delivered in the context of a population-tailored clinical setting, yet the underlying context of both experiences of homelessness and SMI create notable barriers to accessing and engaging with traditional clinic-based primary care. As a result, these individuals receive less preventive care and chronic disease management and often receive the majority of their health care in episodic acute care visits delivered in more costly locations such as emergency departments, which are ill equipped for the complexity of this patient population
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