Unhoused patients admitted to inpatient psychiatry at an academic, safety-net hospital: a cross-sectional study

Introduction: There is a lack of data regarding unhoused patients admitted to inpatient psychiatry in the United States. The authors describe demographic and diagnostic features of unhoused patients admitted to an acute psychiatric inpatient unit (PIU) at an academic, safety net hospital. Methods: This is a cross-sectional, retrospective chart review of 57,902 adult patients admitted to the hospital between January 1, 2018 and May 31, 2023. Eleven percent (n = 6304) were admitted to the PIU and were part of further subgroup analysis examining housing status and primary behavioral health diagnoses. Chi-square tests of independence were used to determine associations between categorical variables. Results: The proportion of patients admitted to the PIU who were unhoused (33%, n = 2065) was 3 times greater than the proportion of patients admitted to non-psychiatric inpatient units who were unhoused (11%, n = 5450). On the PIU, unhoused patients compared to housed patients were more likely to be male (67 and 51%), have a psychotic disorder (35 and 19%) or a substance-related disorder (19 and 8%), and were less likely to have a mood disorder (22 and 44%). Conclusion: Understanding demographic and diagnostic factors is important to develop effective interventions to address the needs of unhoused patients on a PIU.