Impact of the Health Navigator Model on mental health of people experiencing homelessness in Europe

Abstract Background Mental ill-health is a growing global challenge that can increase the risk of homelessness, while the experience of homelessness can exacerbate mental ill-health. This study aims (1) to examine the mental health of people experiencing homelessness (PEH) in four European countries, and (2) to investigate the impact of the Health Navigator Model - a co-adapted, person-centered intervention aimed at improving empowerment and decision making and at removing barriers to access to the healthcare system - on PEHs’ mental health. Methods Data of 600 PEH (age: M = 47.96, SD = 13.14, Range: 19-87 years old; Gender: 384 men, 212 women, 3 non-binary/other, 1 did not provide this information) in Austria (n = 130), Greece (n = 151), Spain (n = 166), and the UK (n = 153) collected as part of the EU-funded CANCERLESS project was analyzed. Mental health was assessed at two timepoints via the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI-18). Analysis was conducted using repeated measures ANOVA with data collection site as an interaction term. Results The mean GSI at the first timepoint was 16.70 (SD = 14.64, range: 0-70) and at the second time point 16.28 (SD = 14.55, range: 0-65). There was no significant difference in the GSI between the two measurement timepoints (p=.349), but there was a significant interaction with the data collection site (F(3,254)=9.928, p = <.001, η2=0.105). In particular, GSI appears to decrease in Austria, but increase in the UK and shows no clear trend in Greece or Spain. Conclusions Mental health issues in PEH appear high compared to the housed population. Although there was no clear impact of the Health Navigator Model on mental health, its impact differed between the countries. This may be explained by country-specific differences in the healthcare system or in the implementation of the model. The results underline the need for further research and efforts to improve mental health in PEH. Key messages • People experiencing homelessness in Europe face considerable mental health challenges. • The Health Navigator Model's impact on mental health varies by country, highlighting the need for targeted interventions to improve the well-being of people experiencing homelessness.