title: Accuracy of reported service use in a cohort of people who are chronically homeless and seriously mentally ill.
abstract: BACKGROUND
  Self-reported service use is an integral feature of interventional research with people who are homeless and mentally ill. The objective of this study was to investigate the accuracy of self-reported involvement with major categories of publicly funded services (health, justice, social welfare) within this sub-population.
  
  
  METHODS
  Measures were administered pre-randomization in two randomized controlled trials, using timeline follow back with calendar aids for Health, Social, and Justice Service Use, compared to linked administrative data. Variables examined were: psychiatric admissions (both extended stays of more than 6 months and two or more stays within 5 years); emergency department visits, general hospitalization and jail in the past 6 months; and income assistance in the past 1 month. Participants (n = 433) met criteria for homelessness and a least one mental illness.
  
  
  RESULTS
  Prevalence adjusted and bias adjusted kappa (PABAK) values ranged between moderate and almost perfect for extended psychiatric hospital separations (PABAK: 0.77; 95 % confidence interval (CI) = 0.71, 0.83), multiple psychiatric hospitalizations (PABAK = 0.50, 95 % CI = 0.41, 0.59), emergency department visits (PABAK: 0.77; 95 % CI = 0.71, 0.83), jail (PABAK: 0.74; 95 % CI = 0.68, 0.81), and income assistance (PABAK: 0.82; 95 % CI = 0.76, 0.87). Significant differences in under versus over reporting were also found.
  
  
  CONCLUSIONS
  People who are homeless and mentally ill reliably reported their overall use of health, justice, and income assistance services. Evidence of under-reporting and over-reporting of certain variables has implications for specific research questions. ISRCTN registry: 57595077 (Vancouver at Home Study: Housing First plus Assertive Community Treatment versus congregate housing plus supports versus treatment as usual); and 66721740 (Vancouver at Home study: Housing First plus Intensive Case management versus treatment as usual).
authors.affiliation: Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. jsomers@sfu.ca.
authors.forename: Julian M
authors.initials: JM
authors.lastname: Somers
authors.affiliation: Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. akm_moniruzzaman@sfu.ca.
authors.forename: Akm
authors.initials: A
authors.lastname: Moniruzzaman
authors.affiliation: Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. clauren@sfu.ca.
authors.forename: Lauren
authors.initials: L
authors.lastname: Currie
authors.affiliation: Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. sra20@sfu.ca.
authors.forename: Stefanie N
authors.initials: SN
authors.lastname: Rezansoff
authors.affiliation: Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. angelarussolillo@gmail.com.
authors.forename: Angela
authors.initials: A
authors.lastname: Russolillo
authors.affiliation: Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. spa16@sfu.ca.
authors.forename: Milad
authors.initials: M
authors.lastname: Parpouchi
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D003156:Community Mental Health Services; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D028642:Persons with Psychiatric Disorders / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*