In collaboration with a local occupational therapist in the adult inpatient acute mental health unit at a small urban hospital in Western Washington, we conducted a systematic literature review to determine which strategies are most effective in reducing readmission to inpatient adult psychiatric facilities for individuals experiencing homelessness and/or substance abuse. Overall results found housing assistance, 24/7 resource access, interdisciplinary teams, and holistic individualized care to be effective in the reduction of recidivism for individuals experiencing homelessness and/or substance abuse. Interventions focused on money management, diagnosis education, and community reintegration were also supported. Evidence indicated systemic social and legislative reform, facility level changes in staffing patterns and culture, and the use of evidence-based interventions at the practitioner level all reduce readmission rates to mental health facilities.

In order to support our collaborator, we created four group interventions which were then implemented at her facility. These interventions focused on money management, accessing community resources, understanding mental health diagnoses, and understanding substance abuse. Practitioners at the facility identified these subjects as very important and that their knowledge of the topics and comfortability leading the sessions increased over time. Participants reported that they learned skills during the sessions and were confident they could apply them to their lives. We recommend that occupational therapists advocate for long-term systematic changes and take immediate action by implementing evidence based, client-centered interventions.

Publication Place

Tacoma, Washington


University of Puget Sound

Project Chairperson

Kirsten Wilbur Ed.D., OTR/L

Project Chairperson

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound