Mapping health-related responses for people experiencing homelessness in Lisboa, Portugal
Abstract
Background: People experiencing homelessness (PEH) rely on a range of residential, social and health services. This study mapped the existing responses which provide any type of healthcare service supporting PEH in the Lisbon area, examining how service models may affect access and continuity of care.
Methods: We conducted a cross-sectional mapping study based on guided visits to public and third-sector services between June 2025 and January 2026. Data were collected through structured field notes during non-participant observation visits and validated for accuracy by staff. Analysis consisted of a structured descriptive synthesis of the information collected across care pathway dimensions, from reachability to follow-up.
Results: Twelve visits were conducted. These include residential (5), outpatient and low threshold (4), and outreach models (3). Services were delivered by public and third-sector organisations. Residential settings combine accommodation and basic support with structured health services. Outpatient and low-threshold services and outreach teams both delivered harm-reduction activities, while outpatient services also focused on mental healthcare and outreach teams provided basic clinical support, mediation, service navigation, and medication supply. Documentation requirements, legal status, electronic prescriptions, lack of phone access, and digital procedures limited access to care and medicines. Follow-up was the most fragile step, mainly due to informal cross-sectoral coordination and difficulty recontacting users.
Conclusions: Health responses for PEH in Lisbon area are delivered through a heterogenous network of actors. Access and continuity of care remain shaped by administrative barriers and challenging continuum of care across sectors. Public health action should prioritize simplified access procedures when standard requirements are not suitable. Ultimately, improving cross-sector data sharing could enhance access and continuum of care.
Key messages: • Health responses for people experiencing homelessness in Lisbon are delivered through diverse service models, but continuity of care remains fragile across the different settings.
• Simplifying administrative procedures and strengthening cross-sectoral coordination may improve access and follow-up for people experiencing homelessness.
Related
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- Disparities in Heat-Related Injuries Among People Experiencing Homelessness
- Community-based interventions for managing frailty among people experiencing homelessness: a systematic review
- Exploring the views of people experiencing homelessness regarding their health and housing support, and their perspectives on deteriorating health and end of life support: a qualitative analysis
- Notes from the Field: Use of Enhanced Surveillance to Detect Severe Group A Streptococcus Infections Among Persons Experiencing Homelessness — Missoula County, Montana, July 2024–September 2025
BibTeX
@article{paparatto2026mapping,
title = {{Mapping health-related responses for people experiencing homelessness in Lisboa, Portugal}},
author = {G Paparatto and S Crisóstomo and D Gorski and RMS Fuertes and CJS Quelhas and F Tonin and L Tavoschi and J Gama-Marques and FA Costa},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1558},
url = {https://doi.org/10.1093/eurpub/ckag169.1558},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Mapping health-related responses for people experiencing homelessness in Lisboa, Portugal
AU - G Paparatto
AU - S Crisóstomo
AU - D Gorski
AU - RMS Fuertes
AU - CJS Quelhas
AU - F Tonin
AU - L Tavoschi
AU - J Gama-Marques
AU - FA Costa
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1558
UR - https://doi.org/10.1093/eurpub/ckag169.1558
AB - Background: People experiencing homelessness (PEH) rely on a range of residential, social and health services. This study mapped the existing responses which provide any type of healthcare service supporting PEH in the Lisbon area, examining how service models may affect access and continuity of care. Methods: We conducted a cross-sectional mapping study based on guided visits to public and third-sector services between June 2025 and January 2026. Data were collected through structured field notes during non-participant observation visits and validated for accuracy by staff. Analysis consisted of a structured descriptive synthesis of the information collected across care pathway dimensions, from reachability to follow-up. Results: Twelve visits were conducted. These include residential (5), outpatient and low threshold (4), and outreach models (3). Services were delivered by public and third-sector organisations. Residential settings combine accommodation and basic support with structured health services. Outpatient and low-threshold services and outreach teams both delivered harm-reduction activities, while outpatient services also focused on mental healthcare and outreach teams provided basic clinical support, mediation, service navigation, and medication supply. Documentation requirements, legal status, electronic prescriptions, lack of phone access, and digital procedures limited access to care and medicines. Follow-up was the most fragile step, mainly due to informal cross-sectoral coordination and difficulty recontacting users. Conclusions: Health responses for PEH in Lisbon area are delivered through a heterogenous network of actors. Access and continuity of care remain shaped by administrative barriers and challenging continuum of care across sectors. Public health action should prioritize simplified access procedures when standard requirements are not suitable. Ultimately, improving cross-sector data sharing could enhance access and continuum of care. Key messages: • Health responses for people experiencing homelessness in Lisbon are delivered through diverse service models, but continuity of care remains fragile across the different settings. • Simplifying administrative procedures and strengthening cross-sectoral coordination may improve access and follow-up for people experiencing homelessness.
SN - 1101-1262
SN - 1464-360X
ER -