A database (n = 1698) at a homeless health care center was used to assess factors associated with a psychiatric hospitalization and subsequent behavioral health outpatient therapy and psychiatry visit adherence. Blacks and those recently incarcerated were less likely to report a psychiatric hospitalization and those with a co-occurring disorder or disability were more likely to report a hospitalization. Of those hospitalized, blacks and those with bipolar disorder were less likely to be high adherers to behavioral health outpatient therapy and those incarcerated 4 to 6 months prior to intake were more likely not to attend behavioral health outpatient therapy. Men were at risk for not keeping psychiatry visits.