Skip to main content
Erschienen in: The Journal of Behavioral Health Services & Research 2/2010

01.04.2010

Twelve-Month Client Outcomes and Service Use in a Multisite Project for Chronically Homelessness Adults

verfasst von: Alvin S. Mares, PhD, MSW, Robert A. Rosenheck, MD

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Collaborative Initiative to Help End Chronic Homelessness clients (N = 734) were enrolled into an evaluation wherein assessments at program entry and quarterly thereafter addressed sociodemographic characteristics, health status, and a wide range of service use and outcomes data. Mixed linear regression analysis was used to test for significant changes over time. The average number of days housed during the previous 3 months increased dramatically from 18 at baseline to 83 by year’s end. Significant improvements of more modest magnitude were also observed in overall quality of life, mental health functioning, and reduced psychological distress. Alcohol and drug problems remained largely unchanged over time, among clients overall. However, among baseline drug users crack, cocaine, and marijuana use decreased by 28–50% over the follow-up period. Total quarterly health cost estimates declined by 50%, as well, from $6,832 to $3,376. These findings suggest that adults who have experienced chronic homelessness may be successfully housed and can maintain their housing, when provided with comprehensive services.
Literatur
1.
Zurück zum Zitat Burt MR. What will it take to end homelessness. Washington, DC: Urban Institute; 2001. Burt MR. What will it take to end homelessness. Washington, DC: Urban Institute; 2001.
2.
Zurück zum Zitat U.S. Department of Housing and Urban Development. The third annual homeless assessment report to congress. Washington, DC: Office of Community Planning and Development; 2008. U.S. Department of Housing and Urban Development. The third annual homeless assessment report to congress. Washington, DC: Office of Community Planning and Development; 2008.
3.
Zurück zum Zitat U.S. Department of Housing and Urban Development, the U.S. Department of Health and Human Services, and the U.S. Department of Veterans Affairs. Notice of funding availability for the Collaborative Initiative to Help End Chronic Homelessness. Federal Register Vol. 68, No. 17, January 27, 2003. U.S. Department of Housing and Urban Development, the U.S. Department of Health and Human Services, and the U.S. Department of Veterans Affairs. Notice of funding availability for the Collaborative Initiative to Help End Chronic Homelessness. Federal Register Vol. 68, No. 17, January 27, 2003.
4.
Zurück zum Zitat Stein LI, Test MA. Alternative to mental hospital treatment: I. Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry. 1980;37(4):392–397.PubMed Stein LI, Test MA. Alternative to mental hospital treatment: I. Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry. 1980;37(4):392–397.PubMed
5.
Zurück zum Zitat Tsemberis S, Eisenberg RF. Pathways to housing: supported housing for street-dwelling homeless individuals with psychiatric disabilities. Psychiatric Services. 2000;51(4):487–493.CrossRefPubMed Tsemberis S, Eisenberg RF. Pathways to housing: supported housing for street-dwelling homeless individuals with psychiatric disabilities. Psychiatric Services. 2000;51(4):487–493.CrossRefPubMed
6.
Zurück zum Zitat Mares AS, Greenberg GA, Rosenheck RA. Client-level measures of services integration among chronically homeless adults. Community Mental Health Journal. 2008;44:367–376.CrossRefPubMed Mares AS, Greenberg GA, Rosenheck RA. Client-level measures of services integration among chronically homeless adults. Community Mental Health Journal. 2008;44:367–376.CrossRefPubMed
8.
Zurück zum Zitat Heslin KC, Andersen RM, Gelberg L. Case management and access to services for homeless women. Journal of Health Care for the Poor and Underserved. 2003;14(1):34–51.CrossRefPubMed Heslin KC, Andersen RM, Gelberg L. Case management and access to services for homeless women. Journal of Health Care for the Poor and Underserved. 2003;14(1):34–51.CrossRefPubMed
9.
Zurück zum Zitat Anderson LA, Dedrick RF. Development of the Trust in Physician Scale: A measure to assess the interpersonal trust in patient–physician relationships. Psychological Reports. 1990;67:1091–1100.PubMed Anderson LA, Dedrick RF. Development of the Trust in Physician Scale: A measure to assess the interpersonal trust in patient–physician relationships. Psychological Reports. 1990;67:1091–1100.PubMed
10.
Zurück zum Zitat Neale MS, Rosenheck RA. Therapeutic alliance and outcome in a VA intensive case management program. Psychiatric Services. 1995;46(7):719–723.PubMed Neale MS, Rosenheck RA. Therapeutic alliance and outcome in a VA intensive case management program. Psychiatric Services. 1995;46(7):719–723.PubMed
11.
Zurück zum Zitat Monahan J, Redlich AD, Swanson JR, et al. Use of leverage to improve adherence to psychiatric treatment in the community. Psychiatric Services. 2005;56(1):37–44.CrossRefPubMed Monahan J, Redlich AD, Swanson JR, et al. Use of leverage to improve adherence to psychiatric treatment in the community. Psychiatric Services. 2005;56(1):37–44.CrossRefPubMed
12.
Zurück zum Zitat Kloos B, Zimmerman SO, Scrimenti K, et al. Landlords as partners for promoting success in supported housing: “It takes more than a lease and a key.”. Psychiatric Rehabilitation Journal. 2002;25(3):235–244.PubMed Kloos B, Zimmerman SO, Scrimenti K, et al. Landlords as partners for promoting success in supported housing: “It takes more than a lease and a key.”. Psychiatric Rehabilitation Journal. 2002;25(3):235–244.PubMed
13.
Zurück zum Zitat Tsemberis S, Rogers ES, Rodis E, et al. Housing satisfaction for persons with psychiatric disabilities. Journal of Community Psychology. 2003;31(6):581–590.CrossRef Tsemberis S, Rogers ES, Rodis E, et al. Housing satisfaction for persons with psychiatric disabilities. Journal of Community Psychology. 2003;31(6):581–590.CrossRef
14.
Zurück zum Zitat Center for Mental Health Services. The CMHS housing initiative. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2001. Center for Mental Health Services. The CMHS housing initiative. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2001.
15.
Zurück zum Zitat Katz AH. Social adaptation in chronic illness: A study of hemophilia. American Journal of Public Health and the Nation’s Health. 1963;53(10):1666.CrossRefPubMed Katz AH. Social adaptation in chronic illness: A study of hemophilia. American Journal of Public Health and the Nation’s Health. 1963;53(10):1666.CrossRefPubMed
16.
Zurück zum Zitat Vaux A, Athanassopulou M. Social support appraisals and network resources. Journal of Community Psychology. 1987;15:537–556.CrossRef Vaux A, Athanassopulou M. Social support appraisals and network resources. Journal of Community Psychology. 1987;15:537–556.CrossRef
17.
Zurück zum Zitat Lehman A. A quality of life interview for the chronically mentally ill. Evaluation and Program Planning. 1988;11:51–62.CrossRef Lehman A. A quality of life interview for the chronically mentally ill. Evaluation and Program Planning. 1988;11:51–62.CrossRef
18.
Zurück zum Zitat Ware JE, Kosinski M, Keller SE. How to score the SF-12 physical and mental health summary scales. 3rd edn. Lincoln, Rhode Island: Quality Metric Incorporated; 1998. Ware JE, Kosinski M, Keller SE. How to score the SF-12 physical and mental health summary scales. 3rd edn. Lincoln, Rhode Island: Quality Metric Incorporated; 1998.
19.
Zurück zum Zitat Derogatis LR, Spencer N. The brief symptom index; Administration, scoring and procedure manual. Baltimore, MD: Johns Hopkins University; 1982. Derogatis LR, Spencer N. The brief symptom index; Administration, scoring and procedure manual. Baltimore, MD: Johns Hopkins University; 1982.
20.
Zurück zum Zitat Dohrenwend B. Psychiatric Epidemiology Research Interview (PERI). New York: Columbia University Social Psychiatry Unit; 1982. Dohrenwend B. Psychiatric Epidemiology Research Interview (PERI). New York: Columbia University Social Psychiatry Unit; 1982.
21.
Zurück zum Zitat McLellan AT, Luborsky L, Woody GE, et al. An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease. 1980;168(1):26–33.CrossRefPubMed McLellan AT, Luborsky L, Woody GE, et al. An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease. 1980;168(1):26–33.CrossRefPubMed
22.
Zurück zum Zitat Rosenheck RA, Leslie D, Sindelar J, et al. Cost-effectiveness of second-generation antipsychotics and perphenazine in a randomized trial of treatment for chronic schizophrenia. American Journal of Psychiatry. 2006;163:2080–2089.CrossRefPubMed Rosenheck RA, Leslie D, Sindelar J, et al. Cost-effectiveness of second-generation antipsychotics and perphenazine in a randomized trial of treatment for chronic schizophrenia. American Journal of Psychiatry. 2006;163:2080–2089.CrossRefPubMed
23.
Zurück zum Zitat Bryk AS, Raudenbush SW. Hierarchical linear models. Newbury Park, CA: Sage; 1992. Bryk AS, Raudenbush SW. Hierarchical linear models. Newbury Park, CA: Sage; 1992.
24.
Zurück zum Zitat Tsemberis S, Gulcur L, Nakae M. Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health. 2004;94(4):651–656.CrossRefPubMed Tsemberis S, Gulcur L, Nakae M. Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health. 2004;94(4):651–656.CrossRefPubMed
25.
Zurück zum Zitat Lipton FR, Nutt S, Sabatini A. Housing the homeless mentally ill: A longitudinal study of a treatment approach. Hospital and Community Psychiatry. 1988;39(1):40–45.PubMed Lipton FR, Nutt S, Sabatini A. Housing the homeless mentally ill: A longitudinal study of a treatment approach. Hospital and Community Psychiatry. 1988;39(1):40–45.PubMed
26.
Zurück zum Zitat Rosenheck R, Kasprow W, Frisman L, et al. Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry. 2003;60:940–951.CrossRefPubMed Rosenheck R, Kasprow W, Frisman L, et al. Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry. 2003;60:940–951.CrossRefPubMed
27.
Zurück zum Zitat Goldfinger SM, Schutt RK, Tolomiczenko GS, et al. Housing placement and subsequent days homeless among formerly homeless adults with mental illness. Psychiatric Services. 1999;50(5):674–679.PubMed Goldfinger SM, Schutt RK, Tolomiczenko GS, et al. Housing placement and subsequent days homeless among formerly homeless adults with mental illness. Psychiatric Services. 1999;50(5):674–679.PubMed
28.
Zurück zum Zitat Hurlburt MS, Hough RL, Wood PA. Effects of substance abuse on housing stability of homeless mentally ill persons in supported housing. Psychiatric Services. 1996;47(7):731–736.PubMed Hurlburt MS, Hough RL, Wood PA. Effects of substance abuse on housing stability of homeless mentally ill persons in supported housing. Psychiatric Services. 1996;47(7):731–736.PubMed
Metadaten
Titel
Twelve-Month Client Outcomes and Service Use in a Multisite Project for Chronically Homelessness Adults
verfasst von
Alvin S. Mares, PhD, MSW
Robert A. Rosenheck, MD
Publikationsdatum
01.04.2010
Verlag
Springer US
Erschienen in
The Journal of Behavioral Health Services & Research / Ausgabe 2/2010
Print ISSN: 1094-3412
Elektronische ISSN: 2168-6793
DOI
https://doi.org/10.1007/s11414-009-9171-5

Weitere Artikel der Ausgabe 2/2010

The Journal of Behavioral Health Services & Research 2/2010 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.