Mental Health Services Research

, Volume 6, Issue 4, pp 199–211 | Cite as

Outcomes of Supported Housing for Homeless Veterans with Psychiatric and Substance Abuse Problems

  • Alvin S. Mares
  • Wesley J. Kasprow
  • Robert A. Rosenheck
Article

Abstract

This study examines the effect of previous participation in time limited residential treatment and other factors on treatment outcomes among homeless veterans with serious mental illness placed into permanent supported housing. The sample consisted of 655 veterans placed into supported housing at 18 sites through the VA's Healthcare for Homeless Veterans (HCHV) Supported Housing Program during the period 1993–2000. Data on client and program characteristics, and treatment outcomes, were documented by HCHV case managers staffing these programs. Data on use of VA services, including time limited residential treatment received 6 months prior to entry into supported housing, were extracted from VA administrative files. The relationship of prior residential treatment, as well as other measures of client characteristics, service use, and program characteristics, to outcomes were assessed using both bivariate and multivariate Cox proportional hazards regression and logistic regression. After adjusting for client characteristics, service use, and program characteristics, no differences in outcomes were found between clients who had received prior residential treatment and those placed directly into permanent supported housing. Prior residential treatment appears to have little effect on treatment outcomes among formerly homeless veterans placed into permanent supported housing programs providing indirect support for the direct placement supported housing model.

homeless mentally ill veteran supported housing 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. Blanch, A. K., Carling, P. J., & Ridgway, P. (1988). Normal housing with specialized supports: A psychiatric rehabilitation approach to living in the community. Rehabilitation Psychology, 33(1), 47–55.Google Scholar
  2. Carling, P. J. (1992). Homes or group homes?: Future approaches to housing, support, and integration for people with psychiatric disabilities. Adult Residential Care Journal, 6(2), 87–96.Google Scholar
  3. Carling, P. J. (1993). Housing and supports for persons with mental illness: Emerging approaches to research and practice. Hospital and Community Psychiatry, 44(5), 439–449.Google Scholar
  4. Carling, P. J. (1996). Emerging approaches to housing and support for people with psychiatric disabilities. In M. Moscarelli, A. Rupp, & N. Sartorius (Eds.), Handbook of mental health economics and health policy: Vol. 1. Schizophrenia (pp. 239–259). New York: Wiley.Google Scholar
  5. Carling, P. J. (1990). Supported housing: An evaluation agenda. Psychosocial Rehabilitation Journal, 13(4), 95–104.Google Scholar
  6. Cohen, M. D., & Somers, S. (1990). Supported housing: Insights from the Robert Wood Johnson Foundation Program on Chronic Mental Illness. Psychosocial Rehabilitation Journal, 13(4), 43–50.Google Scholar
  7. Fakhoury, W., Murray, A., Shepherd, G., & Priebe S. (2002). Research in supported housing. Social Psychiatry and Psychiatric Epidemiology, 37(7), 301–315.Google Scholar
  8. Frisman, L. K., Rosenheck, R. DiLella, D., & Errera, P. (1993). Health care for homeless veterans programs: The fifth annual progress report. West Haven, CT: Northeast Program Evaluation Center.Google Scholar
  9. Goldfinger, S. M., Schutt, R. K., Tolomiczenko, G. S., Seidman, L., Penk, W.E., Turner W., et al. (1999). Housing placement and subsequent days homeless among formerly homeless adults with mental illness. Psychiatric Services, 50(5),674–679.Google Scholar
  10. Gulcur, L., Stefancic, A., Shinn, M., Tsemberis, S., & Fischer S. N. (2003). Housing, hospitalization, and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes. Journal of Community and Applied Social Psychology, 13, 171–186.Google Scholar
  11. Hogan, M. F., & Carling, P. J. (1992). Normal housinrg: A key element of a supported housing approach for people with psychiatric disabilities. Community Mental Health Journal, 28(3), 215–226.Google Scholar
  12. Hurlburt, M. S., Wood, P. A., & Hough, R. L. (1996). Providing independent housing for the homeless mentally ill: A novel approach to evaluating long-term longitudinal housing patterns. Journal of Community Psychology, 24(3), 291–310.Google Scholar
  13. Kasprow, W. J., Rosenheck, R., DiLella, D., Carter, R., & Cavallaro, L. (2001). Healthcare for Homeless Veterans Programs: Fourteenth annual report. West Haven, CT: VA Northeast Program Evaluation Center/182.Google Scholar
  14. Kasprow, W. J., Rosenheck, R., DiLella, D., & Cavallaro, L. (2002). Healthcare for Homeless Veterans Programs: Fifteenth annual report. West Haven, CT: VA Northeast Program Evaluation Center/182.Google Scholar
  15. Knisley, M. B., & Fleming, M. (1993). Implementing supported housing in state and local mental health systems. Hospital and Community Psychiatry, 44(5), 456–461.Google Scholar
  16. Livingston, J. A., & Srebnick, D. (1991). States' strategies for promoting supported housing for persons with psychiatric disabilities. Hospital and Community Psychiatry, 42(11), 1116–1119.Google Scholar
  17. McLellan, A. T., Luborsky, L., O'Brien, C. P., & Woody, G. E. (1980). An improved diagnostic instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168, 26–33.Google Scholar
  18. National Association of State Mental Health Program Directors. (1987). Housing and support for people with long-term mental illness.Google Scholar
  19. Alexandria, VA: Author. Newman, S. J. (1992). The severely mentally ill homeless: Housing needs and housing (Occasional Paper No. 12) policy.Google Scholar
  20. Baltimore: The Johns Hopkins University, Institute for Policy Studies. Newman, S. J. (2001). Housing attributes and serious mental illness: Implications for research and practice. Psychiatric Services, 52(10), 1309–1317.Google Scholar
  21. Ridgway, P., & Zipple, A. M. (1990a). Challenges and strategies for implementing supported housing. Psychosocial Rehabilitation Journal, 13(4), 115–120.Google Scholar
  22. Ridgway, P., & Zipple, A. M. (1990b). The paradigm shift in residential services: From the linear continuum to supported housing approaches. Psychosocial Rehabilitation Journal, 13(4), 11–31.Google Scholar
  23. Rog, D. J., & Randolph, F. L. (2002). A multisite evaluation of supported housing: Lessons learned from cross-site collaboration. New Directions for Evaluation, 94, 61–72.Google Scholar
  24. Rosenheck, R., & Gallop, P. (1991). Involvement in an outreach program for homeless veterans. Journal of Mental and Nervous Disease, 179, 750–754.Google Scholar
  25. Rosenheck, R., Kasprow, W., Frisman, L., & Liu-Mares, W. (2003). Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry, 60(9), 940–951.Google Scholar
  26. Rosenheck, R. A., Gallop, P., & Frisman, L. K. (1993). Service linkage and related costs of an outreach program for homeless mentally ill veterans. Hospital and Community Psychiatry, 44, 1166–1171.Google Scholar
  27. Seibyl, C. L., Rosenheck, R. A., Medak, S., & Corwel, L. (2001). Twelfth progress report on the domiciliary care for homeless veterans program. West Haven, CT: VA Northeast Program Evaluation Center/182.Google Scholar
  28. Sohng, S. L. (1996). Supported housing for the mentally ill elderly: Implementation and consumer choice. Community Mental Health Journal, 32(2), 135–148.Google Scholar
  29. Stata Corporation. (1999). Intercooled Stata 6.0 for Windows 98/95/NT. College Station, TX: Author.Google Scholar
  30. Tsemberis, S., & Eisenberg, R. F. (2000). Pathways to housing: Supported housing for street-dwelling homeless individuals with psychiatric disabilities. Psychiatric Services, 51(4), 487–493.Google Scholar
  31. Wong, Y. I., & Solomon, P. L. (2002). Community integration of persons with psychiatric disabilities in supportive independent housing: A conceptual model and methodological considerations. Mental Health Services Research, 4(1), 13–28.Google Scholar
  32. Yeich, S., Mowbray, C. T., Bybee, D., & Cohen, E. (1994). The case for a “supported housing” approach: A study of consumer housing and support preferences. Psychosocial Rehabilitation Journal, 18(2), 75–86.Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2004

Authors and Affiliations

  • Alvin S. Mares
    • 1
    • 2
  • Wesley J. Kasprow
    • 1
    • 2
  • Robert A. Rosenheck
    • 1
    • 2
  1. 1.Northeast Program Evaluation Center of the Department of Veterans AffairsVA Connecticut Healthcare System
  2. 2.Department of PsychiatryYale University School of MedicineNew HavenConnecticut

Personalised recommendations