Asian Journal of Psychiatry
Volume 2, Issue 3 , Pages 100-105 , October 2009

Lessening homelessness among persons with mental illness: A comparison of five randomized treatment trials

  • Russell K. Schutt

      Affiliations

    • University of Massachusetts Boston and Harvard Medical School, Department of Psychiatry, Harvard Medical School, 401 Park Dr., Landmark Center 2E, Boston, MA 02215, United States
    • Corresponding Author InformationCorresponding author. Tel.: +1 617 998 5034; fax: +1 617 998 5007.
  • ,
  • Richard L. Hough

      Affiliations

    • Children & Family Research Group, 3020 Children's Way, MC5033, San Diego, CA 92123, United States
    • Present address: Center for Rural and Community Behavioral Health, Department of Psychiatry, University of New Mexico, United States.
  • ,
  • Stephen M. Goldfinger

      Affiliations

    • Massachusetts Mental Health Center, Harvard Medical School, United States
    • Present address: Department of Psychiatry, SUNY/Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, United States.
  • ,
  • Anthony F. Lehman

      Affiliations

    • Center for Mental Health Services Research, University of Maryland-Baltimore, 645 W Redwood St., Baltimore, MD 21201, United States
    • Present address: Department of Psychiatry, University of Maryland-Baltimore, United States.
  • ,
  • David L. Shern

      Affiliations

    • New York State Office of Mental Health, United States
    • Present address: National Mental Health Association, United States.
  • ,
  • Elie Valencia

      Affiliations

    • Columbia University, School of Public Health and Medicine, United States
    • Present address: Epidemiology Department, Columbia University, United States.
  • ,
  • Patricia A. Wood

      Affiliations

    • Children & Family Research Group, 3020 Children's Way, MC5033, San Diego, CA 92123, United States
    • Present address: Child and Adolescent Services Research Center at San Diego Children's Hospital and Health Center, United States.

Received 26 December 2008 ,Accepted 19 July 2009.

References 

  1. Bourdon KH, Rae DS, Locke BZ, Narrow WE, Regier DA. Estimating the prevalence of mental disorders in U.S. adults from the Epidemiologic Catchment Area Survey. Public Health Rep. 1992;107:663–668
  2. Caton CLM, Goldstein J. Housing change of chronic schizophrenic patients: a consequence of the revolving door. Soc. Sci. Med. 1984;19:759–764
  3. Center for Mental Health Services . Making a Difference: Interim Status Report of the McKinney Research Demonstration Program for Homeless Adults with Serious Mental Illness. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services; 1994;
  4. Cohen CI. Down and out in New York and London: a cross-national comparison of homelessness. Hosp. Community Psychiatry. 1994;45:769–776
  5. Cohen CI, Ramirez R, Teresi J, Gallagher M, Sokolovsky J. Predictors of becoming redomiciled among older homeless women. Gerontologist. 1997;37:67–74
  6. Cuffel BJ, Heithoff KA, Lawson W. Correlates of patterns of substance abuse among patients with schizophrenia. Hosp. Community Psychiatry. 1993;44:247–251
  7. Devine JA, Wright JD. Losing the housing game: the leveling effects of substance abuse. Am. J. Orthopsychiatry. 1997;67:618–631
  8. Dixon L, Krauss N, Myers P, Lehman A. Clinical and treatment correlates of access to Section 8 certificates for homeless mentally ill persons. Hosp. Community Psychiatry. 1994;45:1196–1200
  9. Drake RE, McHugo GJ, Clark RE, Teague GB, Xie H, Miles K, et al. Assertive community treatment for patients with co-occurring severe mental illness and substance use disorder: a clinical trial. Am. J. Orthopsychiatry. 1998;68:201–215
  10. Drake RE, Osher FC, Wallach MA. Alcohol use and abuse in schizophrenia: a prospective community study. J. Nerv. Ment. Dis. 1989;177(7):408–414
  11. Drake RE, Wallach MA, Hoffman JS. Housing instability and homelessness among aftercare patients of an urban state hospital. Hosp. Community Psychiatry. 1989;40:46–51
  12. Drake RE, Wallach MA. Substance abuse among the chronically mentally ill. Hosp. Community Psychiatry. 1989;40:1041–1046
  13. Folsom DP, Hawthorne W, Lindamer L, Gilmer T, Bailey A, Golshan S, et al. Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. Am. J. Psychiatry. 2005;162(2):370–376
  14. Goldfinger, S.M., Hough, R.L., Lehman, L.F., Shern, D., Valencia, E., 1995. Recruiting and retaining severely mentally ill subjects in longitudinal research. Unpublished report.
  15. Goldfinger SM, Schutt RK, Tolomiczenko GS, Seidman L, Penk WE, Turner W, et al. Housing placement and subsequent days homeless among formerly homeless adults with mental illness. Psychiatr. Serv. 1999;50:674–679
  16. Goldfinger SM, Schutt RK, Seidman LJ, Turner W, Tolomiczenko GS. Self-report and observer measures of substance abuse, in the cross-section and over time. J. Nerv. Ment. Dis. 1996;184:667–672
  17. Han O, Lee HB, Ahn J, Park J, Cho M, Hong J, et al. Lifetime and current prevalence of mental disorders among homeless men in Korea. J. Nerv. Ment. Dis. 2003;191(4):272–275
  18. Hartz D, Banys P, Hall SM. Correlates of homelessness among substance abuse patients at a VA Medical Center. Hosp. Community Psychiatry. 1994;45:491–493
  19. Hawkins RL, Abrams C. Disappearing acts: the social networks of formerly homeless individuals with co-occurring disorders. Soc. Sci. Med. 2007;65:2031–2042
  20. Herrman H, McGorry P, Bennett P, van Riel R, McKensie D, Singh B. Prevalence of severe mental disorders in disaffiliated and homeless people in inner Melbourne. Am. J. Psychiatry. 1989;146(9):1179–1184
  21. Holmes A, Hodge M, Lenten S, Fielding J, Castle D, Velakoulis D, et al. Chronic mental illness and community treatment resistance. Australas. Psychiatry. 2006;14:272–276
  22. Hurlburt MS, Hough RL, Wood PA. Effects of substance abuse on housing stability of homeless mentally ill persons in supported housing. Psychiatr. Serv. 1996;47:731–736
  23. Hurlburt MS, Wood PA, Hough RL. Providing independent housing for the homeless mentally ill: a novel approach to evaluating long-term longitudinal housing patterns. J. Community Psychol. 1996;24:291–310
  24. Jencks C. The Homeless. Cambridge: Harvard University Press; 1994;
  25. Kasprow WJ, Rosenheck RA, Frisman L, DiLella D. Referral and housing processes in a long-term supported housing program for homeless veterans. Psychiatr. Serv. 2000;51:1017–1023
  26. Kay SR, Kalathara M, Meinzer AE. Diagnostic and behavioral characteristics of psychiatric patients who abuse substances. Hosp. Community Psychiatry. 1989;40:1062–1064
  27. Kertesz SG, Crouch K, Milby J, Cusimano RA, Schumacher J. Housing first for homeless persons with active addiction: are we overreaching?. Milbank Q. 2009;87:495–534
  28. Kessler RC, Berglund PA, Bruce ML, Koch JR, Laska EM, Leaf PJ, et al. The prevalence and correlates of untreated serious mental illness. Health Serv. Res. 2001;36:987–1007
  29. Lehman AF, Myers CP, Thompson JW, Corty E. Implications of mental and substance use disorders: a comparison of single and dual diagnosis patients. J. Nerv. Ment. Dis. 1993;181:365–370
  30. Lehman AF, Dixon LB, Kernan E, DeForge BR, Postrado LT. A randomized trial of assertive community treatment for homeless persons with severe mental illness. Arch. Gen. Psychiatry. 1997;54:1038–1043
  31. Linn LS, Gelberg L, Leake B. Substance abuse and mental health status of homeless and domiciled low-income users of a medical clinic. Hosp. Community Psychiatry. 1990;41:306–310
  32. Lipton FR, Nutt S, Sabatini A. Housing the homeless mentally ill: a longitudinal study of a treatment approach. Hosp. Community Psychiatry. 1988;39:40–45
  33. McLellan AT, Luborsky L, Woody GE, O’Brien CP. An improved diagnostic evaluation instrument for substance abuse patients: the addiction severity index. J. Nerv. Ment. Dis. 1980;168:26–33
  34. Montross LP, Barrio C, Yamada A, Lindamer L, Golshan S, Garcia P, et al. Tri-ethnic variations of co-morbid substance and alcohol use disorders in schizophrenia. Schizophr. Res. 2005;79:297–305
  35. Morse GA, Calsyn RJ, Allen G, Tempelhoff B, Smith R. Experimental comparison of the effects of three treatment programs for homeless mentally ill people. Hosp. Community Psychiatry. 1992;43:1005–1010
  36. Mueser KT, Yarnold PR, Levinson DF, Singh H, Bellack AS, Kee K, et al. Prevalence of substance abuse in schizophrenia: demographic and clinical correlates. Schizophr. Bull. 1990;16:31–55
  37. Padgett DK, Henwood B, Abrams C, Drake RE. Social relationships among persons who have experienced serious mental illness, substance abuse, and homelessness: implications for recovery. Am. J. Orthopsychiatry. 2008;78:333–339
  38. Ran MS, Chan CLW, Chen EYH, Xiang MZ, Caine ED, Conwell Y. Homelessness among patients with schizophrenia in rural China: a 10-year cohort study. Acta Psychiatr. Scand. 2006;114:118–123
  39. Rosenheck R, Frisman L, Gallup P. Effectiveness and cost of specific treatment elements in a program for homeless mentally ill veterans. Psychiatr. Serv. 1995;46:1131–1139
  40. Rossi PH. Down and Out in America: The Origins of Homelessness. Chicago: University of Chicago Press; 1989;
  41. Seidman LJ, Bruder GE, Giuliano AJ. Neuropsychological assessment and neurophysiological evaluation. In:  Tasman A,  Kay J,  Lieberman JA,  First MB,  Maj M editor. Psychiatry. 3rd ed.. New York: John Wiley & Sons; 2008;p. 556–569
  42. Schutt RK, Goldfinger SM. Housing preferences and perceptions of health and functioning among homeless mentally ill persons. Psychiatr. Serv. 1996;47:381–386
  43. Shrestha NM. Alcohol and drug abuse in Nepal. Br. J. Addict. 1992;87:1241–1248
  44. Shern DL, Felton CJ, Hough RL, Lehman AF, Goldfinger S, Valencia E, et al. Housing outcomes for homeless adults with mental illness: results from the Second-Round McKinney Program. Psychiatr. Serv. 1997;48:239–241
  45. Shern DL, Tsemberis S, Winarski J, Cope N, Cohen M, Anthony W. A psychiatric rehabilitation demonstration for individuals who are street dwelling and seriously disabled. In:  Breakey W,  Thompson J editor. Mentally Ill and Homeless: Special Programs for Special Needs. New York: Harwood Academic Publishers; 1997;p. 119–147
  46. Shern DL, Wilson NZ, Coen AS, Patrick DC, Foster M, Bartsch DA. Client outcomes II: longitudinal client data from the Colorado treatment outcome study. Milbank Q. 1994;72:123–148
  47. Spitzer RL, Williams JB, Gibbon M, First MB. The Structured Clinical Interview for DSM-III-R (SCID). I. History, rationale, and description. Arch. Gen. Psychiatry. 1992;49:624–629
  48. Stein LI, Test MA. Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation. Arch. Gen. Psychiatry. 1980;37:392–397
  49. Susser E, Valencia E, Conover S, Felix A, Tsai WY, Jed R. Preventing recurrent homelessness among mentally ill men: a ‘critical time’ intervention after discharge from a shelter. Am. J. Public Health. 1997;87:25–62
  50. Takano T, Nakamura K, Takeuchi S, Watanabe M. Disease patterns of the homeless in Tokyo. J. Urban Health. 1999;76(1):73–84
  51. Talukdar A, Roy K, Saha I, Mitra J, Detels R. Risk behaviors of homeless men in India: a potential bridge population for HIV infection. AIDS Behav. 2008;12:613–622
  52. Tessler RC, Dennis DL. A Synthesis of NIMH-Funded Research Concerning Persons Who are Homeless and Mentally Ill. Washington, DC: Program for the Homeless Mentally Ill, Division of Education and Service Systems Liaison, National Institute of Mental Health; 1989;
  53. Uehara ES. Race, gender, and housing inequality: an exploration of the correlates of low-quality housing among clients diagnosed with severe and persistent mental illness. J. Health Soc. Behav. 1994;35:309–321
  54. Wong YI, Piliavin I. A dynamic analysis of homeless-domicile transitions. Soc. Probl. 1997;44:408–423

 This research was supported by research demonstration grants FM-48096, FM-48070, FM-48080, FM-48041, and FM-48215 from the National Institute of Mental Health and, after 1992, the Center for Mental Health Services. We are grateful for the comments of Bruce DeForge, Joe Massaro, and the anonymous AJP reviewers.

PII: S1876-2018(09)00067-7

doi: 10.1016/j.ajp.2009.07.003

Asian Journal of Psychiatry
Volume 2, Issue 3 , Pages 100-105 , October 2009