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Substance Abuse and Mental Health Services Administration
Critical Issues in Serving People Who Are Homeless and Mentally Ill
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Support is increasing for a model of services delivery for homeless people who have mental illness that combines assertive outreach, gradual engagement, respect for the client's service priorities, and a range of clinical, rehabilitative, and social services. While this model is considered by many to be the standard of care for homeless persons with serious mental illness, little has been written about the challenges involved in implementing programs using the model's guiding principles. The authors identify six critical issues for managers, including: confronting (at federal, state and local levels) the political question of whether to serve homeless people who have mental illness; identifying the target population by attempting to define "homelessness" and "mental illness;" putting the guiding principles of non-traditional treatment into operation; facilitating inter-disciplinary and inter-agency collaboration to care for people who are homeless; assessing and responding to racial-ethnic differences among staff and between clients and staff; and addressing the role of formerly homeless and/or mentally ill individuals (consumers) as staff. In addition, specific strategies for addressing the dilemmas that result from developing innovative outreach services within traditional mental health systems are recommended. (HRC)