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Substance Abuse and Mental Health Services Administration
I'm Not a Detective - So Why Worry About Evidence?
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How can evidence-based practice help you in your everyday work with people who are homeless? Check out this Q & A with Dr. Ellen Bassuk of the National Center on Family Homelessness and the Institute on Homelessness and Trauma.
image of Ellen Bassuk

An Interview with Ellen Bassuk, M.D., Founder and President, National Center on Family Homelessness, and Managing Director, Institute on Homelessness and Trauma.

Q: What is the role of evidence-based practices (EBPs) in the homelessness field?
A: EBPs help us identify approaches that achieve the best results, like stability in permanent housing, increased income, and improved physical and mental health. EBPs have outcome data to show that the practice works and produces positive results. Outcomes may be measured by less frequent hospitalization or decreased use of medications, fewer days in shelters, and fewer visits to emergency rooms. The problem in the homelessness field is that we think many practices have good outcomes, but we have little data to support our hunch. In many cases, we don’t know from research what works, for whom, and in what settings.

Q: What are some examples of EBPs in homeless services?
A: Critical Time Intervention is one example. It is an intervention that helps people transition from homelessness into housing, and mobilize natural supports and whatever services they might need to help them stabilize. Another is Assertive Community Treatment (ACT)—a multi-disciplinary team-based approach to providing support for people with mental health problems. A third is Pathways to Housing, a housing first intervention, which has recently been accepted as an EBP by NREPP, SAMHSA’s National Registry of Evidence-Based Programs and Practices (www.nrepp.samhsa.gov).

Q: Describe the benefits of using EBPs.
A: Benefits for consumers are that EBPs are more likely to achieve positive outcomes such as improved housing stability, and mental and physical well-being. For providers, descriptions of EBPs (like the ones at NREPP) provide information about key ingredients, implementation and expected outcomes.

Q: What are the challenges associated with choosing and implementing EBPs in the real world of homeless services?
A: Many of the practices that are considered evidence-based are psychotherapeutic in nature and are offered within traditional, clinical environments. In homeless services, interventions happen in non-traditional settings—shelters, mobile vans, the streets. With limited outcomes-based evidence, it can be difficult to know exactly what practices work for whom.

Q: What advice would you give service providers and program managers?
A: Since EBPs are beneficial for consumers and providers, we have to figure out how to make the body of evidence more robust. One thing that providers and administrators can do is to participate in data collection that will add to the body of evidence and help bridge the gap between research and practice.
Q & A
SAMHSA
2009
Rockville, MD
617-467-6014
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