Articles for the Topic "Mental Health"

Addressing Co-Occurring Disorders in Non-Traditional Service Settings: Overview Paper 4

2007-08-20T01:33:14

Only about half the people with co-occurring disorders (COD) receive any services within substance abuse and mental health (SA/MH) settings. Settings outside the SA/MH system, or settings where service missions do not include a primary focus on COD, are the focus of this overview paper. Primary health, public safety and criminal justice, and social service settings, where persons with COD are likely to be seen, are highlighted. These settings should be prepared to identify and effectively respond to persons with COD. The use of specialized techniques appropriate to these settings can increase the likelihood that the person with COD will access treatment. (SAMHSA)

An Examination of Fulfilled Housing Preferences and Quality of Life Among Homeless Persons With Mental Illness And/or Substance Use Disorders

2007-04-06T04:07:44

This study examined the types of housing features considered important to a sample of homeless persons diagnosed with a mental illness and/or substance use disorder and the relationship between the degree to which important features were obtained in subsequent housing and subjective quality of life, clinical and housing outcomes at 3-month and 1-year follow-up periods. After controlling for significant clinical and sociodemographic covariates, results from regression analyses indicate that the degree to which a client's individual housing preferences were realized in dwellings is significantly associated with greater quality of life in the future, but not clinical outcomes or housing tenure. This study was conducted at the Yale Department of Psychiatry, VA Northeast Program Evaluation Center, 950 Campbell Avenue, West Haven, CT 06516, USA. (Authors)

Community Model for Homeless People With Mental Illness

2007-04-06T11:55:11

The Community Model was developed to assist the homeless mentally ill overcome thee afflictions through a symptom of "high-tolerance" and strong supports.

Definitions and Terms Relating to Co-Occurring Disorders - Overview Paper 1

2009-12-15T04:17:28

It is essential to use a common language to develop consensus on how to address the needs of persons with co-occurring disorders. This paper provides definitions of terms associated with substance-related disorders, mental disorders, co-occurring disorders, and programs. (Authors)

Effectiveness of Integrated Services for Homeless Adults with Serious Mental Illness

2007-07-06T08:20:00

This report presents current results of the Department of Mental Health's administration and implementation of programs at the county and city level required by Assembly Bills (AB) 34 and 2034. Services were expanded for parolees, probationers, and people who are homeless with serious mental illnesses. The department continues to find that the effects of the intensive, integrated outreach and community based services enable the target population to reduce symptoms that impaired their ability to live independently, work, maintain community supports, care for their children, remain healthy, and avoid crime. This report describes the processes used and the identification of approaches to services and strategies that were helpful in identifying and engaging clients and that may serve as guidelines and/or standards for future projects. Key among these approaches continues to be a very close collaboration at the local level among core service providers, including mental health services, law enforcement, veterans service agencies, and other community agencies. (Authors)

Emotional Distress and Mental Health Service Use Among Urban Homeless Adolescents

2006-12-11T01:12:48

The Expanded Behavioral Model for Vulnerable Populations was used to examine the predisposing, enabling, and need factors associated with mental health service use in a homeless adolescent sample. Among all youth, 32% perceived a need for help with mental health problems and 15% met Brief-Symptom Inventory (BSI) criteria for emotional distress. The rate of mental health service use in our sample was 32%. One enabling factor, having a case manager/discussed mental health concerns, and one need factor, which met criteria for BSI, were found to be associated with mental health service use in the past 3 months. The majority of youth who used mental health services had obtained services from crisis centers. Among those who perceived a need for help with mental health problems but who did not use services, the most common barrier was not knowing where to go or what service to use (57%). These findings suggest that due to the high prevalence of mental health problems among homeless youth, it would be helpful for service providers coming into contact with youth to make them aware of existing community resources for mental health services; making youth aware of these resources may in turn decrease the rate of crisis center use and instead allow youth to receive mental health services in outpatient settings that provide continuity of care. (Soloria, M. Rosa. Milburn, Norweeta. Andersen, Ronald. Trifskin, Sharone. Rodriguez, Michael.)

Expanding Service Delivery: Does it Improve Relationships Among Agencies Serving Homeless People with Mental Illness?

2007-07-09T04:47:14

Enhancing interagency services integration for homeless people has been advocated as an approach for improving service delivery to this population. In contrast to system-level top-down interventions, this study examines the association of expanded funding of client-level homeless services, a bottom-up approach, with strengthening of interorganizational relationships. We compared Veterans Affairs/non-Veterans Affairs interagency relationships at VA facilities supporting community-oriented programs (N=72), at VA facilities supporting on-site internally focused homeless programs (N=10), and at facilities with no specialized homeless programs (N=47). VA facilities that supported community-oriented homeless programs enjoyed stronger VA-community agency relationships than the other two VA facility types. The study identifies an effective bottom-up resource-based approach to services integration. (Authors)

Housing First Services for People Who Are Homeless With Co-Occurring Serious Mental Illness and Substance Abuse

2007-03-28T02:31:23

This study shows that adults with co-occurring mental illness and substance abuse can remain stably housed without increasing their substance use. It draws on data from a longitudinal experiment contrasting Housing First and treatment first programs.

In Their Own Words: Trauma and Substance Abuse in the Lives of Formerly Homeless Women with Serious Mental Illness

2007-09-27T01:25:03

In-depth interviews were conducted with 13 formerly homeless mentally ill women to capture their individual life trajectories of mental illness, substance abuse, and trauma in their own words. Cross-case analyses produced 5 themes: (a) betrayals of trust, (b) graphic or gratuitous nature of traumatic events, (c) anxiety about leaving their immediate surroundings (including attending group treatment programs), (d) desire for one's own space, and (e) gender-related status loss and stigmatization. Findings suggest formerly homeless mentally ill women need (and want) autonomy, protection from further victimization, and assistance in restoring status and devalued identity. Avenues for intervention include enhanced provider training, addressing experiences of betrayal and trauma, and more focused attention to current symptoms rather than previous diagnoses. (Authors)

Innovation and Implementation in Mental Health Services for Homeless Adults: a Case Study

2007-07-23T01:50:35

Seeking to identify conditions that support newly implemented evidence-based practices, this case study examined an implementation in which an existing agency was invited to move into the neighboring county to introduce its housing first practice with seriously mentally ill homeless adults. Using a constructivist methodology to elicit the narratives of key actors and observers about the implementation and its attendant controversy, this study found three issues at the core of actors' experiences: mode of presentation, use of an outside agency and the questioned uniqueness of the new practice. Barriers rather than facilitators dominated participants' interpretations of events despite significant researcher-observed facilitators. (Author)

Mental Health Training in Emergency Homeless Shelters

2007-11-13T11:45:17

The prevalence of mental illness among homeless persons points to the importance of providing mental health training to emergency shelter staff. The authors report on their own work and argue that such training offers the potential to significantly improve shelter staff's ability to respond to the needs of shelter residents with mental illness, and to the behavioral problems some of these individuals may pose for shelter operation. Mental health care providers should take into consideration organizational dynamics when planning and implementing such training. (Authors)

Needs for Mental Health Care and Service Provision for Single Homeless People

2007-11-13T11:08:12

Background: Specific problems in sampling methodology, case-finding strategies and a standardised needs assessment in mentally ill homeless people have contributed to their being neglected as a mental health care clientele.

Outcomes and Service Use Among Homeless Persons with Serious Mental Illness and Substance Abuse

2007-12-03T11:29:03

Objective: This study compared baseline characteristics and clinical improvement after 12 months among homeless persons with a diagnosis of serious mental illness with and without a comorbid substance use disorder.

Outcomes of Homeless Adults with Mental Illness in a Housing Program and in Case Management Only

2007-10-02T10:21:20

OBJECTIVE: The effectiveness of two types of service programs in ameliorating homelessness among individuals with severe mental illness was compared.

Outcomes of Shelter Use Among Homeless Persons With Serious Mental Illness.

2007-03-28T06:00:04

OBJECTIVE: The purpose of this study was to examine the extent to which the use of case management services predicted public shelter use among homeless persons with serious mental illness after the termination of Access to Community Care and Effective Services and Supports (ACCESS), a five-year outreach and case management program.

Overarching Principles to Address the Needs of Persons with Co-Occurring Disorders: Overview Paper 3

2007-09-27T08:36:31

This overview paper outlines 12 overarching principles for working with persons with co-occurring disorders (COD). These principles are intended to help guide, but not define, systemic and clinical responses. They are grouped according to whether they guide systems of care or individual providers and can be used as benchmarks to assess whether plans in development, or programs in operation, are grounded in the field's best thinking. (COCE)

Perceived Reasons for Loss of Housing and Continued Homelessness Among Homeless Persons With Mental Illness

2007-03-28T06:03:37

OBJECTIVE: The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness.

Predicting Staying in Or Leaving Permanent Supportive Housing That Serves Homeless People With Serious Mental Illness

2007-05-09T06:09:23

This study focuses on the questions: why people leave permanent housing and what happens to them. It examines the experience of some 943 residents of permanent supportive housing in Philadelphia during the period from 2001 to 2005. The study shows that it is not necessarily a “bad thing” that some people leave “permanent” supportive housing. This study contributes to the understanding of how the structure of permanent supportive housing and the use of various means of stabilization at critical junctures in a resident’s stay can promote more stability and, thereby, greater health and independence, among those living there, whether they stay or subsequently leave. (Authors)

Promoting Children’s Mental Health in Family Supportive Housing: A Community-University Partnership for Formerly Homeless Children and Families

2007-06-24T02:00:37

Emerging research indicates that significant numbers of formerly homeless families residing in permanent supportive housing have caregivers with substance use and mental health disorders, and children with histories of exposure to violence, abuse, and out-of-home placement. These factors place children at risk for adverse psychosocial outcomes, including later homelessness, providing a strong rationale for embedding child-focused prevention and intervention services in supportive housing contexts. This article describes a developing community–university partnership whose goal is to advance practice and research in the adaptation and dissemination of mental health prevention and early intervention for children in supportive housing. (Authors)

The Applicability of Housing First Models to Homeless Persons with Serious Mental Illness

2007-10-15T10:29:47

This report presents the findings from an exploratory study of the Housing First approach of providing permanent supportive housing to single, homeless adults with mental illness and co-occurring substance-related disorders. In recent years, Congress and the leadership of the U.S. Department of Housing and Urban Development (HUD) have encouraged the development of permanent housing for homeless people. Concurrently, there has been a shift toward committing a greater proportion of HUD McKinney-Vento Act funds toward housing as opposed to supportive services and an increase in attention toward the hardest-to-serve, chronically homeless population, a substantial number of whom are mentally ill. Because it addresses this population and its needs, the Housing First approach is currently experiencing increased attention as a method of serving this population consistent with the above-stated goals. (Authors)

The Effectiveness of Assertive Community Treatment for Homeless Populations With Severe Mental Illness: a Meta-analysis

2007-04-16T10:36:55

OBJECTIVE: The purpose of this study was to assess the effectiveness of assertive community treatment in the rehabilitation of homeless persons with severe mental illness using a meta-analysis.

The Impact of NY/NY Housing on Criminal Justice System Involvement Among Homeless Persons with Serious Mental Illness

2007-09-03T07:37:28

In addition to examining the impact of NY/NY housing on the use of medical, psychiatric, and emergency shelter services, the University of Pennsylvania study also matched 2,286 homeless individuals with mental illness who were placed into NY/NY housing with a set of cohorts who also had a similar record of shelter use, matched by various demographic characteristics, indicators for mental illness and substance abuse, and Medicaid eligibility. Criminal justice involvement was then compared for these groups for the two years before and after the first group was placed into supportive housing. (CSH)

The Impact of Supportive Housing for Homeless People With Severe Mental Illness on the Utilization of the Public Health, Corrections, and Emergency Shelter Systems: The New York-New York Initiative

2009-01-22T12:07:11

Data on 4,679 homeless people with severe mental disorders placed in supportive housing in New York City between 1989 and 1997 were merged with administrative data on the utilization of public shelters, public hospitals, Medicaid-funded services, veterans’ inpatient services, State psychiatric inpatient services, State prisons, and the city’s jails. A series of matched controls who were concurrently homeless but were not placed in housing were similarly tracked through administrative records.

Vocational Outcomes Among Formerly Homeless Persons With Severe Mental Illness in the Access Program

2007-06-20T07:53:50

OBJECTIVE: This study examined the vocational outcomes of 4,778 formerly homeless individuals with severe mental illness who were enrolled in the Access to Community Care and Effective Services and Support (ACCESS) program, a multisite demonstration project designed to provide services to this population.