Case Management Models in Permanent Supported Housing Programs for People with Complex Behavioral Issues who are Homeless
OBJECTIVE:
The
purpose of this article is to examine two evidence-based models of case
management for people with co-occurring disorders and histories of chronic
homelessness, and to better understand their roles in permanent supported
housing. Critical Time Intervention and Assertive Community Treatment are
examined in terms of key elements, how they assist in ending homelessness, as
well as the role they play in an individual's recovery from co-occurring
disorders.
METHODS:
Participants
in two supported housing programs were interviewed at baseline and 6 months.
One program used Critical Time Intervention (n = 144) and the other used
Assertive Community Treatment (n = 90). Staff in both programs were interviewed
about their experiences and fidelity assessments were conducted for each
program.
RESULTS:
Both
programs operated at high levels of fidelity. Despite similar criteria for
participation, there were significant differences between groups. Critical Time
Intervention participants were older, more likely to be male, more likely to be
homeless, and reported greater psychiatric symptoms and higher levels of
substance use (all p's < .001). Separate outcome analyses suggested that
each program was successful in supporting people to transition from
homelessness to stable housing; 88.6% of Assertive Community Treatment
participants were homeless at baseline, while at 6 months 30% were homeless (p
< .001), and 91.3% of those in the Critical Time Intervention were homeless
at baseline, while 44.3% were homeless at 6 months (p < .001). Participants
in the Critical Time Intervention program also showed significant decreases in
alcohol use, drug use and psychiatric symptoms (all p's < .01). The
preliminary results suggest that each case management model is helpful in
assisting people with complex behavioral health needs and chronic homelessness
to move to stable housing.
CONCLUSIONS:
Permanent
supported housing seems to be an effective way to end homelessness among people
with co-occurring disorders. Further research is needed to determine which case
management models work most effectively with supported housing to help policy
makers and program directors make informed decisions in developing these
programs.
- 1 University of South Florida , Department of Mental Health Law and Policy.
- J Dual Diagn. 2016 Apr 12:0
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