Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Substance Abuse among Homeless Persons

Barriers to Treatment for Homeless People with Substance Use Disorders

The purpose of this study was to increase our understanding of the barriers that homeless persons with substance use disorders experience in accessing substance abuse treatment services. Although there has been substantial interest and program development in assertive outreach and service linkage for homeless persons with psychiatric disorders, including dual disorders, there has been a relative lack of attention devoted to engaging homeless persons with substance use disorders into treatment. In this study, ten case managers with the Outreach and Engagement Project in New Haven, Connecticut completed survey questionnaires on a total of 119 homeless people with substance use disorders. This survey examined linkages to treatment over the last year for project clients. Over 35% of project clients were referred to treatment services, and 70% of these clients successfully entered treatment. There was a high correlation between referral to treatment and the client’s motivation for treatment indicating that referrals were initiated for clients at a higher stage of motivational readiness. The major barrier to treatment for clients who were referred but not admitted to programs was their lack of willingness to enter treatment (n=7), rather than our expected finding that programs would not readily accept homeless clients. Two findings emerged from the surveys that were surprising. The first was that a high percentage of homeless people the project served with assertive outreach were successfully enrolled into substance abuse treatment services. The second was that no clients were successfully referred to substance abuse treatment programs at the host agency despite the fact that the agency has three outpatient treatment clinics. There are important implications of this research for social work practice. Since untreated substance abuse results in enormous social and economic costs, creative strategies to engage and link homeless persons with substance use disorders to treatment services is critical. As such, homeless outreach projects may offer an effective option to manage the soaring costs of substance use disorders. Such research can also provide managers with tools to identify treatment gaps in the local service system. Given that assertive outreach may be a cost effective alternative as well as a promising practice for linking homeless peoples with substance abuse treatment, more research attention needs to be focused on this approach as a viable treatment alternative.

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