Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Substance Abuse among Homeless Persons

Integrating Services for Homeless Adults with Substance Abuse Disorders: 6 Month Outcomes

Individuals with complex needs may require intervention from several different institutions to achieve stability. Often these different institutions fail to coordinate their efforts with one another effectively, leading to treatment plans that lack coherence or that even may contradict each other. To address the problems presented by fragmented and categorical service systems, advocates for multi-need clients frequently call for innovative approaches that will integrate service systems. This study evaluated a case management strategy designed to address the problem of service integration for individuals who are homeless and abuse alcohol or drugs, many of whom also have a co-occuring mental health disorder. The strategy involved establishing a case management team comprised of representatives from agencies operating in three major service delivery systems in a large Midwestern city– substance abuse treatment, mental health treatment, and housing services. It was hypothesized that the inter-agency structure of the team would improve the case managers’ ability to coordinate care plans across multiple service systems and would contribute to more positive client outcomes. To evaluate this hypothesis the integration team’s clients were interviewed by an independent researcher shortly after intake (n=220) and six months post intake (77% follow up rate). Using a combination of standardized and program-specific research instruments, the research interview gathered data on residential stability, substance use, mental health status, recent and lifetime service use, and basic demographics. Baseline and six month responses were compared using correlated-sample t-tests and chi square tests.

Results of the analyses indicate there were significant improvements for clients overall in four areas: housing status, monthly income, employment, and use of alcohol. There was also a significant improvement in mental health among the subset of clients who had mental health needs at intake. Among the subset of clients who were actively abusing drugs at intake, frequency of drug use significantly declined. These results suggest that the integration team’s approach generated positive results for clients with complex service needs. The study results should inform policy makers and program administrators who wish to design innovative solutions for increasing coordination across service delivery systems that can enhance treatment of clients with complex needs.

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