Introduction: Locating services in neighborhoods often meets resistance, making the argument that “undesirables” will follow services to their new locations. This phenomenon, labeled NIMBY (“Not In My Back Yard”), is often associated with addiction, mental health, and homelessness services. Yet, in spite of the argument's frequency and intensity, it remains untested. The purpose of this study is to test a “NIMBY hypothesis”—that clients move closer to their services—in a homeless drug abusing population.

Methods: A homeless sample (N=400) was randomly recruited for the NIDA-funded SUNCODA study (Service Use, Needs, Costs, Outcomes of Drug Abuse). Individuals provided addresses of their current sleeping locations at baseline, and again at 12-month follow-up. Structured diagnostic interviews were conducted for lifetime substance abuse/dependence (alcohol, marijuana, cocaine, amphetamine, opioid) and other mental illness (schizophrenia, depression, mania, PTSD). Service use data were collected directly from all homeless, addiction, and mental health services within the urban area. Using ArcView software, street-route distance was calculated from the current sleeping location to the address of each service agency used during the interim (n=7,700). Using the Taylor Service Linearization Method (SAS' Proc Surveyreg) for regression analyses, standard errors were corrected for intra-subject correlation to compare: (1) change in distance traveled to services at baseline versus follow-up and (2) change in distance among psychiatric diagnoses.

Results: Change in distance did not decrease significantly baseline to follow-up, in the full sample or in any diagnostic subgroup.

Discussion: Results failed to support the NIMBY hypothesis. For homelessness, it appears that sleeping location did not increasingly cluster geographically with services over time. One possible explanation is that sleeping location is dictated more by availability than convenience among homeless. The findings appear to support a counter-argument that, in terms of sleeping location, NIMBY with homeless is driven more by stigma than by reality.

Supported by NIDA grants R03 DA15809 and R01 DA10713.