Improving Health Well-Being, and Stability Research

Do Homeless Veterans Have the Same Needs and Outcomes as Non-Veterans

Jack Tsai, Alvin S. Mares, and Robert A. Rosenheck                                                                                  December 2012

This observational study compared 162 chronically homeless Veterans to 388 non-Veterans enrolled in a national-supported housing initiative over a 1-year period. Results showed that Veterans  . . .

Early Reading Skills and Academic Achievement Trajectories of Students Facing Poverty, Homelessness, and High Residential Mobility

Janette E. Herbers, et al.

Univerisity of Minnesota

December 2012

This investigation tested the importance of early academic achievement for later achievement trajectories among 18,011 students grouped by level of socioeconomic risk. Students considered to be at highest risk were those who experienced homelessness or high residential mobility (HHM). HHM students were compared with students eligible for free meals, students eligible for reduced price meals, and students who were neither HHM nor low income...

Executive Function Skills and School Success in Young Children Experiencing Homelessness

Ann S. Masten, et al.

University of Minnesota

December 2012

The authors examined the role of executive function (EF) skills as a predictor of kindergarten or first-grade adjustment in 138 children living in shelters for homeless families. During the summer, children completed a battery of six EF tasks and three IQ measures. Teachers later rated children’s school adjustment in five domains of achievement and social conduct...

Academic Achievement Trajectories of Homeless and Highly Mobile Students: Resilience in the Context of Chronic and Acute Risk

J.J. Cutuli, et. al.
University of Minnesota
October 2012

Analyses examined academic achievement data across third through eighth grades (= 26,474), comparing students identified as homeless or highly mobile (HHM) with other students in the federal free meal program (FM), reduced price meals (RM), or neither (General). Achievement was lower as a function of rising risk status (General > RM > FM > HHM)... 

Medicaid-Financed Services in Supportive Housing for High-Need Homeless Beneficiaries: The Business Case

Michael Nardone, Richard Cho, and Kathy Moses
The Corporation for Supportive Housing and The Center for Health Care Strategies

June 2012
Medicaid expansion under the Affordable Care Act (ACA) will provide new insurance coverage to more individuals who are homeless. States could consider leveraging various Medicaid service options, such as health homes, to provide these new beneficiaries with care management services linked to supportive housing....

Linking Human Services & Housing Assistance for Homeless Families & Families At-Risk of Homelessness

Alvaro Cortes, Ph.D. et al. 
Abt. Associates
April 2012

Recent reports have brought national attention to the prevalence of family homelessness and the need to coordinate across all levels of government to prevent and end family homelessness.  In June 2011, the U.S. Department of Housing and Urban Development (HUD) released the 2010 Annual Homeless Assessment Report (AHAR), the sixth in a series of annual reports on the extent and nature of homelessness nationwide. The report documents a 29 percent increase in sheltered family homelessness between 2007 and 2010.  Today, an estimated 168,000 families— 567,000 people—use an emergency shelter or a transitional housing program at some point during the year. The toll of homelessness on children living with their families is troubling.  Homelessness can adversely affect children’s mental health and behavior, school attendance and educational achievement, cognitive and motor development, and general health...

A Family Intervention to Reduce Sexual Risk Behavior, Substance Use, and Delinquency Among Newly Homeless Youth

Norweeta G. Milburn, et. al.
April 2012

We evaluate the efficacy of a short family intervention in reducing sexual risk behavior, drug use, and delinquent behaviors among homeless youth using a randomized controlled trial of 151 families with a homeless adolescent aged 12 to 17 years. Between March 2006 and June 2009, adolescents were recruited from diverse sites in Southern California and were assessed at recruitment (baseline), and at 3, 6, and 12 months later...

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness

Martha R. Burt and Carol Wilkins                                                                                                                                                                                                                                        February 2012

This Issue Paper describes three subgroups of the people experiencing chronic homelessness, and the services and housing configurations currently supporting them.

U.S. Housing Insecurity and the Health of Very Young Children

Diana Becker Cutts, Alan F. Meyers, Maureen M. Black, Patrick H. Casey, Mariana Chilton, John T. Cook, Joni Geppert, Stephanie Ettinger de Cuba, Timothy Heeren, Sharon Coleman, Ruth Rose-Jacobs, and Deborah A. Frank
August 2011

This study investigated the association between housing insecurity and the health of very young children. Researchers assessed food insecurity, child health status, developmental risk, weight, and housing insecurity for each child's household.  Indicators for housing insecurity were crowding and multiple moves...

Health Behaviors and Infant Health Outcomes in Homeless Pregnant Women in The United States

Rickelle Richards, Ray M. Merrill, and Laurie Baksh
August 2011

The objective of this study is to describe select demographics, maternal health behaviors before, during, and after pregnancy, and infant health outcomes among homeless women in the United States. Analyses are based on Pregnancy Risk Assessment Monitoring System data from 31 participating states...

The Impact of Shelter Use and Housing Placement on Mortality Hazard for Unaccompanied Adults and Adults in Family Households Entering New York City Shelters: 1990-2002

Stephen Metraux, Nicholas Eng, Jay Bainbridge, and Dennis Culhane
August 2011

This study examines mortality among New York City (NYC) homeless shelter users, assessing the relationships between mortality hazard and time in shelter, patterns of homelessness, and subsequent housing exits for both adults in families and single adults...

Applying the Chronic Care Model to Homeless Veterans: Effect of a Population Approach to Primary Care on Utilization and Clinical Outcomes
“Homelessness and Trauma Go Hand-in-Hand”: Pathways to Homelessness among Women Veterans

Alison B. Hamilton, Ines Poza, and Donna L. Washington                                                                             2011

Veterans comprise a disproportionate fraction of the nation’s homeless population, with women Veteransup to four times more likely to be homeless than non-Veteran women. This paper provides a grounded description of women Veterans’ pathways into homelessness.

Thomas P. O'Toole, Lauren Buckel, Claire Bourgault, Jonathan Blumen, Stephen G. Redihan, Lan Jiang, and Peter Friedmann
December 2010

This study compared a population-tailored approach to primary care for homeless veterans with an usual care approach. Researchers conducted a retrospective prolective cohort study of homeless veterans enrolled in a population-tailored primary care clinic matched to a historical sample in general internal medicine clinics...

Associations of Housing Status with Substance Abuse Treatments and Service Use Outcomes Among Veterans

Jonathan R. Buchholz, Carol A. Malte, Donald A. Calsyn, John S. Baer, Paul Nichol, Daniel R. Kivlahan, Ryan M. Caldeiro and Andrew J. Saxon
July 2010

This secondary analysis evaluated the prevalence and stability of homelessness over one year among veterans entering substance abuse treatment and explored associations among housing status, treatment outcomes, and Veterans Affairs (VA) service utilization...

Effective Interventions for Homeless Youth

Astrid M. Altena, Sonja N. Brilleslijper-Kater and Judith R.L.M. Wolf
June 2010

To date, there has not been clear evidence regarding interventions that are effective in addressing the specific needs of homeless youth. A systematic and comprehensive international review on effective interventions for homeless youth is presented. This study seeks to provide an accurate and complete picture of ...

Homeless Children: Update on Research, Policy, Programs, and Opportunities

Judith Samuels, Marybeth Shinn, and John C. Buckner
May 2010

This paper provides an update on the research, policy, laws, and funding for programs and services for children who are homeless in the United States. Education, health, and mental health for homeless children are examined. Homeless children here refers to minor children accompanying their parent(s)/guardian(s) during a homeless ...

Effect of Full-Service Patnerships on Homelessness, Use and Costs of Mental Health Services, and Quality of Life among Adults with Serious Mental Illness

Sam Tsemberis

Chronically homeless adults with severe mental illness are heavy users of costly inpatient and emergency psychiatric services. Full-service partnerships (FSPs) provide housing and engage clients in treatment....

The Effects of HIV Stigma on Health, Disclosure of Health Status, and Risk Behavior of Homeless and Unstably Housed Persons Living with HIV

Richard J. Wolitski, Sherri L. Pals, Daniel P. Kidder, Cari Courtenay-Quirk and David R. Holtgrave
December 2009

HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = ...

Associations Between Substance Use, Sexual Risk Taking and HIV Treatment Adherence Among Homeless People Living With HIV

Mark S. Friedman, Michael P. Marshal, Ron Stall, Daniel P. Kidder, Kirk D. Henny, Cari Courtenay-Quirk, Study Group The Project START, Angela Aidala, Scott Royal, and David R. Holtgrave
June 2009

Prior research suggests that the interconnections between substance use, HIV risk, and lack of adherence to HIV medications are especially strong among homeless individuals.  The objectives of ...

Behavioral Health/Primary Care Integration and the Person-Centered Healthcare Home

Barbara J. Mauer
April 2009

People living with serious mental illnesses are dying 25 year earlier than the rest of the population, in large part due to unmanaged physical health conditions. To address the gap in current thinking...

Factors Associated With Adherence to Highly Active Antiretroviral Therapy in Homeless or Unstably Housed Adults Living With HIV

Scott W. Royal, Daniel P. Kidder, Satyendra Patrabansha, Richard J. Wolitski, David R. Holtgrave, Angela Aidala, Sherri Pals, and Ron Stall
April 2009

The purpose of the study is to investigate adherence to highly active antiretroviral therapy (HAART) in persons living with HIV/AIDS (PLWHA) who are homeless or unstably housed.  Using baseline data and controlling for gender, race, age, ...

Housing Status and HIV Risk Behaviors Among Homeless and Housed Persons with HIV

Daniel P. Kidder, Richard J. Wolitski, Sherri L. Pals, and Michael L. Campsmith
December 2008

The purpose of this study was to compare drug, alcohol, and sexual HIV transmission risk behaviors of homeless and housed people living with HIV/AIDS. D ata were compiled from 8,075 respondents in a cross-sectional, multi-site behavioral survey of adults recently reported to have HIV infection. At ...

Factors Associated with Incarceration History Among HIV-Positive Persons

Cari Courtenay-Quirk, Sherri Pals, Daniel Kidder, Kirk Henry and James Emshoff
June 2008

Among persons living with HIV/AIDS (PLWHA) experiencing homelessness or at imminent risk of homelessness, a history of incarceration may serve as a marker for ongoing risk behavior or health disparities. The study examines factors associated with a history of incarceration among HIV-positive clients of housing agencies...

Effective Teaching and At Risk/Highly Mobile Students: What Do Award Winning Teachers Do?

Leslie Grant, James H. Stronge, and Patricia Popp
May 2008

This study was designed jointly between the National Center for Homeless Education (NCHE) and researchers at The College of William and Mary. The project was funded through NCHE and was designed to explore a critical factor in working with at-risk/highly mobile students – the teacher. The researchers on this team had prior ...

Rates and Risk Factors for Homelessness after Successful Housing in a sample of Formerly Homeless Veterans

Maria J. O'Connell,  Wesley Kasprow and Robert A. Rosenheck
March 2008

Research suggests that subsidized housing combined with mental health services may be an effective intervention for successfully placing individuals who have a mental illness and a history of homelessness into community housing. However, there is limited longitudinal information available...

Health Status, Health Care Use, Medication Use, and Medication Adherence Among Homeless and Housed People Living with HIV/AIDS

Daniel P. Kidder, Richard J. Wolitski, Michael L. Campsmith, and Glenn V. Nakamura
December 2007

The purpose of the study was to compare health status, health care use, HIV antiretroviral medication use, and HIV medication adherence among homeless and housed people with HIV/AIDS.  Data were obtained from a cross-sectional, multisite behavioral survey of adults (N=7,925) recently ...

Physical and Sexual Abuse Among Homeless Adults Living With HIV: Prevalence and Associated Risks

Kirk D. Henny, Daniel P. Kidder, Ron Stall and Richard J. Wolitski
November 2007

The purpose of this study was to examine the prevalence and risks associated with interpersonal (physical and sexual) abuse among HIV-seropositive homeless or unstably housed adults. Data were obtained from the Housing and Health Study of participants living in Baltimore, Chicago, and Los Angeles ...

Access to Housing as a Structural Intervention for Homeless and Unstably Housed People Living With HIV: Rationale, Methods, and Implementation of the Housing and Health Study

Daniel P. Kidder, Richard J. Wolitski, Scott Royal, Angela Aidala, Cari Courtenay-Quirk, David R. Holtgrave, David Harre, Esther Sumartojo, and Ron Stall
November 2007

Homelessness and unstable housing have been associated with HIV risk behavior and poorer health among persons living with HIV/AIDS (PLWHA), yet prior research has not tested causal associations. This paper describes the ...

Moving from Fact to Policy: Housing is HIV Prevention and Health Care

Virginia Shubert and Nancy Bernstine
November 2007

A growing body of empirical evidence shows strong correlations between improved housing status and reduced HIV risk behaviors, improved access to health care for persons living with HIV/AIDS, and better health outcomes...

Housing Need, Housing Assistance, and Connection to HIV Medical Care

Angela A. Aidala, Gunjeong Lee, David M. Abramson, Peter Messeri and Anne Siegler
November 2007

HIV infection has become a chronic condition that for most persons can be effectively managed with regular monitoring and appropriate medical care. However, many HIV positive persons remain unconnected to medical care...

HIV, Homelessness, and Public Health: Critical Issues and a Call for Increased Action

Richard J. Wolitski, Daniel P. Kidder and Kevin A. Fenton
November 2007

Homelessness and housing instability are significant public health issues that increase the risks of HIV acquisition and transmission and adversely affect the health of people living with HIV. This article highlights...

HIV and Housing Assistance in Four U.S. Cities: Variations in Local Experience

Alison Scott, Jonathan Ellen, Gretchen Clum and Lori Leonard
November 2007

This paper provides an account of how young, HIV-positive women manage their lives on limited budgets in four United States cities: New York City, New Orleans, Miami, and Chicago...

A Look at Child Welfare From a Homeless Education Perspective

Jan Moore
Fall 2007

More and more frequently, local homeless education liaisons are asked to determine whether students involved with the child welfare system are eligible for services under the McKinney-Vento Homeless Assistance Act and, if so, how to serve them appropriately. Although the confusion of navigating the child welfare system can deter local liaisons from their task, the ...

The Unique Impact of Out-of-Home Placement and the Mediating Effects of Child Maltreatment and Homelessness on Early School Success

John Fantuzzo and Staci Perlman
July 2007

Increased national attention has underscored the importance of promoting educational well-being for children who have been placed in out-of-home care. This study, informed by a developmental epidemiology framework, examined the unique impact of out-of-home placement and the mediating effects of child maltreatment and homelessness on the academic ...

The Effectiveness of Assertive Community Treatment for Homeless Populations with Severe Mental Illness

Craig M. Coldwell and William S. Bender
March 2007

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. A structured literature search identified...

Treating Homeless Clients with Severe Mental Illness, Substance Use Disorders

Gary A. Morse, Robert J. Calsyn, W. Dean Klinkenberg, Thomas W. Helminiak, Nancy Wolff, Robert E. Drake, Robert D. Yonker, Gyanesh Lama, Matthew R. Lemming and Suzanne McCudden
August 2006

This study compares the costs and outcomes associated with three treatment programs that served 149 individuals with dual disorders (i.e., individuals with co-occurring severe mental illness and substance ...

Comparison of ACT and Standard Case Management For Delivering Integrated Treatment For Co-Occurring Disorders

Susan M. Essock, Kim T. Mueser, Robert E. Drake, Nancy H. Covell, Gregory J. McHugo, Linda K. Frisman, Nina J. Kontos, Carlos T. Jackson, Flora Townsend, and Karin Swain
February 2006

Clients with co-occurring severe mental and substance use disorders are at high risk of institutionalization and other adverse outcomes. Although integrated mental health and substance abuse treatment is ...

Collaborations of Schools and Social Service Agencies

Jan Moore
December 2005

In the past two decades, there has been a dramatic rise in the number of homeless students enrolled in US schools. Overwhelmed school personnel lack adequate resources and skills to successfully address the myriad of challenges – especially those outside the scope of academics – faced by homeless children. Issues like hunger, inadequate housing, poor ...

The Experience of Violence in the Lives of Homeless Women: A Research Report

Jana L. Jasinski, Jennifer K. Wesely, Elizabeth Mustaine, and James D. Wright
November 2005

Studies investigating the experience of violence by homeless women date to the mid 1980’s, but most prior research has been more concerned with establishing the face of violence committed against these women than in exploring the risk factors responsible for it. This multi-site statewide study ...

Unmet Need for Medical Care among Homeless Adults with Serious Mental Illness

Mayur M. Desai and Robert A. Rosenheck
November 2005

The objective of this study was to determine the rates and predictors of unmet medical needs among homeless adults with serious mental illness entering a community-based case management program and those of receipt of medical care in the subsequent 3-month period...

An Exploration of Child Maltreatment Among Homeless Families: Implications For Family Policy 

John T. Pardeck
May 2005

This research explores the incidence of child maltreatment among homeless families. The maltreatment explored in the study includes physical, emotional and sexual abuse. The data reported a high incidence of child maltreatment in the lives of the homeless. The policy ...

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

Ramin Mojtabai
February 2005

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.  A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent ...

A Modified Therapeutic Community for Homeless Persons in a Shelter: An Outcome Study

Darren C. Skinner
January 2005

This article reports on a study conducted to determine the effectiveness of a modified therapeutic community (MTC) shelter on client outcomes. The seven-study hypotheses focused on whether greater effectiveness in the MTC would be demonstrated in longer periods of sobriety, fewer days of...

Using Medicaid to Support Working-Age Adults with Serious Mental Illnesses in the Community

Gary Smith, Cille Kennedy, Sarah Knipper, John O'Brien and Janet O'Keeffe
January 2005

This Handbook is designed to improve understanding and provide greater clarity concerning Medicaid’s contribution in supporting working-age adults with serious mental illnesses in the community. The Handbook focuses on working age adults between the ages of 21 and 64 with serious mental illnesses...

HIV Testing and Receipt of Test Results among Homeless Persons with Serious Mental Illness

Mayur M. Desai and Robert A. Rosenheck
December 2004

The purpose of this study was to determine the rates and predictors of HIV testing and receipt of results among homeless adults with serious mental illness in the initial 3-month period after contact with a community-based case management program...

Outcomes of Supported Housing among Homeless Veterans with Serious Mental Illness

Alvin S. Mares, Wesley J. Kasprow and Robert A. Rosenheck
December 2004

This study examines the effect of previous participation in time limited residential treatment and other factors on treatment outcomes among homeless veterans with serious mental illness placed into permanent supported housing...

Long-Term Effectiveness of the ACCESS Program

Aileen B. Rothbard, So-Young Min, Eri Kuno and Yin-Ling Irene Wong
October 2004

This study examined the long-term effectiveness of the Access to Community Care and Effective Services and Supports (ACCESS) project on service utilization and continuity of care among homeless persons with serious mental illness. A 3-year longitudinal analysis, using Medicaid claims data, tracked behavioral ...

Housing Characteristics and Adequacy of the Physical Care of Children

Joy Swanson Ernst, Megan Meyer and Diane DePanfilis
September 2004

This study explored the relationship between housing conditions and the adequacy of the physical care of children. The sample included 106 caregivers who were participating in a neglect prevention demonstration project in a low-income, inner-city neighborhood. Children who lived with caregivers who had unsafe housing ...

One-Year Housing Arrangements among Homeless Adults with Serious Mental Illness in the ACCESS Program

Alvin S. Mares and Robert A. Rosenheck
May 2004

This study examined the various living arrangements among formerly homeless adults with mental illness 12 months after they entered case management. The study surveyed 5,325 clients who received intensive case management services in the Access to Community Care and Effective Services and Supports (ACCESS) program....

Reaching the Hard to Reach

Jamie Van Leeuwen

This article features three housing programs designed to target the needs of youth aging out of child welfare. One program combines housing and treatment to move substance-dependent youth off the streets; one combines the resources of Urban Peak, the only licensed homeless and runaway youth shelter in Colorado...

Outcomes of shelter use among Homeless Persons with Serious Mental Illness

So-Young Min

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...

Increasing School Stability for Students experiencing Homelessness: overcoming challenges to providing transportation to the school of origin

Diana Bowman

Underscoring the importance of school stability for children and youth experiencing homelessness, the McKinney-Vento Homeless Education Assistance Act, reauthorized as Title X, Part C, of the No Child Left Behind Act of 2001, requires that school districts provide transportation to enable children and youth to remain in their school of origin...

School stability and school performance: a review of the literature

Beth Garriss Hardy

While the topic of student mobility and its effects on school performance is of growing concern to educational researchers and practitioners, there remains a notable lack of rigorous scientific inquiry in this arena. A review of the literature reveals...

Evaluation of the Family Self-Sufficiency Program: Retrospective Analysis: 1996 - 2000

Robert C. Ficke

To break the cycle of reliance of government assistance, HUD’s legislation includes a requirement that most public housing authorities (PHAs) offering the Housing Choice Voucher program develop action plans promoting family self-sufficiency (FSS) for client families...

Students on the move: reaching and teaching highly mobile children and youth

Patricia A. Popp, James H. Stronge, Jennifer L. Hindman
November 2003

The purpose of this handbook it to synthesize research on the education of various subpopulations of students who tend to be highly mobile and to explore common characteristics and significant differences. While research studies may still be limited, practitioners have been addressing mobility on a variety of fronts...

Prevalence of Hepatitis C Virus Infection among a sample of Homeless Veterans

Rani A. Desai, Robert A. Rosenheck and Vincent Agnello
July 2003

This study measures the prevalence of Hepatitis C Virus (HCV) infection in a sample of homeless veterans treated in a Domiciliary Care for Homeless Veterans (DCHV) program in Massachusetts. The study also examines risk factors and correlates for HCV infection, including substance abuse and service in Vietnam...

Waking Rip van Winkle: Why developments in the last 20 years should teach the mental health system not to use housing as a tool of coercion

Michael Allen
July 2003

Many housing programs for people with mental illnesses rely on models that require the person to adhere to treatment as a condition of continuing access to housing. These models that ‘bundle’ housing and treatment are relics of a past in which persons with mental illnesses were afforded little real choice in treatment, housing...

Health Status, Service Use, and Costs among Veterans Receiving Outreach Services in Jails or Community

James McGuire, Robert A. Rosenheck, and Wesley Kasprow
February 2003

This study compared client characteristics, service use, and health care costs of two groups of veterans who were contacted by outreach workers: a group of veterans who were contacted while incarcerated at the Los Angeles jail and a group of homeless veterans who were contacted in community settings.

Blueprint for Change: Ending chronic homelessness for persons with serious mental illness and/or co-occurring substance use disorders

Susan Wells

The Substance Abuse and Mental Health Services Administration (SAMHSA) and its Center for Mental Health Services, in collaboration with SAMHSA’s Center for Substance Abuse Treatment (CSAT), have developed this Blueprint for Change to disseminate state-of-the-art information about ending homelessness for people who have serious mental illnesses, including those with co-occurring substance use disorders...

Research on evidence-based practices: Future directions in an era of recovery

William Anthony

Many mental health systems are trying to promote the adoption of what has come to be known as evidence-based practices while incorporating a recovery vision into the services they provide. Unfortunately, much of the existing, published, research on evidence-based practices was conceived without an understanding of the recovery vision...

Sexual Abuse Among Homeless Adolescents: Prevalence, Correlates, and Sequelae

Jody M. Greene, Rebecca Sanchez, Jennifer Manlove, Elizabeth Terry-Humen, Sharon Vandivere, Richard Wertheimer, Stephanie Williams, Jonathan Zaff, and Christopher L. Ringwalt
November 2002

Over the past two decades, there has been increasing recognition that runaway and homeless youth constitute a vulnerable population that faces a multitude of problems while away from home and, often, ...

Impact of Work Therapy on Health Status among Homeless Substance Dependant Veterans

T. Michael Kashner, Robert Rosenheck, Anthony Brian Campinell, Alina Surís, Randy Crandall, Nancy J. Garfield, Paul Lapuc, Karen Pyrcz, Thomas Soyka, Annie Wicker and the CWT Study Team
October 2002

Little is known about the health outcomes of clinician-supervised, performance-based, abstinence-contingent therapeutic work programs on homeless persons with addiction disorders. This study examined the effect of the Department of Veterans Affairs compensated work therapy program (CWT) on nonvocational outcomes.

Hispanic Client Case Manager Matching: Differences in Outcomes and Service Use in a Program for Homeless Persons with Severe Mental Illness

Alexander N. Ortega and Robert A. Rosenheck
May 2002

Mental health professionals have responded to ethnic and racial disparities in mental health care by advocating increasing cultural relevancy in treatment. A central component of cultural relevancy is ethnic and racial pairing of clients and providers.

Quality of Preventative Medical Care for Homeless Veterans with Mental Illness

Benjamin G. Druss Robert A. Rosenheck, Mayur M. Desai and Johnathan B. Perlin
February 2002

This study compares quality of preventive services between persons with and without mental/substance use disorders for a national sample of medical outpatients. The research design was a cross-sectional study using a sample of 113,505 veterans with chronic conditions and at least three general medical visits to Veterans Health Administration medical providers during 1998 to 1999...

Outcomes After Initial Receipt of Social Security Benefits Among Homeless Veterans With Mental Illness

Robert A. Rosenheck, David J. Dausey, Linda Frisman, and Wesley Kasprow
December 2000

This study examines the relationship between receiving disability payments and changes in health status, community adjustment, and subjective quality of life.  The study evaluated outcomes among homeless mentally ill veterans who applied for Social Security Disability Insurance or Supplemental ...

Client-Case Manager Racial Matching in a Multi-Site Program for Homeless People with Mental Illness

Matthew J. Chinman, Robert A. Rosenheck and Julie A. Lam
October 2000

This study evaluated the relationship between client-case manager racial matching and both service use and clinical outcomes in a case management program for homeless persons with serious mental illness. The study focused on 1,785 clients from the first cohorts that entered the Center for Mental Health Services' Access to Community Care and Effective Services and Supports (ACCESS) program...

The Case Management Relationship and Outcomes for Homeless People with Serious Mental Illness

Matthew J. Chinman, Robert Rosenheck and Julie A. Lam
September 2000

The effect of the case management relationship on clinical outcomes was examined among homeless persons with serious mental illness. The sample consisted of the first two cohorts that entered the Access to Community Care and Effective Services and Supports (ACCESS) program, a five-year demonstration program for mentally ill homeless persons funded by the Center for Mental Health Services in 1994...

Comparing Consumer and Nonconsumer Provided Case Management Services for Homeless Persons with Mental Illness

Matthew J. Chinman, Robert Rosenheck, Julie A. Lam, and Larry Davidson
July 2000

This study compared the outcomes of services provided by case managers who are mental health system consumers and case managers who were not consumers. The study focused on the first two cohorts that entered the ACCESS program, a 5-year demonstration program funded by the Center for Mental Health Services between...

Correlates of Improvement in Quality of Life among Persons Who are Homeless and Have Serious Mental Illness

Julie A. Lam and Robert A. Rosenheck
January 2000

Longitudinal data from 4,331 homeless mentally ill clients at 18 sites participating in the Access to Community Care and Effective Services and Supports program were used to assess participants' quality of life over a one-year period. 

Serving street dwelling individuals with psychiatric disabilities

David L. Shern

This study tested a psychiatric rehabilitation approach for organizing and delivering services to street dwelling persons with severe mental illness. Compared with persons in standard treatment, members of the experimental group were more likely to attend a day program...

Street Outreach for Homeless Persons with Serious Mental Illness: Is It Effective?

Julie A. Lam and Robert A. Rosenheck
September 1999

This study examined data on case management clients who are homeless and have a severe mental illness to determine how those contacted through street outreach differ in their socio-demographic characteristics, service needs, and outcomes from those clients contacted in shelters and other health and social service agencies. 

Homeless Veterans’ Satisfaction with Residential Treatment

Wesley J. Kasprow, Linda Frisman, Robert A. Rosenheck
April 1999

Because little is known about homeless individuals' satisfaction with mental health services or the association between satisfaction and measures of treatment outcome, the study examined those issues in a group of homeless veterans. Demographic and clinical data were obtained...

Social Support and Service Use among Homeless Persons with Serious Mental Illness

Julie A. Lam and Robert Rosenheck
March 1999

It has been widely hypothesized that persons with greater social support use fewer health care services, although previous studies have shown variable results. This study examines the relationship between levels of social support and formal service use among clients entering 18 community treatment programs...

Assertive community treatment for patients with co-occurring severe mental illness and substance abuse disorder: A clinical trial

Robert E. Drake

Integrated mental health and substance abuse treatment within an assertive community treatment (ACT) approach was compared to that within a standard case management approach for 223 patients with dual disorders over three years.

Treatment Involvement and Outcomes for Four Subtypes of Homeless Veterans

Keith Humphreys and Robert Rosenheck
April 1998

A longitudinal study examined treatment services and outcomes in a nationwide sample of 565 homeless veterans who were classified as alcoholic, psychiatrically impaired, multi-problem, or best-functioning.

Impact of Representative Payees on Substance Use among Homeless Persons Diagnosed with Serious Mental Illness and Substance Abuse

Robert Rosenheck, Julie Lam and Frances Randolph
June 1997

Assignment of representative payees, third parties responsible for managing clients' funds, has been proposed to counter potential use of public support payments for abused substances by people with severe mental illness and substance use disorders. This study examines substance use outcomes...

Preventing recurrent homelessness among mentally ill men: a critical time intervention after discharge from a shelter

Ezra Susser

This study examined a strategy to prevent homelessness among individuals with severe mental illness by providing a bridge between institutional and community care. Ninety-six men with severe mental illness who were entering community housing from a shelter institution were randomized to receive 9 months of a "critical time" intervention plus usual services or usual services only. 

An experimental comparison of three types of case management for homeless mentally ill persons

Gary A. Morse

Three types of case management were compared to determine their relative effectiveness in helping people with severe mental illness who were homeless or at risk of homelessness. 

Effectiveness and Cost of Specific Treatment Elements in a Program for Homeless Mentally Ill Veterans

Robert Rosenheck, Linda Frisman and Peggy Gallup
November 1995

The study examined relationships between specific treatment elements and their costs and ten outcome measures using data from a longitudinal outcome study of a Veterans Affairs program for homeless mentally ill veterans. Baseline and outcome data over an eight- month period were analyzed...

A Model of Homelessness among Male Veterans of the Vietnam War Generation

Robert Rosenheck and Alan Fontana
March 1994

This study explored a multifactorial model of vulnerability to homelessness among male veterans of the Vietnam war generation. Data from 1,460 male veterans who participated in the National Vietnam Veterans Readjustment Study were used to evaluate hypotheses...

Mental Health Status and Community Adjustment after Treatment in a Residential Treatment Program for Homeless Veterans

Catherine Leda and Robert Rosenheck
September 1992

An uncontrolled outcome study was conducted to examine clinical improvement and the relationship of psychiatric and substance abuse problems, community adjustment, and housing status among homeless veterans who participated in a multisite residential treatment program. The study was performed at three U.S. Department of Veterans Affairs medical centers...

Geographic mobility and student achievement in an urban setting

Gary M. Ingersoll

Geographic mobility has long been suspected to have a negative impact on student achievement and adjustment. Urban schools, in particular, are subject to highly mobile subpopulations whose contribution to overall district performance can be a source of serious policy concerns.