Serving street-dwelling individuals with psychiatric disabilities: outcomes of a psychiatric rehabilitation clinical trial.
OBJECTIVE
This study tested a psychiatric rehabilitation approach for organizing and delivering services to street-dwelling persons with severe mental illness.


METHODS
Street-dwelling persons with severe mental illness were randomly assigned to the experimental program (called Choices) or to standard treatment in New York City. We assessed study participants at baseline and at 6-month intervals over 24 months, using measures of service use, quality of life, health, mental health, and social psychological status. The average deviation from baseline summary statistic was employed to assess change.


RESULTS
Compared with persons in standard treatment (n = 77), members of the experimental group (n = 91) were more likely to attend a day program (53% vs 27%), had less difficulty in meeting their basic needs, spent less time on the streets (55% vs 28% reduction), and spent more time in community housing (21% vs 9% increase). They showed greater improvement in life satisfaction and experienced a greater reduction in psychiatric symptoms.


CONCLUSIONS
With an appropriate service model, it is possible to engage disaffiliated populations, expand their use of human services, and improve their housing conditions, quality of life, and mental health status.
Shern
D L
DL
New York State Office of Mental Health, Albany, USA. shern@fmhi.usf.edu
Tsemberis
S
S
Anthony
W
W
Lovell
A M
AM
Richmond
L
L
Felton
C J
CJ
Winarski
J
J
Cohen
M
M
D000328:Adult; D000368:Aged; D003156:Community Mental Health Services / Q000458:organization & administration*; D003159:Community-Institutional Relations; D005260:Female; D006302:Health Services Research; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008603:Mental Health; D008875:Middle Aged; D017146:Models, Organizational; D020380:Needs Assessment; D009519:New York City; D017063:Outcome Assessment, Health Care; D010549:Personal Satisfaction; D019989:Persons with Intellectual Disabilities / Q000534:rehabilitation*; D015397:Program Evaluation; D011638:Public Housing; D011788:Quality of Life; D019037:Urban Health Services / Q000458:organization & administration*