The impact of federal systems integration initiatives on services for mentally ill homeless persons.
Nearly everyone writing on homelessness over the past 15 years has called for comprehensive integrated systems of care to address the multiple and complex needs of people who become homeless, especially those with mental illness. What is often overlooked is that calls for systems integration are far from new. Although the names have changed over the years, the underlying concepts have not. The purposes of this paper are fourfold: (1) to clarify the distinction between services integration and systems integration; (2) to map the evolution of federal programs to demonstrate that most of these really have been focused on services integration rather than systems integration; (3) to assess the extent that data from these programs supports the idea of systems integration; and (4) to show how the current ACCESS demonstration for persons who are homeless and mentally ill is likely to provide answers that prior programs have not. Without these new data, systems integration, as one solution to the problems of homelessness, remains a theory without empirical evidence; albeit a theory with persuasive conceptual underpinnings.
Policy Research Associates, Inc., Delmar, New York 12054, USA.
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Cocozza
D003266:Continuity of Patient Care / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated; D005380:Financing, Government; D006703:Ill-Housed Persons / Q000523:psychology*; D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000458:organization & administration*; D015397:Program Evaluation; D018511:Systems Integration; D014481:United States