Consumer preference programs for individuals who are homeless and have psychiatric disabilities: a drop-in center and a supported housing program.
We illustrate Fairweather's approach to Experimental Social Innovation and Dissemination with two experimental studies of programs to reduce homelessness for 168 and 225 people with mental illness and often substance abuse. Literally homeless participants were randomly assigned to programs that emphasized consumer choice or to the usual continuum of care, in which housing and services are contingent on sobriety and progress in treatment. A drop-in center that eliminated barriers to access to services was more successful than control programs in reducing homelessness, but after 24 months only 38% of participants had moved to community housing. A subsequent apartment program, in which individuals in the experimental condition moved to subsidized apartments directly from the street, with services under their control, had 79% in stable housing (compared to 27% in the control group) at the end of 6 months. Groups in this study did not differ on substance abuse or psychosocial outcomes.
Tsemberis
Sam J
SJ
Pathways to Housing, Inc., New York, New York 10027, USA. pathman101@aol.com
Moran
Linda
L
Shinn
Marybeth
M
Asmussen
Sara M
SM
Shern
David L
DL
D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003256:Community Participation; D003266:Continuity of Patient Care; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D005260:Female; D016352:Group Homes / Q000706:statistics & numerical data; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000534:rehabilitation*; D008875:Middle Aged; D009519:New York City; D010043:Outcome and Process Assessment, Health Care; D011788:Quality of Life; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012917:Social Adjustment; D019966:Substance-Related Disorders / Q000150:complications / Q000534:rehabilitation*