Outcomes of shelter use among homeless persons with serious mental illness.
OBJECTIVE
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.


METHODS
The sample consisted of 475 Philadelphia ACCESS program participants. Client-level interview data and case manager service delivery records that were collected during the ACCESS intervention period were linked with administrative data on public shelter use for the 12-month period after the ACCESS program was terminated. By using Cox's proportional hazards model, multivariate analyses were conducted to test how the characteristics of the participants and the intensity of case management service use affected the rate of the first entry into a public shelter.


RESULTS
Homeless individuals with serious mental illness who were younger, were African American, had fewer years of schooling, and had longer shelter stays during the ACCESS intervention period were more likely to enter shelters in the 12 months after the ACCESS program ended. Although use of vocational and supportive services was associated with a lower probability of shelter entry, use of housing assistance was associated with a higher probability of shelter entry.


CONCLUSIONS
The study found that the total number of case management service contacts was not significantly associated with residential outcomes. Rather, the use of specific types of services was important in reducing the use of homeless shelters. These findings suggest that case management efforts should focus on developing vocational and psychosocial rehabilitation services to reduce the risk of recurrent homelessness among persons with serious mental illness.
Center for Mental Health Policy and Services Research, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor Room 3132, Philadelphia, PA 19104, USA. som@ssw.upenn.edu
So-Young
SY
Min
Yin Ling I
YL
Wong
Aileen B
AB
Rothbard
D000328:Adult; D019090:Case Management / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D001523:Mental Disorders; D011638:Public Housing; D014481:United States