title: Chronically homeless women report high rates of substance use problems equivalent to chronically homeless men.
abstract: BACKGROUND
  The U.S. federal government recently committed itself to ending chronic homelessness within 5 years. Women constitute one out of four chronically homeless adults and represent a particularly vulnerable group, but have been little studied. To identify potentially unique needs in this group, we report characteristics and 2-year outcomes in a large sample of male and female chronically homeless adults participating in a multisite, supportive housing program.
  
  
  METHODS
  Men and women participating in the outcome evaluation of the 11-site Collaborative Initiative on Chronic Homelessness (n = 714) supportive housing program and who received at least one follow-up assessment were compared on baseline characteristics and up to 2-year follow-up outcomes. Mixed model multivariate regression adjusted outcome findings for baseline group differences.
  
  
  RESULTS
  Few significant baseline differences existed between males and females, with both sexes self-reporting very high rates of lifetime mental health (83% women, 74% men) and substance use (68% women, 73% men) problems. Throughout the 2-year follow-up, both men and women dramatically increased the number of days housed, showed minimal changes in substance use patterns, and had modest improvements in mental health outcomes, without significant differences between genders.
  
  
  CONCLUSIONS
  Unlike other U.S. populations, chronically homeless adults do not demonstrate substantial gender differences on mental health or addiction problems. Policy and service delivery must address these remarkably high rates of substance use and mental illness.
authors.affiliation: VA New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut 06516, USA. ellen.edens@va.gov
authors.forename: Ellen Lockard
authors.initials: EL
authors.lastname: Edens
authors.forename: Alvin S
authors.initials: AS
authors.lastname: Mares
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D016387:Women's Health; D055815:Young Adult