The literature on homeless adults with severe mental illness is generally silent a critical issue surrounding service delivery—the contrast between housing first and treatment program philosophies. This study draws data from longitudinal experiment contrasting (which offers immediate permanent without requiring compliance or abstinence) (standard care) programs for 225 who were in New York City. After 48 months, results showed no significant group differences alcohol drug use. Treatment...

A meta-analysis of the literature controlled studies educational and psychooocial interventions in treatment diabetes mellitus yielded 93 7451 patients testing effects eight intervention types: (1) didactic education, (2) enhanced (3) diet instruction, (4) exercise (5) self-monitoring (6) social learning/behavior modification, (7) counseling, (8) relaxation training. An overall mean effect size (ES) +0.51 ± 0.11 was found indicating moderate but significant (P < 0.05) improvements for all...

OBJECTIVES. Factors affecting ethnic differences in the use of outpatient mental health services are analyzed an insured, nonpoor population to determine if lower by Blacks and Hispanics persists when socioeconomic other factors controlled. METHODS. To identify significant predictors probability amount use, insurance claims data for a 1.2 million federal employees insured Blue Cross/Blue Shield 1983 were with Andersen Newman model service utilization. Logistic ordinary least squares...

This study describes use of medical, mental health, alcohol, and drug services by 832 adult residents the New York City homeless shelter system examines associations between service during past three months an array predisposing, enabling, need factors. Utilization rates were 23% for medical services, 13% health 10 7.5% alcohol treatment respectively. Service contacts more often hospitals than ambulatory care clinics. Logistic regression analyses revealed that factors stronger predictors all...

Permanent supportive housing (PSH) is an intervention to address long-term homelessness. Evidence has resulted in a shift US policy toward using PSH rather than shelters and transitional housing. Despite recognizing that individuals transitioning from homelessness experience high burden of disease health disparities, public research not considered whether how improves physical outcomes. Based on diverse areas research, we argue addition improved access quality care, social determinants...

The new paradigm of recovery has highlighted the importance positive social relationships, but little is known about their role in among homeless individuals with serious mental illness and comorbid substance abuse. This study used within- across-case analyses longitudinal data from qualitative interviews 41 dually diagnosed entering residential programs to exit homelessness receive needed services. Thematic findings include (a) "loner talk" need for privacy; (b) family ties as "good news,...

We report on the use of photo elicitation interviewing (PEI) with 13 participants in a qualitative study formerly homeless men and women serious mental illness. Following respondent-controlled approach, were asked to take up 18 photographs visually portraying positive negative aspects their lives subsequently narrate meaning photos one-on-one interview. Thematic analysis (N = 205) revealed two approaches PEI: (a) "slice life" (b) "then vs. now." Examples show how PEIs yielded deeper, more...

Research on the bi-directional relationship between mental health and homelessness is reviewed extended to consider a broader global perspective, highlighting structural factors that contribute housing instability its ill sequelae. Local, national international initiatives address include Housing First in Western countries promising local programmes India Africa. Ways psychiatrists physicians can be agents of changes range from brief screening for stability competence training. Narrow...

Data from a 1987 survey of 1,260 homeless adults in New York City show that mental problems and substance dependence were significantly linked to beating sexual assault among women several types injury victimization men. The extremely high rates underscore need for greater attention the safety welfare people.

Employing data from a 1987 shelter survey of 1260 homeless adults in New York City, multivariate models emergency room (ER) use are developed which include an array risk factors for visiting hospital ER including health and mental problems, victimization injuries. The study's primary goal is to identify that predict this population. Multivariate logistic linear regression were tested separately men women predicting three outcomes: any the during past 6 months, injuries vs all other reasons...

This qualitative study assessed the frequency and subjective meaning of adverse experiences using case analyses interviews with 38 formerly homeless adults co-occurring serious mental illness (SMI) substance abuse histories. Adverse life events were inventoried an adaptation Lloyd Turner's (2008) 41-item checklist. Participants averaged 8.8 events, approximately one-third having experienced incarceration (37%), suicidality (32%), abandonment by one or both parents (30%), death their mother...