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Serving street-dwelling individuals with psychiatric disabilities: Outcomes of a psychiatric rehabilitation clinical trial

Author

Listed:
  • Shern, D.L.
  • Tsemberis, S.
  • Anthony, W.
  • Lovell, A.M.
  • Richmond, L.
  • Felton, C.J.
  • Winarski, J.
  • Cohen, M.

Abstract

Objectives. This study tested a psychiatric rehabilitation approach for organizing and delivering services to street-dwelling persons with severe mental illness. Methods. Street-dwelling persons with severe mental illness were randomly assigned to the experimental program (called Choices) or to standard treatment in New York City. We assessed study participants at baseline and at 6-month intervals over 24 months, using measures of service use, quality of life, health, mental health, and social psychological status. The average deviation from baseline summary statistic was employed to assess change. Results. Compared with persons in standard treatment (n=77), members of the experimental group (n=91) were more likely to attend a day program (53% vs 27%), had less difficulty in meeting their basic needs, spent less time on the streets (55% vs 28% reduction), and spent more time in community housing (21% vs 9% increase). They showed greater improvement in life satisfaction and experienced a greater reduction in psychiatric symptoms. Conclusions. With an appropriate service model, it is possible to engage disaffiliated populations, expand their use of human services, and improve their housing conditions, quality of life, and mental health status.

Suggested Citation

  • Shern, D.L. & Tsemberis, S. & Anthony, W. & Lovell, A.M. & Richmond, L. & Felton, C.J. & Winarski, J. & Cohen, M., 2000. "Serving street-dwelling individuals with psychiatric disabilities: Outcomes of a psychiatric rehabilitation clinical trial," American Journal of Public Health, American Public Health Association, vol. 90(12), pages 1873-1878.
    • Handle: RePEc:aph:ajpbhl:2000:90:12:1873-1878_2
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    Cited by:

    1. Alison L. Weightman & Mark J. Kelson & Ian Thomas & Mala K. Mann & Lydia Searchfield & Simone Willis & Ben Hannigan & Robin J. Smith & Rhiannon Cordiner, 2023. "Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta‐analysis and thematic synthesis," Campbell Systematic Reviews, John Wiley & Sons, vol. 19(2), June.
    2. David Ponka & Eric Agbata & Claire Kendall & Vicky Stergiopoulos & Oreen Mendonca & Olivia Magwood & Ammar Saad & Bonnie Larson & Annie Huiru Sun & Neil Arya & Terry Hannigan & Kednapa Thavorn & Anne , 2020. "The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-21, April.
    3. Jorien van der Laan & Barbara van Straaten & Sandra N. Boersma & Gerda Rodenburg & Dike van de Mheen & Judith R. L. M. Wolf, 2018. "Predicting homeless people’s perceived health after entering the social relief system in The Netherlands," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(2), pages 203-211, March.
    4. Ciara Keenan & Sarah Miller & Jennifer Hanratty & Terri Pigott & Jayne Hamilton & Christopher Coughlan & Peter Mackie & Suzanne Fitzpatrick & John Cowman, 2021. "Accommodation‐based interventions for individuals experiencing, or at risk of experiencing, homelessness," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(2), June.
    5. Anita Hubley & Lara Russell & Anita Palepu & Stephen Hwang, 2014. "Subjective Quality of Life Among Individuals who are Homeless: A Review of Current Knowledge," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 115(1), pages 509-524, January.
    6. Rich, Alexander R. & Clark, Colleen, 2005. "Gender differences in response to homelessness services," Evaluation and Program Planning, Elsevier, vol. 28(1), pages 69-81.
    7. Stefancic, Ana & Schaefer-McDaniel, Nicole J. & Davis, Andrew C. & Tsemberis, Sam, 2004. "Maximizing follow-up of adults with histories of homelessness and psychiatric disabilities," Evaluation and Program Planning, Elsevier, vol. 27(4), pages 433-442, November.
    8. Aliza Moledina & Olivia Magwood & Eric Agbata & Jui‐Hsia Hung & Ammar Saad & Kednapa Thavorn & Ginetta Salvalaggio & Gary Bloch & David Ponka & Tim Aubry & Claire Kendall & Kevin Pottie, 2021. "A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(2), June.

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