Assessing the Impact of Two Residential Programs for Dually-Diagnosed Homeless Individuals

Two residential programs for dually diagnosed (severely mentally ill and substance abusing) homeless individuals in Philadelphia were compared in a quasi-experimental field study. Findings indicate that the experimental model, a hybrid psychosocial and drug rehabilitation program, did significantly better in maintaining clients in care and in successful rehabilitation than the comparison model, a modified therapeutic community program. However, the overall rate of success in both programs was quite modest. We found Emile Durkheim\u27s concepts of organic and mechanical solidarity to be useful in comparing the structure of the two programs. Because of the small number of clients treated by these programs and the unique characteristics (predominantly young, black and male) of this urban population, findings are not conclusive but clarify direction for further practice and study

Childhood Risk Factors in Dually Diagnosed Homeless Adults

Although the negative long term effects of specific childhood risk factors - sexual and physical abuse, parental mental illness and substance abuse, and out of home placement - have been recognized, most studies have focused on just one of these risks. This article examines the prevalence of these five childhood risk factors among dually diagnosed (mental illness and substance abusing) homeless adults in rehabilitation programs. It further assesses the impact of each risk factor individually and in combinations of two on the social functioning skills and rehabilitation progress of these multiply disadvantaged clients

Assessing the Impact of Serving the Long-term Mentally Disabled Homeless

Homelessness has emerged as a major social problem. In an attempt to understand this problem, attention has been focused on postulating its causes, describing the individuals who hold this status, and estimating its magnitude. This study assesses the outcome of one social service program for long-term mentally disabled homeless individuals. It includes a synopsis of the state of the art in serving homeless individuals with severe mental health problems; a description of a program created to meet their needs; and an analysis of the outcome of this program

Estimated payments to employment service providers for persons with mental illness in the Ticket to Work program

OBJECTIVE: The Ticket to Work and Work Incentives Improvement Act of 1999 removes work disincentives and promotes access to vocational services for people with disabilities. This study calculated the amount of payments that would have been made to employment service providers if study participants had been enrolled in the Ticket program. METHODS: Data were from 450 Social Security Disability Insurance beneficiaries with psychiatric disabilities enrolled in a multisite study of supported employment. Earnings over two years were used to calculate provider payments under two reimbursement formulas used in the Ticket program. RESULTS: Only a quarter of service recipients (26 percent) reached earnings levels that would have triggered provider payments under the first reimbursement formula. Only 4 percent would have completed their trial work period and left the rolls, generating payments under the second formula. CONCLUSIONS: The current provider payment systems of the Ticket to Work program do not reflect the reality of rehabilitation for individuals with severe mental illness. Reforms should take into account outcomes of return-to-work services for this population