Predictors of residential stability among homeless young adults : a cohort study.

Abstract : BACKGROUND: Homelessness episodes have been shown to be associated with serious health outcomes among youth. This study was undertaken to estimate the probability of reaching residential stability over time and to identify predictors of residential stability among homeless young adults aged 18 to 25 years. METHODS: A prospective cohort study was carried out in Montréal, Canada, between April 5(th) 2006 and January 21(th) 2009. Interviews conducted every three months included questions on life conditions and social and mental health factors that are known to influence residential trajectories. Residential status was determined, starting on the first day after recruitment; each follow-up day was classified as a homeless day or a housed day. A period of 90 days was used to define residential stability; therefore the main study outcome was the occurrence of the first consecutive 90 housed days during the follow-up period. Kaplan-Meier and Cox proportional-hazards regression analyses were conducted. RESULTS: Of the 359 participants, 284 reached 90 days of residential stability over the study period, representing an annual probability of 80.5 %. In multivariate analysis, youth who had a high school degree, had a formal sector activity, and those who had sought psychological help were more likely to reach residential stability. Being a man, injecting substances, and having an informal sector activity were associated with a decreased probability to reach residential stability. CONCLUSION: Exposure to factors related to opportunities that promote social integration increases the chance of reaching residential stability. On the other hand, factors related to high level of street entrenchment seem to interfere with stabilization. Maximum efforts should be made to prevent chronic homelessness among youth, targeting not only individual impairments but also hinging on services adapted to foster social connections among the youth

Factors Predicting Arrest for Homeless Persons Receiving Integrated Residential Treatment for Co-Occurring Disorders

Background Homeless individuals are at increased risk for health and criminal justice problems. Aims The aim of this study was to examine risk factors affecting arrest rates in a cohort of homeless people with co-occurring psychiatric and substance-abuse disorders. Methods Baseline data were collected from 96 homeless individuals residing in a residential treatment facility for people with co-occurring disorders. Arrest data were obtained for 2 years following treatment intake. Regression analyses were employed to examine interactions between study variables. Results One third of the sample was arrested during the 2-year follow-up period, principally for drug offences. People referred to treatment directly from the criminal justice system were four times more likely to re-offend than those referred from other sources. Participants’ perceived need for mental-health services reduced risk of arrest while their perception of medical needs increased this risk. Conclusions The relationship between referral from a criminal justice source and re-arrest after admission to the treatment facility is unsurprising, and consistent with previous literature, but the suggestion of an independently increased risk in the presence of perceived physical health-care needs is worthy of further study. The lower risk of arrest for people who perceive that they have psychological needs is encouraging

The effectiveness of critical time intervention for abused women and homeless people leaving Dutch shelters: study protocol of two randomised controlled trials

Contains fulltext : 117787.pdf (publisher's version ) (Open Access)BACKGROUND: One of the main priorities of Dutch organisations providing shelter services is to develop evidence-based interventions in the care for abused women and homeless people. To date, most of these organisations have not used specific intervention models and the interventions which have been implemented rarely have an empirical and theoretical foundation. The present studies aim to examine the effectiveness of critical time intervention (CTI) for abused women and homeless people. METHODS: In two multi-centre randomised controlled trials we investigate whether CTI, a time-limited (nine month) outreach intervention, is more effective than care-as-usual for abused women and homeless people making the transition from shelter facilities to supported or independent housing. Participants were recruited in 19 women's shelter facilities and 22 homeless shelter facilities across The Netherlands and randomly allocated to the intervention group (CTI) or the control group (care-as-usual). They were interviewed four times in nine months: once before leaving the shelter, and then at three, six and nine months after leaving the shelter. Quality of life (primary outcome for abused women) and recurrent loss of housing (primary outcome for homeless people) as well as secondary outcomes (e.g. care needs, self-esteem, loneliness, social support, substance use, psychological distress and service use) were assessed during the interviews. In addition, the model integrity of CTI was investigated during the data collection period. DISCUSSION: Based on international research CTI is expected to be an appropriate intervention for clients making the transition from institutional to community living. If CTI proves to be effective for abused women and homeless people, shelter services could include this case management model in their professional standards and improve the (quality of) services for clients. TRIAL REGISTRATION: NTR3463 and NTR3425