Multicomponent Co-Occurring Disorders Treatment and Wraparound Services for Individuals Experiencing Chronic Homelessness.

Addiction Behavioral health Co-occurring disorders treatment Homelessness Mental health Substance use Treatment

Journal

Community mental health journal
ISSN: 1573-2789
Titre abrégé: Community Ment Health J
Pays: United States
ID NLM: 0005735

Informations de publication

Date de publication:
16 Apr 2024
Historique:
received: 21 08 2023
accepted: 19 03 2024
medline: 16 4 2024
pubmed: 16 4 2024
entrez: 16 4 2024
Statut: aheadofprint

Résumé

Individuals experiencing chronic homelessness have high rates of persistent co-occurring mental health and substance use disorders (COD), and they often have difficulty with service engagement and retention, resulting in symptom exacerbation and housing loss. This study pilot tested Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking (MISSION), a multicomponent wraparound treatment approach to improve COD symptoms and housing stability among individuals experiencing chronic homelessness and persistent COD. This open pilot study enrolled and assessed 109 individuals with a COD experiencing chronic homelessness and offered one year of MISSION. Statistically significant improvements were observed in behavioral health symptoms and functioning, days of illicit drug use, and housing stability. By treatment completion, 85% of participants were referred to social and behavioral supports. This pilot study demonstrates that MISSION helped to successfully engage participants in treatment, reduce substance use and mental health symptoms, and improve housing outcomes.

Identifiants

pubmed: 38625650
doi: 10.1007/s10597-024-01271-w
pii: 10.1007/s10597-024-01271-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : SAMHSA HHS
ID : 1H79TI080430-01
Pays : United States

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Breslow, N. R., & Clayton, D. G. (1993). Approximate inference in generalized linear mixed models. Journal of the American Statistical Association, 88, 9–25. https://doi.org/10.2307/2290687 .
doi: 10.2307/2290687
Caputo, D., Le, M., & Reid, M. (2023). US loses 8% of affordable housing units during the pandemic, Capital Investors Eye Entry into the Sector. Moody’s Analytics, Inc.
CDC/ATSDR Social Vulnerability Index. (2022). C. f. D. C. a. Prevention.
Data, U. S. A., & Springfield (2020)., MA. Census Place https://datausa.io/profile/geo/springfield-ma#:text=In%202020%2C%20Springfield%2C%20MA%20had,%2441%2C571%2C%20a%205.42%25%20increase .
Eisen, S. V., & Youngman, D. (1994). Instruction manual for BASIS-32.
Eisen, S. V., Wilcox, M., Leff, H. S., Schaefer, E., & Culhane, M. A. (1999). Assessing behavioral health outcomes in outpatient programs: Reliability and validity of the BASIS-32. The Journal of Behavioral Health Services & Research, 26, 5–17.
doi: 10.1007/BF02287790
Herman, D. B., & Mandiberg, J. M. (2010). Critical time intervention: Model description and implications for the significance of timing in social work interventions. Research on Social Work Practice, 20(5), 502–508. https://doi.org/10.1177/1049731509360667 .
doi: 10.1177/1049731509360667
Klein, A. R., Cnaan, R. A., & Whitecraft, J. (1998). Significance of peer social support with dually diagnosed clients: Findings from a pilot study. Research on Social Work Practice, 8(5), 529–551.
doi: 10.1177/104973159800800503
Lawless, M., & Corr, C. (2005). Drug use among the homeless population in Ireland: A report for the National Advisory Committee on Drugs. Merchants Quay Project.
McLellan, A. T., Grissom, G. R., Zanis, D., Randall, M., Brill, P., & O’Brien, C. P. (1997). Problem-service matching in addiction treatment: A prospective study in 4 programs. Archives of General Psychiatry, 54(8), 730–735.
doi: 10.1001/archpsyc.1997.01830200062008 pubmed: 9283508
Montgomery, A. E., Cusack, M., Szymkowiak, D., Fargo, J., & O’Toole, T. (2017). Factors contributing to eviction from permanent supportive housing: Lessons from HUDVASH. Evaluation and Program Planning, 61, 55–63.
doi: 10.1016/j.evalprogplan.2016.11.014 pubmed: 27940343
Moulin, A., Evans, E. J., Xing, G., & Melnikow, J. (2018). Substance Use, Homelessness, Mental Illness and Medicaid Coverage: A set-up for high Emergency Department utilization. West J Emerg Med, 19(6), 902–906.
doi: 10.5811/westjem.2018.9.38954 pubmed: 30429919 pmcid: 6225935
Nilsson, S., Nordentoft, M., & Hjorthoj, C. (2019). Individual-level predictors for becoming homeless and exiting homelessness: A systematic review and Meta-analysis. Journal of Urban Health, 96(5), 741–750. https://doi.org/10.1007/s11524-019-00377-x .
doi: 10.1007/s11524-019-00377-x pubmed: 31388823 pmcid: 6814700
Polcin, D. L. (2016). Co-occurring substance abuse and mental health problems among homeless persons: Suggestions for research and practice. Journal of Social Distress and the Homeless, 25, 1–10. https://doi.org/10.1179/1573658X15Y.0000000004 .
doi: 10.1179/1573658X15Y.0000000004 pubmed: 27092027
Rog, D. J., Marshall, T., Dougherty, R. H., George, P., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Permanent supportive housing: Assessing the evidence. Psychiatric Services, 65, 287–294. https://doi.org/10.1176/appi.ps.201300261 .
doi: 10.1176/appi.ps.201300261 pubmed: 24343350
SAS Institute Inc. (2023). SAS/STAT® 15.3 user’s guide. SAS Institute Inc.
Smelson, D. A., Losonczy, M. F., Castles-Fonseca, K., Sussner, B. D., Rodrigues, S., Kaune, M., & Ziedonis, D. (2005). 2005/06/07). Preliminary outcomes from a Community Linkage Intervention for Individuals with co-occurring substance abuse and Serious Mental illness. Journal of Dual Diagnosis, 1(3), 47–59. https://doi.org/10.1300/J374v01n03_05 .
doi: 10.1300/J374v01n03_05
Smelson, D., Losonczy, M., Ziedonis, D., Castles-Fonseca, K., & Kaune, M. (2007). Six month outcomes from a booster case management program for individuals with a cooccurring substance abuse and a persistent psychiatric disorder. Eur J Psychiatry Clin Neurosci, 21, 143–152.
Smelson, D., Kalman, D., Losonczy, M., Kline, A., Sambamoorthi, U., Hill, S., Castles-Fonseca, L., K., & Ziedonis, D. (2012). A brief treatment engagement intervention for individuals with co-occurring mental illness and substance use disorders: Results of a randomized clinical trial. Community Mental Health Journal, 48(2), 127–132.
doi: 10.1007/s10597-010-9346-9 pubmed: 20859765
Smelson, D. A., Zaykowski, H., Guevermont, N., Siegfriedt, J., Sawh, L., Modzelewski, D., Tsemberis, S., & Kane, V. (2016). 2016/04/02). Integrating Permanent supportive housing and Co-occurring disorders treatment for individuals who are homeless. Journal of Dual Diagnosis, 12(2), 193–201. https://doi.org/10.1080/15504263.2016.1174010 .
doi: 10.1080/15504263.2016.1174010 pubmed: 27064939
Smelson, D. A., Chinman, M., Hannah, G., Byrne, T., & McCarthy, S. (2018, May 5). An evidence-based co-occurring disorder intervention in VA homeless programs: outcomes from a hybrid III trial. BMC Health Serv Res, 18(1), 332. https://doi.org/10.1186/s12913-018-3123-9 .
Sousa, T., Andrichik, A., Cuellar, M., Marson, J., Prestera, E., & Rush, K. (2022). The 2022 Annual Homelessness Assessment Report (AHAR) to Congress. The U.S. Department of Housing and Urban Development.
Springfield (2021)., Massachusetts Quick Facts. United States Census Bureau https://www.census.gov/quickfacts/fact/table/springfieldcitymassachusetts/PST045221#PST045221 .
Substance Abuse Mental Health Services Administration (2011). Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings.
Substance Abuse Mental Health Services Administration (2015). CSAT GPRA Modernization Act Data Collection Tools.
The gap: A shortage of affordable rental homes. (2023). National Low Income Housing Coalition.
The (2016). Annual Homelessness Assessment Report (AHAR). (2016). U. S. D. o. H. a. U. D. O. o. C. P. a. Development. https://www.hudexchange.info/programs/hdx/guides/ahar/#reports .
Tsemberis, S. (2010). Housing First. The pathways model to end homelessness for people with mental illness And addiction manual. European Journal of Homelessness, 5(2).
Ware, N. C., Hopper, K., Tugenberg, T., Dickey, B., & Fisher, D. (2007). Connectedness and citizenship: Redefining social integration. Psychiatric Services, 58, 469–474. https://doi.org/10.1176/ps.2007.58.4.469 .
doi: 10.1176/ps.2007.58.4.469 pubmed: 17412847
Wilson, M. E., Flanagan, S., & Rynders, C. (1999). The FRIENDS program: A peer support group model for individuals with a psychiatric disability. Psychiatric Rehabilitation Journal, 22(3), 239.
doi: 10.1037/h0095238
Ziedonis, D. M., & Stern, R. (2001). Dual recovery therapy for schizophrenia and substance abuse. Psychiatric Annals, 31(4), 255–264.
doi: 10.3928/0048-5713-20010401-09

Auteurs

Abigail F Helm (AF)

Department of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA. Abigail.Helm@umassmed.edu.

Michael A Andre (MA)

Department of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA.

Paige M Shaffer (PM)

Department of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA.

Kathryn E Bruzios (KE)

Department of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA.

Sarah Marcus (S)

Department of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA.

Jennifer Harter (J)

Department of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA.

David Smelson (D)

Department of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA.

Classifications MeSH