Previous research has shown that homeless populations use substantial amounts of services. Further, greater amounts and more types of services used have been demonstrated to be robustly associated with positive outcomes. One limitation of this research has been that the complex interrelationships among demographic, diagnostic, homelessness, and service use variables previously identified have not been adequately explored through a simultaneous estimation strategy such as structural equation modeling (SEM). This study addressed this shortcoming using data from an epidemiologic study of service use. Systematic sampling selected 400 subjects, approximately two-thirds drug-abusing, from a variety of public settings frequented by homeless people, as well as from streets. The sample was assessed with the Diagnostic Interview Schedule (DIS), Composite International Diagnostic Interview/Substance Abuse Module, Homeless Supplement to the DIS, and a self-report service instrument developed for the study. SEM examined relationships among predisposing characteristics (demographics), need factors (diagnosis, homelessness), and service use (30-day, lifetime). Service use was divided into four conceptual constructs: homeless amelioration, homeless maintenance, mental health, and chemical dependency services. Separate models were developed for 30-day and lifetime service use. In general, models yielded poor fit. Significant positive associations included mental illness diagnoses and female gender with mental health and chemical dependency services; and substance abuse/dependence diagnoses with chemical dependency and homeless maintenance and amelioration services. The findings suggest the need to tailor services to individuals and potential utility of providing multiple services in single settings.
Learning Objectives: 1. To describe the variety of services appropriate for the homeless drug abusing population. 2. To explain the interrelationships among demographic, diagnostic, homelessness, and service use in the homeless drug abusing population. 3. To discuss the service implications derived from the results of this study.
Keywords: Access and Services, Homeless
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.