Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Recorded presentation

Linda K. Frisman, PhD, Hsiu-Ju Lin, PhD, Eleni Rodis, MS, and Elissa McCarthy, MA. CT Dept Mental Health & Addiction Services, Research Division MS # 14 RSD, PO Box 341431, 410 Capitol Avenue, Hartford, CT 06134, 860-418-6788, linda.frisman@uconn.edu

As part of the SAMHSA-funded Homeless Families study, the Connecticut site compared the outcomes of homeless women with substance use disorders at outreach and case management sites with high intensity case management (4 sites, n=90) and medium intensity case management (2 sites, n=65). Intensity was defined both in terms of staff per client ratio and length of services. The staff ratios were 1:5-10 in high intensity sites, and 1:12-20 in medium intensity sites; the length of services were 9 months in high intensity sites, and 5 months in medium intensity. Case managers in both models were trained and supervised in Motivational Interviewing, case management, and gender-sensitive approaches. Data were collected via face-to-face interviews at baseline and 3, 9, and 15 months later. We used Propensity Scoring to control for baseline differences in the populations, and we applied both Hierarchical Linear Modeling and General Estimating Equations to examine outcomes. For most outcomes, both groups improved over time and there were no significant differences between groups. Contrary to expectations, with respect to several mental health measures, including the overall mental health functioning, depression, positive symptoms, trauma symptoms, and spiritual well-being, the medium intensity group improved at a greater rate than the high intensity group. Thus, it appears that the style of assistance related to high-intensity case management (offering rides, direct counseling, and providing much hands-on assistance) may not have the positive mental health effect of less intensive services, where the client more often needs to act independently of the case manager.

Learning Objectives: