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APHA Scientific Session and Event Listing

Recorded presentation

Yin-ling Wong, PhD¹, Stephen R. Poulin, MSW², and Trevor R. Hadley, PhD². (1) School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, (215) 898-5505, ylwong@sp2.upenn.edu, (2) Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market Street, Room 3107, Philadelphia, PA 19104

Background: Permanent supportive housing (PH) is a widely advocated intervention considered to be a basic human right and shown to be associated with positive outcomes for seriously mentally ill homeless. While research has found that housing tenure is limited for a significant portion of PH participants, little is known about factors associated with leaving. Methods: This is an administrative tracking study, supplemented with interview data. The sample consisted of 804 residents from 27 PH programs in a large metropolitan area. Data on socio-demographics and service use characteristics were extracted from an integrated database comprising of PH stays, shelter use, Medicaid eligibility and claims, and non-Medicaid publicly-funded behavioral health services. Statistical models include survival curves and Cox's proportional hazards regression. A sub-sample of 80 leavers was recruited to document circumstances surrounding PH departure. Results: One-year and two-year housing retention rates were, respectively, 82% and 66%. 50% of residents left PH within 3.7 years. Male, younger age, shelter use, and admissions to psychiatric emergency services predicted a higher hazard exit rate. Diagnosis of schizophrenia and use of non-case management outpatient and community rehabilitation services predicted a lower exit rate. Interview data suggest that common reasons for leaving were violation of program rules, psychiatric relapses, aggravated drug/alcohol problem, and poor housing conditions. Implications: Monitoring behavioral health service use through an integrated database can be an effective mechanism for identifying PH participants at risk for unfavorable discharges. The implementation of an “early warning system” may help target those at greatest needs for intensive intervention.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the permanent supportive housing program available to formerly homeless persons with mental illness in Philadelphia;
• List at least five factors that influence the probability of exiting permanent supportive housing in Philadelphia;
• Realize the potential of using integrated administrative databases for mental health research.

Keywords: Mental Health Services, Homelessness

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation