198681 Impact of housing and service use on the well-being and community integration of homeless individuals with and without mental illness

Tuesday, November 10, 2009: 8:30 AM

Leyla Gulcur, PhD , Partnership for the Homeless, New York, NY
Tuo-Yen Tseng, MA , Partnership for the Homeless, New York, NY
Objectives: The role of housing and services in well-being for homeless individuals with and without mental illness was evaluated.

Methods: 199 participants at a non-profit agency who were either homeless or housed at the time of interview participated in the study. A 3-way MANOVA was conducted with housing status (homeless-housed), service use (high-low) and psychiatric symptoms (high-low) as the independent variables and quality of life and sense of community as the dependent variables.

Results: For clients manifesting no or low psychiatric symptoms, being housed was the sole significant predictor of well-being and community integration. Level of service use did not have any impact on outcomes for these clients. For clients who manifested moderate to high psychiatric symptoms, the positive impact of service use on their well-being and community integration was minimum or none when they were homeless, but increased dramatically when they were stably housed.

Conclusions: Homeless individuals report having a higher quality of life and greater sense of belonging in their communities when they are stably housed -- and level of service use has minimal or no additional added value for most. However, for individuals with mental illness, high-intensity services coupled with housing are necessary to achieve higher levels of well-being. Thus for homeless individuals, the priority is to achieve housing first and to provide additional high-intensity services to those with mental illness. This finding stands in contrast to the continuum of care model that focuses on the provision of services first and housing second.

Learning Objectives:
Discuss how to adjust housing and services for homeless individuals with and without mental illness.

Keywords: Homelessness, Housing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Education: 1996, New York University, Ph.D., Community Psychology; 1985, Duke University, B.Sc., Psychology. Recent positions: 2006- present, Partnership for the Homeless, New York, NY Vice President of Research Member of senior management team responsible for strategic analysis, organizational development and innovation; spearheading outcomes management processes leading to the development of best practice models of service delivery and program evaluation. 2001-2006, Pathways to Housing, New York, NY Director of Research Senior manager in charge of the Department of Research. Conceptualized, designed and supervised longitudinal survey research projects involving previously homeless individuals with mental illness and substance use problems. Conducted data analysis; authored papers; represented the organization in professional meetings and conferences. Managed personnel of up to 10 staff and a grants budget of 1.3 million dollars. 1998 - present, New York University, New York, NY Adjunct Associate and Assistant Professor Instructor of master's and graduate-level classes in: Community Psychology, Cross-Cultural Psychology, International Women's Movements. Selected Publications: Gulcur, L., Tsemberis, S., Stefancic, A., & Greenwood, R. (2007). Community integration of adults with psychiatric disabilities and histories of homelessness. Community Mental Health Journal, Vol. 43: 3, 211-228. Padgett, D., Gulcur, L. & Tsemberis, S. (2006). Housing First services for people who are homeless with co-occurring serious mental illness and substance abuse. Research on Social Work Practice, 16, 74-83. Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for individuals who are homeless with dual diagnosis: A 24-month follow-up. American Journal of Public Health, Vol. 94:4, 651-656. Gulcur, L., Stefancic, A., Shinn, M., Tsemberis, S., & Fischer, S. (2003). Housing, hospitalization and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes. Journal of Community and Applied Social Psychology, Vol. 13, 171-186.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.