Improbable Mission: Securing stable housing for Baltimore homeless persons with mental illnesses

Introduction: People Encouraging People (PEP) - a 30-year-old non-profit provides behavioral health services in Maryland. Among its services is the homeless/mental health outreach program that provides co-occurring treatment and rehabilitation services to street-based clients and other hard-to-reach populations. The program helps consumers with mental and co-occurring substance use disorders gain stable housing through outreach, case management, integrated treatment and financial support. Method: PEP's team of case assessment specialists canvass city parks and under beltway bridges where homeless individuals and families reside. Consumers are assessed for rehabilitation requirements including alcohol/drug use, mental illness, sexual risk behaviors, criminality, employment/education history, social connectedness, housing and in-home support needs. Result: Literature shows, and PEP data confirm, strong correlation between adult homelessness and mental health /co-occurring disorders. PEP's data show key factors in recovery and stability of homeless adults with co-occurring mental illness. At 12-month follow-up 60% of PEP homeless clients “had a permanent place in the community” compared to 10% at intake, in 2008. PEP street-team report that access to regular care (psychiatric, substance use and somatic) is a critical stabilizer followed by consumer placement in stable housing. A third important factor is social connectedness - linking consumers to social influences that vary by individuals but include family, friends and successful peers who help consumers navigate recovery systems and services. Peers help new clients adjust to homes, participate in therapies and adhere to medication regiments. Meeting emergent needs (food, clothing) and use of incentives (coupons) at counseling sessions encourage consumer's treatment participation and adherence.