PATH out of homelessness: Does early intervention result in better outcomes?

Background: Forty-percent of the homeless in Cincinnati, Ohio were identified as mentally ill in 2008. PATH, an early intervention street outreach program, provides long-term case management to severely mentally homeless on the streets. Research demonstrates that utilization of case management is associated with fewer homeless days. Less known is if the timing of the case manager influences housing outcomes. The purpose of this study is to determine if engagement by PATH prior to becoming sheltered is associated with positive outcomes compared to those engaged after entering shelter. Methods: The sample included 419 homeless persons in Cincinnati, Ohio in 2006 and followed annually until 2009 using HMIS data. The mean age was 41.8(SD 11.2) years, 75.4% were male, and 62.9% were Black. Chi-square and binary logistic regression were used. Results: Twenty-two percent were enrolled in PATH prior to entering shelter. Those engaged by PATH prior to entering shelter were more likely to enter transitional and permanent supportive housing compared to those who were not engaged prior to becoming sheltered(p<.001). If the person left shelter, those engaged by PATH before becoming housed were more likely to leave under favorable circumstances (62.5%) compared to those not engaged by PATH before housing (41.6%) (p=.013). Length of stay in emergency shelter, transitional housing, or permanent supportive housing was not associated with timing of the PATH intervention. Implications: PATH provides consistent case management resulting in better housing outcomes. Resources should be allocated to early intervention programs to guide people into the most appropriate housing situation.