Online Program

329035
Exploring Facilitators and Barriers of a Statewide Rollout to End Homelessness


Wednesday, November 4, 2015

Mary-Kate Duffy, B.A., Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
Leon Sawh, MPH, School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell, MA
Cheryl Kennedy-Perez, MSW, Housing and Homeless Services, Bureau of Substance Abuse Services, MA Department of Public Health, Boston, MA
David Smelson, Psy.D., Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
Alice Colegrove, DrPh, Bureau of Substance Abuse Services/ contracted through DMA Health, MA Department of Public Health, Boston, MA
Purpose: This presentation will describe the facilitators and barriers of a one-year co-occurring mental and substance use disorder wraparound intervention that adheres to Housing-First principles. MISSION is one component of a statewide effort to end homelessness. Previously implemented with 147 participants in the Central/Western region of Massachusetts (Phase 1), MISSION has been adapted and tested with 59 additional clients in the Metropolitan Boston area (Phase 2).

Methods:  Participants across both phases (N=206) completed ASI, BASIS-32, and SAMHSA questionnaires. Advisory board meetings and qualitative interviews (n=12) were completed to further examine facilitators, barriers, and needed adaptations to MISSION to account for rural and intercity population differences.

Findings: Participants reported average lifetime homelessness of 8.96 years, long-term alcohol use (mean=18.6 years), drug use (mean=15.9 years), and a history of mental illness (depression, 85%; anxiety, 83%). Eighteen percent identified as veterans, and 72% of clients have been placed in housing, while 90% of unhoused clients in Phase 2 have received vouchers.  Facilitators included regional networks for housing placements, a peer navigator, and the addition of a housing specialist.  Barriers include coordination of benefits, traumatic brain injuries, and poor family engagement. Collection of demographic, housing, clinical, and qualitative data will continue through September 2015.

Implications: This project offers lessons learned in a statewide rollout to end homelessness and suggested adaptations to MISSION. Various stakeholder perspectives regarding the facilitators, barriers, and treatment needs of homeless subpopulations, including those in rural and inner city areas and the needs of veterans will be discussed.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Program planning
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify and describe the facilitators and barriers of a three-part rollout of MISSION, a one-year co-occurring mental and substance use disorder wraparound intervention that adheres to Housing-First principles, as part of a statewide effort to end homelessness.

Keyword(s): Homelessness, Mental Health Treatment &Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been co-investigator on multiple federally funded grants focusing on chronically homeless veteran and non-veteran populations with co-occurring mental and substance use disorders. I am specifically involved and interested in the implementation and evaluation of evidence-based, manualized, treatment interventions.
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.