Motivational and cognitive correlates of community integration in homeless veterans entering a permanent supported housing program.

Abstract Background In an initial study (Study 1), we found that motivation predicted community integration (i.e. functional recovery) 12 months after receiving housing in formerly homeless Veterans with a psychotic disorder. The current study examined whether the same pattern would be found in a broader, more clinically diverse, homeless Veteran sample without psychosis. Methods We examined four categories of variables as potential predictors of community integration in non-psychotic Veterans: perception, non-social cognition, social cognition, and motivation at baseline (after participants were engaged in a permanent supported housing program but before receiving housing) and a 12-month follow-up. A total of 82 Veterans had a baseline assessment and 41 returned for testing after 12 months. Results The strongest longitudinal association was between an interview-based measure of motivation (the motivation and pleasure subscale from the Clinical Assessment Interview for Negative Symptoms) at baseline and measures of social integration at 12 months. In addition, cross-lagged panel analyses were consistent with a causal influence of general psychiatric symptoms at baseline driving social integration at 12 months, and reduced expressiveness at baseline driving independent living at 12 months, but there were no significant causal associations with measures of motivation. Conclusions The findings from this study complement and reinforce those in Veterans with psychosis. Across these two studies, our findings suggest that motivational factors are associated at baseline and at 12 months and are particularly important for understanding and improving community integration in recently-housed Veterans across psychiatric diagnoses.

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Incarceration Histories of Homeless Veterans and Progression Through a National Supported Housing Program

Community Mental Health Journal ◽

10.1007/s10597-013-9611-9 ◽

2013 ◽

Vol 50 (5) ◽

pp. 514-519 ◽

Cited By ~ 11

Author(s):

N. Tejani ◽

R. Rosenheck ◽

J. Tsai ◽

W. Kasprow ◽

J. F. McGuire

Keyword(s):

Supported Housing ◽

Housing Program ◽

Homeless Veterans

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Motivational and cognitive factors linked to community integration in homeless veterans: study 1 – individuals with psychotic disorders

Psychological Medicine ◽

10.1017/s0033291720001889 ◽

2020 ◽

pp. 1-9

Author(s):

Michael F. Green ◽

Jonathan K. Wynn ◽

Sonya Gabrielian ◽

Gerhard Hellemann ◽

William P. Horan ◽

...

Keyword(s):

Social Cognition ◽

Independent Living ◽

Psychotic Disorders ◽

Community Integration ◽

Supported Housing ◽

Cross Sectional ◽

Targeted Interventions ◽

Homeless Veterans ◽

Housing Services ◽

History Of

Abstract Background Little is known about the determinants of community integration (i.e. recovery) for individuals with a history of homelessness, yet such information is essential to develop targeted interventions. Methods We recruited homeless Veterans with a history of psychotic disorders and evaluated four domains of correlates of community integration: perception, non-social cognition, social cognition, and motivation. Baseline assessments occurred after participants were engaged in supported housing services but before they received housing, and again after 12 months. Ninety-five homeless Veterans with a history of psychosis were assessed at baseline and 53 returned after 12 months. We examined both cross-sectional and longitudinal relationships with 12-month community integration. Results The strongest longitudinal association was between a baseline motivational measure and social integration at 12 months. We also observed cross-sectional associations at baseline between motivational measures and community integration, including social, work, and independent living. Cross-lagged panel analyses did not suggest causal associations for the motivational measures. Correlations with perception and non-social cognition were weak. One social cognition measure showed a significant longitudinal correlation with independent living at 12 months that was significant for cross-lagged analysis, consistent with a causal relationship and potential treatment target. Conclusions The relatively selective associations for motivational measures differ from what is typically seen in psychosis, in which all domains are associated with community integration. These findings are presented along with a partner paper (Study 2) to compare findings from this study to an independent sample without a history of psychotic disorders to evaluate the consistency in findings regarding community integration across projects.

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Referral and Housing Processes in a Long-Term Supported Housing Program for Homeless Veterans

Psychiatric Services ◽

10.1176/appi.ps.51.8.1017 ◽

2000 ◽

Vol 51 (8) ◽

pp. 1017-1023 ◽

Cited By ~ 32

Author(s):

Wesley J. Kasprow ◽

Robert A. Rosenheck ◽

Linda Frisman ◽

Diane DiLella

Keyword(s):

Supported Housing ◽

Housing Program ◽

Homeless Veterans

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Outcomes of Supported Housing for Homeless Veterans with Psychiatric and Substance Abuse Problems

Mental Health Services Research ◽

10.1023/b:mhsr.0000044746.47589.06 ◽

2004 ◽

Vol 6 (4) ◽

pp. 199-211 ◽

Cited By ~ 17

Author(s):

Alvin S. Mares ◽

Wesley J. Kasprow ◽

Robert A. Rosenheck

Keyword(s):

Substance Abuse ◽

Supported Housing ◽

Homeless Veterans

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Stress factors in persons with intellectual disabilities in different types of housing

Medicinski pregled ◽

10.2298/mpns2008221t ◽

2020 ◽

Vol 73 (7-8) ◽

pp. 221-228

Author(s):

Daniela Tamas ◽

Nina Brkic-Jovanovic ◽

Danica Vasiljevic

Keyword(s):

Intellectual Disabilities ◽

Life Stress ◽

Interpersonal Relationship ◽

Well Being ◽

Supported Housing ◽

The Other ◽

Stress Factors ◽

Housing Program ◽

Different Types ◽

People With Intellectual Disabilities

Introduction. Type of housing is of great importance for the overall quality of life and general psychosocial well-being of persons with intellectual disabilities, as evidenced by the results of numerous studies showing that people with intellectual disabilities living in institutions have a lower level of life satisfaction compared to those living in the open community. Material and Methods. In order to determine the levels of experienced stress related to the type of housing in people with intellectual disabilities, we carried out a study including 122 persons with intellectual disabilities living in different types of housing; in institutions (n = 51), with families (n = 38), and in the supported housing program (n = 33). The Life Stress Inventory was used for the purpose of this research. Results. The results showed that people who were included in the supported housing program experienced the least stress, compared to the subjects who lived with their families or in institutions (p < 0.001). Stress was the least prevalent in the supported housing program, but the other two groups had similar results. The presence of stress did not differ significantly between subjects living with their families and those living in institutions. Conclusion. We can conclude that subjects living in supported housing experienced significantly less stress compared to the other two groups. Different types of housing were associated with different levels of stress. Overall, negative interpersonal relationship was identified as the stress factor that correlated most significantly with other stress factors.

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Supplemental Material for Actuarial Prediction Versus Clinical Prediction of Exits From a National Supported Housing Program

American Journal of Orthopsychiatry ◽

10.1037/ort0000603.supp ◽

2022 ◽

Keyword(s):

Supported Housing ◽

Clinical Prediction ◽

Housing Program ◽

Actuarial Prediction

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Mental Illness and Substance Use Disorders Among Homeless Veterans

Homelessness Among U.S. Veterans ◽

10.1093/oso/9780190695132.003.0003 ◽

2018 ◽

pp. 35-60

Author(s):

Sonya Gabrielian ◽

Ashton M. Gores ◽

Lillian Gelberg ◽

Jack Tsai

Keyword(s):

Mental Illness ◽

Substance Use ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Supported Housing ◽

United States Armed Forces ◽

Homeless Veterans ◽

Veteran Status ◽

Epidemiology Data ◽

Housing Outcomes

Mental illness and substance use disorders (SUDs) are strong risk factors for homelessness, regardless of Veteran status. This chapter describes the interplay between mental illness, SUDs, the co-occurrence of these disorders (CoD), and homelessness among Veterans; the authors consider military-specific experiences (e.g., combat) and factors associated with homelessness for both Veteran and non-Veteran adults (e.g., childhood adversity). They present epidemiology data on mental illness and SUDs among homeless Veterans, considering specific diagnoses (e.g., post-traumatic stress disorder) and experiences (e.g., military sexual trauma) that are highly prevalent within or unique to persons who served in the United States Armed Forces. In addition, the authors present qualitative and quantitative data on pathways to homelessness for Veterans with mental illness, SUDs, and/or CoD, considering distinct pathways seen in special populations (e.g., women Veterans, who have high rates of trauma, and the newest cohort of Veterans who served in Iraq or Afghanistan). Last, the authors discuss supported housing outcomes for homeless Veterans with psychiatric disorders and SUDs. They discuss the utility of these programs for homeless Veterans with mental health problems and explore the influence of psychiatric disorders and SUDs among Veterans with poor supported housing outcomes.

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