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

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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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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The Milwaukee Continuum: Older Veterans and Nonveterans Use Housing First to Exit Homelessness

Journal of Humanistic Psychology ◽

10.1177/0022167819866523 ◽

2019 ◽

pp. 002216781986652

Author(s):

David A. Nelson ◽

Jeff Morzinski ◽

Mark Flower

Keyword(s):

Healing Process ◽

Community Based Participatory Research ◽

Research Process ◽

Public Health Issue ◽

Community Based ◽

Deep Time ◽

Homeless Veterans ◽

Process Understanding ◽

Formerly Homeless

Background: Homelessness is about survival and more than an issue of bricks and mortar. It is not a static dimension and alludes to a troubled age and brokenness of society. Despite dramatic declines in numbers of people presently homeless, the issue continues to be a public health issue. The number of veterans currently homeless continues to be of national concern despite application of resources. More needs to be done to better understand the concerns of veterans, once homeless and now housed. Method: Qualitative research in the form of interviews provided insights from the veterans on their experience around achieving housing. Qualitative methods are often used in evaluations as they speak of the experience of the program being evaluated by capturing and then communicating the narratives of the participants. This study was grounded in community-based participatory research where a member of community was a part of all phases of the research process. Results: Seven interviews with formerly homeless veterans were conducted. Themes included the following: Burnt Brides and Regrets, Survival, Spirituality, Recovery and Stress, Supportive Care, Reunite Family, and Sickness and Health. Discussion: The themes provide insight into the experience of the veterans and a means to better understand the healing process. Understanding of the healing process includes the following: Acknowledging the Courage to go Deep, Time, Veterans Giving Back, and Recovery is Ongoing. Despite what was learned, further research is needed to better understand the long-term implications of people formerly homeless now housed.

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What Makes a House a Home? An Evaluation of a Supported Housing Project for Individuals with Long-Term Psychiatric Backgrounds

Canadian Journal of Community Mental Health ◽

10.7870/cjcmh-1992-0008 ◽

1992 ◽

Vol 11 (1) ◽

pp. 109-123 ◽

Cited By ~ 20

Author(s):

Katherine M. Boydell ◽

Barbara Everett

Keyword(s):

Consumer Choice ◽

Health Agency ◽

Supported Housing ◽

Ethnographic Study ◽

Equal Weight ◽

Housing Project ◽

Community Mental Health Agency ◽

Qualitative Component ◽

Qualitative Methodologies

Supported housing (as distinct from supportive housing) emphasizes the values of consumer choice; independence; participation; permanence; normalcy; and flexible, ongoing supports. As a model, it has only recently become popular in the literature and therefore little is known of its effectiveness in serving people with long-term psychiatric backgrounds. In 1989, Homeward Projects, a community mental health agency located in Metropolitan Toronto, established a supported housing project. Homeward included an evaluative component in its program from the outset. In order to give equal weight to the tenants' opinions, both quantitative and qualitative methodologies were employed. In the quantitative component, residential milieu, social support, and service delivery were examined. The qualitative component involved an ethnographic study which allowed the tenants to voice their experiences of living in such a setting. Results provided a rich understanding of the model. Overall, the tenants eventually came to describe their house as a home.

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The "Sting" of Vancouver's Better Housing "Spree", 1919–1949

Urban History Review ◽

10.7202/1016793ar ◽

2013 ◽

Vol 21 (2) ◽

pp. 92-103

Author(s):

Jill Wade

Keyword(s):

Social Housing ◽

Financial Hardship ◽

Housing Program ◽

Housing Scheme ◽

The City ◽

National Housing

Contrary to other accounts of the 1919 national housing program, this article examines the plan's long-term history using Vancouver as a case study. It argues that a basic structural flaw in the local Better Housing Scheme created financial hardship for the City of Vancouver as well as for mortgagors during the depression. The burden of mortgage repayment that fell to the city discouraged it from participating in other housing initiatives in the 1930s and 1940s. Still, the labour, women's, and veterans' organizations that supported the scheme represented the beginnings of Vancouver's social housing movement that matured in the late 1930s and achieved significant improvements in residential conditions in the 1940s.

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