scholarly journals Severe Psychopathology and Substance Use Disorder Modify the Association Between Housing Trajectories and Food Security Among Homeless Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
James Lachaud ◽  
Cilia Mejia-Lancheros ◽  
Michael Liu ◽  
Ri Wang ◽  
Rosane Nisenbaum ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Food Security ◽  
Substance Use Disorders ◽  
Homeless Adults ◽  
Stable Housing ◽  
Trajectory Group ◽  
Severe Psychopathology ◽  
Housing Trajectories

Purpose: We examined the housing trajectories of homeless people with mental illness over a follow-up period of 6 years and the association of these trajectories with food security. We then examined the modifying role of psychopathology and alcohol and substance use disorders in this association.Materials and Methods: We followed 487 homeless adults with mental illness at the Toronto site of the At Home/Chez-Soi project—a randomized trial of Housing First. Food security data were collected seven times during the follow-up period. Psychopathology (Colorado Symptom Index score) and alcohol and substance use disorders were assessed at baseline. Housing trajectories were identified using group-based trajectory modeling. Logistic regression was used to estimate the association between housing trajectory groups and food security.Results: Three housing trajectory groups were identified: rapid move to consistent stable housing (34.7%), slow and inconsistent housing (52.1%), and never moved to stable housing (13.2%). Individuals included in the rapid move to consistent housing trajectory group had higher odds of remaining food secure compared with those in the never moved to stable housing trajectory group over the follow-up period [AOR 2.9, 95% CI: 1.3–6.6, P-value: 0.009]. However, when interactions were considered, this association was significant among those with moderate psychopathology but not severe psychopathology. Individuals with substance use disorder and in the never moved to stable housing group had the lowest food security status.Discussion: Severe psychopathology and substance use disorders modified the association between housing trajectories and food security.International Standard Randomized Control Trial Number Register (ISRCTN42520374).

Severe Psychopathology and Substance Use Disorder Modify the Association between Housing Trajectories and Food Security among Homeless Adults

2020 ◽  
Author(s):  
James Lachaud ◽  
Cilia Mejia-Lancheros ◽  
Ri Wang ◽  
Michael Liu ◽  
Rosane Nisenbaum ◽  
...  
Keyword(s):  
Substance Use ◽  
Food Security ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Homeless Adults ◽  
Stable Housing ◽  
Trajectory Group ◽  
Severe Psychopathology ◽  
Housing Trajectories

Abstract Background We examined the housing trajectories of homeless people with mental illness over a follow-up period of 6 years, and the association of these trajectories with food security. We then examined the modifying role of psychopathology and alcohol and substance use disorders in this association.Methods We followed 487 homeless adults with mental illness at the Toronto site of the At Home/Chez-Soi project –a randomized trial of Housing First. Housing data were collected every 3 months (Phase I) or 6 months (Phase II) during follow-up. Food security data were collected 7 times during the follow-up period. Psychopathology (Colorado Symptom Index score) and alcohol and substance use disorders were assessed at baseline. Housing trajectories were identified using group-based trajectory modelling. Logistic regression was used to estimate the association between housing trajectory groups and food security.Results Three housing trajectory groups were identified: a rapid move to consistent stable housing (34.7%), slow and inconsistent housing (52.1%), and never moved to stable housing (13.2%). Individuals included in the rapid move to consistent housing trajectory group had higher odds of remaining food secure compared to those in the never moved to stable housing trajectory group over the follow-up period [AOR 2.9, 95% CI: 1.3–6.6, P-value: 0.009]. However, when interactions were considered, this association was significant among those with moderate psychopathology but not severe psychopathology. Individuals with substance use disorder and in the group never move to stable house group had the lowest food security status.Conclusion Severe psychopathology and substance use disorders modified the association between housing trajectories and food security. Housing interventions need to focus on long term housing stability as well as food security, especially among those with severe psychopathology and substance use disorder.Ethical considerations The Toronto AH/CS study received approval from the St. Michael’s Hospital Research Ethics Board (Canada), and all participants gave informed written consent to participate in the AH/CS study. The AH/CS study is also registered with the International Standard Randomized Control Trial Number Register (ISRCTN42520374).

scholarly journals Social support and housing transitions among homeless adults with serious mental illness and substance use disorders.

2018 ◽  
Vol 41 (3) ◽  
pp. 208-215 ◽  
Author(s):  
Sonya Gabrielian ◽  
Alexander S. Young ◽  
Jared M. Greenberg ◽  
Elizabeth Bromley
Keyword(s):  
Social Support ◽  
Mental Illness ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Serious Mental Illness ◽  
Homeless Adults

scholarly journals Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial

2017 ◽  
Vol 20 (11) ◽  
pp. 2023-2033 ◽  
Author(s):  
Patricia O’Campo ◽  
Stephen W Hwang ◽  
Agnes Gozdzik ◽  
Andrée Schuler ◽  
Vered Kaufman-Shriqui ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Food Security ◽  
Mental Health Services ◽  
Health Services ◽  
Usual Care ◽  
Homeless Adults ◽  
Adults With Mental Illness ◽  
At Home

AbstractObjectiveIndividuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population.DesignAt Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months).SettingCommunity settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver).SubjectsHomeless adults with mental illness (n2148).ResultsApproximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites.ConclusionsOur large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

Standard EMDR Protocol for Alcohol and Substance Dependence Comorbid With Posttraumatic Stress Disorder: Four Cases With 12-Month Follow-Up

2016 ◽  
Vol 10 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Claire Kullack ◽  
Jonathan Laugharne
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Alcohol Dependence ◽  
Posttraumatic Stress ◽  
Substance Use Disorders ◽  
Substance Dependence ◽  
Stress Disorder ◽  
Case Series ◽  
Post Traumatic Stress

This report begins with a summary of the literature regarding the theoretical models behind the comorbid relationship between posttraumatic stress disorder and substance use disorders and the various modified addiction protocols formulated to assist in treating these disorders. This case series outlines the effect that the standard eye movement desensitization and reprocessing (EMDR) protocol had on alcohol and substance dependence for 4 patients who attended our Post Traumatic Stress Clinic in Fremantle, Western Australia, primarily for treatment for posttraumatic stress disorder. Patients were assessed for substance use disorders using the Mini International Neuropsychiatric Interview Plus prior to, immediately after, and 12 months after completing EMDR therapy. Results indicate that the standard EMDR protocol was successful in reducing alcohol and substance use. Prior to treatment, 3 patients met criteria for alcohol dependence and 1 met criteria for substance dependence. At 12-month follow-up, 3 out of 4 clients did not meet the diagnostic criteria for current alcohol dependence or current substance dependence. The implications of these findings are discussed with reference to theories of comorbid posttraumatic stress disorder and substance use disorder and the modified EMDR protocols developed for patients with substance dependence.

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