Permanent Supportive Housing


Book Description

Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.




Homelessness, Housing, and Mental Illness


Book Description

Humans are social animals and, in general, don’t thrive in isolated environments. Homeless people, many of whom suffer from serious mental illnesses, often live socially isolated on the streets or in shelters. Homelessness, Housing, and Mental Illness describes a carefully designed large-scale study to assess how well these people do when attempts are made to reduce their social isolation and integrate them into the community. Should homeless mentally ill people be provided with the type of housing they want or with what clinicians think they need? Is residential staff necessary? Are roommates advantageous? How is community integration affected by substance abuse, psychiatric diagnoses, and cognitive functioning? Homelessness, Housing, and Mental Illness answers these questions and reexamines the assumptions behind housing policies that support the preference of most homeless mentally ill people to live alone in independent apartments. The analysis shows that living alone reduces housing retention as well as cognitive functioning, while group homes improve these critical outcomes. Throughout the book, Russell Schutt explores the meaning and value of community for our most fragile citizens.







Costs Associated with First-Time Homelessness for Families and Individuals


Book Description

Examines costs associated with the use of homeless and mainstream service delivery systems by families and individuals experiencing homelessness for the first time in six study communities. Assigning costs to public programs is a first step toward developing measures of the value of public interventions compared to the public costs incurred by ignoring or avoiding the problems those interventions are intended to address. The study finds that the experience of homelessness is diverse and the associated costs vary tremendously depending on the pattern of homelessness and family or individual status. It is not, however, a study of either cost-effectiveness or quality of care, but rather a calculation of costs associated with homelessness. Illustrations.




Rebuilding the Research Capacity at HUD


Book Description

Today, the nation faces an array of housing and urban policy challenges. No federal department other than HUD focuses explicitly on the well-being of urban places or on the spatial relationships among people and economic activities in urban areas. If HUD, Congress, mayors, and other policy makers are to respond effectively to urban issues, they need a much more robust and effective Office of Policy Development and Research (PD&R). PD&R conducts independent research and program evaluation, funds data collection and research by outside organizations, and provides policy advice to the Secretary and to other offices in HUD. Most of PD&R's work is of high quality, relevant, timely, and useful. With adequate resources, PD&R could lead the nation's ongoing process of learning, debate, and experimentation about critical housing and urban development challenges. Rebuilding the Research Capacity at HUD makes seven major recommendations about PD&R's resources and responsibilities, including more active engagement with policy makers, formalizing various informal practices, strengthening surveys and data sets, and more. Acknowledging that the current level of funding for PD&R is inadequate, the book also makes several additional recommendations to help enable PD&R to reach its full potential.




Toward Justice


Book Description

Designed as a text for Criminal Justice and Criminology capstone courses, Toward Justice encourages students to engage critically with conceptions of justice that go beyond the criminal justice system, in order to cultivate a more thorough understanding of the system as it operates on the ground in an imperfect world—where people aren’t always rational actors, where individual cases are linked to larger social problems, and where justice can sometimes slip through the cracks. Through a combined focus on content and professional development, Toward Justice helps students translate what they have learned in the classroom into active strategies for justice in their professional lives—preparing them for careers that will not simply maintain the status quo and stability that exists within our justice system, but rather challenge the system to achieve justice.




How to House the Homeless


Book Description

How to House the Homeless, editors Ingrid Gould Ellen and Brendan O'Flaherty propose that the answers entail rethinking how housing markets operate and developing more efficient interventions in existing service programs. The book critically reassesses where we are now, analyzes the most promising policies and programs going forward, and offers a new agenda for future research. How to House the Homeless makes clear the inextricable link between homelessness and housing policy. Contributor Jill Khadduri reviews the current residential services system and housing subsidy programs. For the chronically homeless, she argues, a combination of assisted housing approaches can reach the greatest number of people and, specifically, an expanded Housing Choice Voucher system structured by location, income, and housing type can more efficiently reach people at-risk of becoming homeless and reduce time spent homeless. Robert Rosenheck examines the options available to homeless people with mental health problems and reviews the cost-effectiveness of five service models: system integration, supported housing, clinical case management, benefits outreach, and supported employment. He finds that only programs that subsidize housing make a noticeable dent in homelessness, and that no one program shows significant benefits in multiple domains of life. Contributor Sam Tsemberis assesses the development and cost-effectiveness of the Housing First program, which serves mentally ill homeless people in more than four hundred cities. He asserts that the program's high housing retention rate and general effectiveness make it a viable candidate for replication across the country. Steven Raphael makes the case for a strong link between homelessness and local housing market regulations—which affect housing affordability—and shows that the problem is more prevalent in markets with stricter zoning laws. Finally, Brendan O'Flaherty bridges the theoretical gap between the worlds of public health and housing research, evaluating the pros and cons of subsidized housing programs and the economics at work in the rental housing market and home ownership. Ultimately, he suggests, the most viable strategies will serve as safety nets—"social insurance"—to reach people who are homeless now and to prevent homelessness in the future. It is crucial that the links between effective policy and the whole cycle of homelessness—life conditions, service systems, and housing markets—be made clear now. With a keen eye on the big picture of housing policy, How to House the Homeless shows what works and what doesn't in reducing the numbers of homeless and reaching those most at risk.




50 Years after Deinstitutionalization


Book Description

This volume will examine deinstitutionalization’s legacies approximately 50 years after reintegration began. It will highlight pressing issues around mental health treatment, social and health policy, and the lived experiences of those coping with mental illness that were or continue to be significantly influenced by deinstitutionalization reforms.




Handbook of Community Psychiatry


Book Description

During the past decade or more, there has been a rapid evolution of mental health services and treatment technologies, shifting psychiatric epidemiology, changes in public behavioral health policy and increased understanding in medicine regarding approaches to clinical work that focus on patient-centeredness. These contemporary issues need to be articulated in a comprehensive format. The American Association of Community Psychiatrists (AACP), a professional organization internationally recognized as holding the greatest concentration of expertise in the field, has launched a methodical process to create a competency certification in community psychiatry. As a reference for a certification examination, that effort will benefit enormously from a comprehensive handbook on the subject.




The Open Door


Book Description

The Open Door provides a comprehensive, carefully documented "state of the science" on homelessness and mental illness. The book reviews the effectiveness of service and housing interventions targeted at this constituency, and discusses efforts to bring evidence-based programs to scale.