Yale Bulletin and Calendar

October 3, 2003|Volume 32, Number 5

Homeless benefit from combination
of services, says study

A combination of subsidized housing and intensive case management keeps more homeless people off the street, but at a higher cost, according to a Yale study.

The study comes at a time of national policy discussions about providing permanent subsidized housing for the homeless, as President George W. Bush has set a goal of ending chronic homelessness in 10 years.

Advocates of this approach proposed that decreased expenditure for shelter, health care and criminal justice services would offset the program's added cost. The Yale study in the September issue of the Archives of General Psychiatry is the first to test this hypothesis.

Three models of subsidy were compared, according to the principal investigator, Dr. Robert Rosenheck, professor of psychiatry and epidemiology and public health. The first group received housing vouchers and intensive case management; the second group, case management alone; the third group received standard treatment from Veterans Adminstration (VA) Medical Centers.

Four hundred sixty homeless veterans at VA Medical Centers in San Francisco, San Diego, New Orleans and Cleveland, Ohio, were randomly assigned to the study groups and monitored for three years. Each participant had a diagnosis of schizophrenia, bi-polar disorder, major affective disorder, post-traumatic stress disorder, and/or an alcohol or drug abuse disorder.

Veterans who received housing vouchers and intensive case management spent 25% more nights housed than those who received standard VA treatment and 16% more nights housed than veterans who received case management without vouchers. They also had larger networks of social support than either comparison group. The group receiving only case management had 7% more days housed than the group that received standard VA care. Although effective, the extended program cost an added $45 for each night the veterans spent in an apartment.

The recent report of the Freedom Commission on Mental Illness concluded one of the most serious impediments to the delivery of effective services is the fragmentation of the mental health service system. According to the Yale researchers, this study demonstrates that the "team-based" approach to solving this problem appears to be more effective than past efforts to integrate entire service systems from the top down.

-- By Jacqueline Weaver

T H I SW E E K ' SS T O R I E S

F&ES to get 20% of its electricity from wind power

Program will help train future leaders in patient-oriented research

Student helped strengthen neighborhoods in her hometown . . .

Heading for 'Jeopardy!'

SOM professors' study on mutual funds gets renewed notice

Rule of law is slowly advancing in China, ambassador asserts

Yale endowment reaches record high in last fiscal year

Pulitzer Prize-winning composer joins School of Music faculty

Experts on air pollution and energy systems join the F&ES faculty

Conference to explore the future of globalization

Team learns sugars produced by cancers may help disease spread

Events mark the centennial of Russian composer

Intersection of architecture and psychoanalysis to be explored

Exhibit honors theologian who helped shape American psyche

Study: Caregivers, patients often disagree over health decisions

Universities should ensure global access patented new medicines . . .

New Yorker publisher to discuss how the magazine got its 'mojo' back

Symposium celebrates career of biochemist Donald Crothers

Homeless benefit from combination of services, says study

Robert Macnab, noted for his research on bacteria, dies

Two studies aim to help smokers quit the habit

True Blue tradition

Campus Notes