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Study backs federally funded programs for chronically homeless with mental illness

Adults with a history of homelessness and serious mental illness experienced more favorable outcomes when bolstered by a federally funded employment and permanent supportive housing program, according to data published in Psychiatric Services.

According to researcher Martha R. Burt, PhD, an affiliated scholar with the Urban Institute in Washington, D.C., “this very challenged population can achieve improved work outcomes if programs devote adequate and appropriate resources to help them.”

In 2003, a federal initiative funded five demonstration projects, including Los Angeles’ Homeless Opportunity Providing Employment (LA’s HOPE). Burt compared outcomes data for 56 LA’s HOPE participants with that of data for 415 participants of similar homeless programs in Los Angeles enrolled between July 1, 2004 and May 17, 2005.

LA’s HOPE participants, whose diagnoses included schizophrenia, major depression and bipolar disorder, were much more likely to gain permanent supportive housing than the study’s comparison group (50% to 1%; P<.001). Burt also reported that LA’s HOPE participants more than doubled the comparison group, 57% to 22%, in finding employment.

Burt concluded LA’s HOPE participants benefited to a greater degree from the resources and structure afforded to them. Contrary to the norm, LA’s HOPE employed a “housing first” model, in which participants received housing before treatment for substance abuse issues and mental illnesses. Comparison group participants, serviced through state-funded homeless assistance programs, had to be “drug-free” and have stabilized psychiatric symptoms before they received housing.

By coordinating housing and employment services, Burt noted, LA’s HOPE demonstrated “what provision of housing and employment services … can mean for people with disabilities who have been homeless a long time. In doing so it adds to the substantial separate literatures on the effectiveness of supported employment and permanent supportive housing by showing what the two can do together.”

Disclosure: Dr. Burt reports no relevant financial disclosures.