Supported housing for the homeless is more efffective, but also more costly

September 24, 2003

New Haven, Conn. -- The combination of subsidized housing and intensive case management for homeless people with mental illness keeps many more people off the street, but at an additional cost of $45 per day housed, or approximately $2,000 a year, according to a Yale study.

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

Advocates of this approach proposed that decreased expenditure of shelter resources, health care and criminal justice services would offset the additional cost of the program. The Yale study published this month in the Archives of General Psychiatry is the first to examine this hypothesis and suggests that costs may increase, although modestly.

Researchers tested three models of subsidy, according to the principal investigator of the study, Robert Rosenheck, M.D., 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 VA treatment.

Study participants were required to be homeless and living in the streets or shelters with a diagnosis of schizophrenia, bi-polar disorder, major affective disorder, posttraumatic stress disorder, and/or an alcohol or drug abuse disorder. Four hundred sixty homeless veterans were randomly assigned to the study groups and monitored over a three-year period. The study sites were Veterans Administration (VA) Medical Centers in San Francisco, San Diego, New Orleans and Cleveland, Ohio.

In the study, veterans who received a combination of housing vouchers and intensive case management spent 25 percent more nights housed than those who received standard VA treatment and 16 percent 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 only seven percent more days housed than the group that received standard VA care.

The study also addressed another timely issue. The final report of the Freedom Commission on Mental Illness recently concluded that one of the most serious impediments to the delivery of effective services is the fragmentation of the mental health service system. 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.
Citation: Archives of General Psychiatry, Vol. 60: 940-951 (September 2003).

Yale University

Related Mental Illness Articles from Brightsurf:

Mental illness, mental health care use among police officers
A survey study of Texas police officers examines how common mental illness and mental health care use are in a large urban department.

Hospitals miss mental illness diagnosis in more than a quarter of patients
Severe mental illness diagnoses are missed by clinicians in more than one quarter of cases when people are hospitalised for other conditions, finds a new study led by UCL researchers, published in PLOS Medicine.

Young migrants at risk of mental illness
Experience of trauma, abuse and poverty puts the mental health of many young refugees at risk.

Chronic illness in childhood linked to higher rates of mental illness
Children with long-term health conditions may be more likely to experience mental illness in early adolescence than healthy children, according to new research from Queen Mary University of London.

Did 'Joker' movie perpetuate prejudices against those with mental illness?
Researchers in this survey study examined whether watching the 2019 movie 'Joker,' in which the namesake character is violent and has mental illness, was associated with a change in the level of prejudice toward people with mental illness compared with others who watched another movie.

Skills training opens 'DOORS' to digital mental health for patients with serious mental illness
Digital technologies, especially smartphone apps, have great promise for increasing access to care for patients with serious mental illness such as schizophrenia.

Research calls for new measures to treat mental illness and opioid use
Opioid use among psychiatric hospital patients needs to be addressed through an integrated approach to managing mental illness, pain and substance use, a study by researchers at the University of Waterloo has found.

Researchers challenge myth of the relationship between mental illness and incarceration
Researchers examined the relationship between psychiatric diagnoses and future incarceration by merging data from psychiatric interviews that took place in the 1980s with 30 years of follow-up data.

New research raises important questions on how mental illness is currently diagnosed
This research raises questions as to whether current diagnoses accurately reflect the underlying neurobiology of mental illness.

Young teens of color more likely to avoid peers with mental illness
Students identifying as black or Latino are more likely to say they would socially distance themselves from peers with a mental illness, a key indicator of mental illness stigma, according to research published by the American Psychological Association.

Read More: Mental Illness News and Mental Illness Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to