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This paper presents findings from in-depth qualitative interviews conducted with 31 formerly homeless tenants and nine direct service staff at a supportive housing site, where a structured process for matching tenants with case managers (“Tenant Choice”) was piloted in which tenants were offered the option of choosing their respective case managers. Tenant Choice aims to increase the opportunity for tenants to make choices that will enable them to have more control over their treatment and recovery and obtain the optimal match between tenant and case manager. This study sought to understand how tenants and staff experienced Tenant Choice, determine whether Tenant Choice was meeting its goals, and identify areas for improvement. The major themes identified were: (1) pre-existing satisfaction drove tenant choices; (2) personal qualities of case managers were valued by tenants over professional qualifications and work experience; (3) the views of tenants and staff differed regarding whether minimal contact v...

New initiatives to house chronically street homeless (CSH) adults have led to increasing proportions of this population living in congregate supportive housing, but little is known about the impact of this shift on supportive housing programs. The present multisite, mixed-methods study examined service utilization and lease compliance among 52 chronically street homeless and 46 long-term shelter stayer (LTSS) adults during their first 12 months in congregate supportive housing. Quantitative analysis of administrative data revealed that CSH tenants used significantly more service resources than LTSS tenants, including more advocacy, escorting, and psychiatric treatment and more assistance with financial, housing, and mental and physical health issues. The 2 groups did not differ significantly on measures of lease compliance. Qualitative focus groups with CSH tenants, service provider staff, and property management staff all indicated that existing supportive housing services are suitable for this population, although some adjustments, additional resources, or both, may be indicated.

Social workers and paraprofessionals serve psychiatric populations at high risk for suicide, but may receive little training related to suicidality. This study evaluated a suicide awareness and prevention training workshop for providers working with mentally ill homeless and previously homeless adults. Trainees attended a half day of training, and completed knowledge posttests and training evaluations. Half the trainees completed knowledge pretests, and those onsite at 21 months completed follow-up knowledge tests. Both professionals and paraprofessionals showed substantially improved knowledge at posttest and follow-up. Trainees also reported high levels of satisfaction with training format and content.

This article presents findings from in-depth qualitative interviews conducted with 20 long-term unsheltered homeless adults who had recently been placed into housing by Street to Home (S2H), a housing-focused outreach program in New York City. S2H places individuals directly into transitional and permanent housing, breaking from the prevailing linear treatment and housing models that require a demonstration of ‘housing readiness’ via sobriety and psychiatric stability prior to permanent housing placements. The major themes identified were: (1) negative perceptions of homeless services and service resistance; (2) readiness to leave the street; (3) believable housing options as triggers for change; (4) adapting to new surroundings and discovering benefits; and (5) the importance of knowing supports are in place. Fulfilling promises in the wake of past disappointments and providing an ongoing sense of support appear to be the key elements that have enabled the program to engage and maintain clients.

Objectives. We compared Home to Stay, a pilot of intensive housing placement and community transition services for episodic and recidivist homeless families, with a standard services approach. Methods. Using intention-to-treat analyses, we conducted a modified randomized trial of 138 Home to Stay client families and a control group of 192 client families receiving standard shelter services. Results. Home to Stay clients exited shelter more quickly than clients in the control group (Cox regression, P Conclusions. Relative to standard services, Home to Stay services can accelerate exit from shelter and reduce return to shelter and total sheltered days for episodic and recidivist homeless families. Standard shelter services may be able to narrow this performance gap by incentivizing work with all episodic and recidivist homeless families.

Objective: This study evaluated the effects of the illness management and recovery program on mental illness and functional outcomes of persons with serious mental illness who were receiving supportive housing services. Methods: A randomized controlled trial was conducted with 104 persons with serious mental illness who were assigned either to illness management classes for six months or to a waitlist control group, with followup assessments conducted six months posttreatment. Assessments included self-reports, nonblinded clinical ratings, and blinded interview ratings and included the domains of illness management, symptoms, psychosocial functioning, hospitalizations, and substance abuse and dependence. Results: Participants assigned to the program showed significantly greater improvements than the control group in self-reported and clinician ratings of illness management, interview-based ratings of symptoms on the Brief Psychiatric Rating Scale, and interview-based ratings of psychosocial functioning on the abbreviated Quality of Life Scale. Participants in both groups improved in self-ratings of symptom distress and had low rates of hospitalization and substance abuse over the course of the study. Conclusions: The results suggest that the program was effective at improving illness management and functional outcomes for persons with serious mental illness who were receiving supportive housing services. (Psychiatric Services 60:1629–1636, 2009)