Conference Addresses Homelessness
By Melissa Capers
 People
with serious mental illnesses and co-occurring substance
use disorders are especially vulnerable to becoming homeless
during the transition from institutions such as inpatient
treatment or jail to community-based care.
A workshop on transition planning was one of more than 65 sessions
offered at SAMHSA's third national conference on ending homelessness
among persons with mental illnesses and/or substance use disorders,
Preparing People for Change: Knowledge & Choice. The conference
convened in Washington, DC, at the end of October.
"We wanted everyone to come away from the conference with
new skills and information about new approaches," said Lawrence
D. Rickards, Ph.D., Chief of the Homeless Programs Branch of the
Division of Service and Systems Improvement at SAMHSA's Center for
Mental Health Services.
More than 800 service providers, consumers, and Federal staff
participated in the conference, according to Dr. Rickards. "A
learning community was established here," he said. "Participants
had the opportunity to network and exchange perspectives with colleagues
from across the Nation."
In addition, SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W.,
presented Exemplary Program Awards to 12 organizations that serve
the homeless population in cities across the Nation.
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Transition Planning
Panelists from SAMHSA's National Resource and Training Center
on Homelessness and Mental Illness (NRTC), the National GAINS Center,
and the Massachusetts Department of Mental Health shared their strategies
for preventing homelessness during transition periods.
Inadequate planning time, stigma and discrimination,
lack of accountability and incentives, and even differences
in language among service systems are significant challenges
to effective transition planning for persons with mental
illnesses and/or substance use disorders, according to
Francine Williams, M.A. "But the greatest challenge,"
she said, "is not in the discharge planning process,
it is in the development of available housing."
As a result, creating a variety of housing options is
one of eight principles of effective discharge planning
that NRTC supports.
Panelists from the New York State prison system and the Massachusetts
Department of Health shared their strategies for success.
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New York State
Daniel Abreu, M.S., C.R.C., of the GAINS Center, described
the barriers to effective transition planning for persons
with mental illnesses discharged from New York State
prisons and jails. These include a fear of ex-offenders
(even among service providers); the difficulty in coordinating
the criminal justice and mental health service systems;
and negotiating Social Security and Medicaid for people
in transition.
In New York State, planning for prison discharge can
begin as early as admission.
Pre-release counselors seek to develop a discharge plan, link
individuals in prison to services within the communities to which
they will be released, and begin the process of securing benefits
well in advance of the day of discharge.
Service providers are invited to the prison or jail to meet with
individuals in person. Video-conference sites allow housing interviews
to be held before the release date, and a medication grant program
provides prescription cards for released prisoners, so that they
can fill prescriptions during the time between release and Medicaid
approval.
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Massachusetts
Massachusetts recognizes that "housing is a clinical issue,"
according to Peggy Lester, M.P.A., M.Ed., Director of Housing for
the Massachusetts Department of Mental Health. A housing specialist
works to promote the development of community-based housing in each
of the department's geographic service areas, and the department
has developed more than 3,000 beds for persons with serious mental
illnesses. These facilities include supportive housing units, group
homes, safe havens, and other housing models.
Policy and legislation have played a significant role in the state's
success in reducing homelessness among persons released from inpatient
services. Through the Special Initiative to House the Homeless Mentally
Ill, the state legislature supports more than 1,000 beds for homeless
persons with mental illnesses.
"With Hurricane Katrina, the sheer number of people affected
by this lethal storm has directed a very powerful spotlight on the
challenges that you in this room have been wrestling with for a
long time," said Kathryn Power, M.Ed., Director of SAMHSA's
Center for Mental Health Services.
"This disaster has elevated the ‘issue' of homelessness
to dramatic new heights of awareness," she said.
For more information, visit the SAMHSA Web site at www.samhsa.gov/Matrix/matrix_homelessness.aspx. 
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