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SAMHSA Offers New Resource for Helping Homeless Persons with Mental Disorders

By Rebecca A. Clay

Blueprint for Change: Ending Chronic Homelessness for Persons with Serious Mental Illnesses and/or Co-Occurring Substance Use Disorders report cover

With a scar on her face betraying a history of physical abuse, Helen reported being homeless for 3 years. She had experienced audio hallucinations since girlhood. And, she never received any mental health treatment or managed to benefit from substance abuse treatment.

People like Helen were once thought to be unreachable. But after more than 15 years of study, research shows that homeless people who have mental illness and/or co-occurring substance abuse disorders can indeed benefit from integrated mental health services, substance abuse services, and supportive housing. Now, a forthcoming publication from SAMHSA's Center for Mental Health Services (CMHS) gathers that evidence and offers practical advice for planning, organizing, and sustaining comprehensive services designed to end homelessness. Featuring Helen's story, Blueprint for Change: Ending Chronic Homelessness for Persons with Serious Mental Illnesses and/or Co-Occurring Substance Use Disorders is available in an online version on SAMHSA's Web site. The print version of the book should be available early this year.

"We know what works," said Frances L. Randolph, Dr.P.H., Chief of the Homeless Programs Branch at CMHS, noting that the book will be sent to state officials nationwide. "Now we must put what we know to work. This book will be a useful roadmap for states and communities that are serious about ending chronic homelessness."

Step-by-Step Guidance

An estimated 200,000 Americans experience chronic homelessness. More than 40 percent may have substance use disorders, and 20 percent have serious mental disorders. Some homeless persons have both.

Over the years, SAMHSA and other Federal Agencies sponsored research and demonstration programs to determine how to best serve this complex population. In addition, hundreds of community-based providers continue to work on the problem. Together, they have replaced many misconceptions with evidence-based findings.

Consider outreach to homeless people with mental illness and/or substance abuse disorders. Once thought of as a non-traditional service, outreach is now recognized as the most important step in connecting such individuals to the services they need. Housing is another consideration. In the past, group homes for people with mental illness were the norm. Now, researchers know that these individuals prefer regular housing and that housing with supportive services can help them recover. What's more, researchers discovered that providing regular housing is actually cheaper than allowing people to remain homeless.

Getting states and communities to put those kind of research findings to work is the goal of Blueprint for Change.

The book comprises four main sections:

Before You Begin. In this section, readers learn more about the changing context of care and our Nation's response. Risk factors for homelessness and challenges in serving this population are described. And, the principles needed for a comprehensive system of care are explained.

Plan for Services. This section provides detailed suggestions for how to establish and finance a comprehensive, integrated system of care.

Organize Services. Communities don't have to start from scratch to organize services to help homeless people with mental illnesses and substance abuse. This section offers an overview of proven practices that have worked in the field in the past. Also, specific tips are provided on how to make the best use of Federal resources.

Sustain Services. It's often easier to create a new program than it is to sustain an existing program once the original funding ends. Evaluation is a critical step because funding entities need to see that a program is actually achieving its goals. It's also important to know how to put the wide array of mainstream resources to work for people who are homeless.

Blueprint for Change also includes a comprehensive list of additional resources.

According to Blueprint, these types of integrated services helped Helen regain control of her life. Referred by a homeless shelter, she moved into a supportive residential program at the local YMCA. There, she worked with staff on basic life skills like hygiene and food preparation, started seeing a psychiatrist at the on-site mental health clinic, and stopped drinking. Today, she lives in a large studio apartment, happy to be cooking her own meals again and enjoying her own space.

Blueprint for Change: Ending Chronic Homelessness for Persons with Serious Mental Illnesses and/or Co-Occurring Substance Use Disorders is available from SAMHSA's National Resource Center on Homelessness and Mental Illness. Call the Center at 1 (800) 444-7415 for free copies. Also visit the Center's Web site at www.nrchmi.samhsa.gov. The site features fact sheets; additional publications; information about training and technical assistance opportunities; bibliographies; contact information for national organizations concerned with mental illness, housing, and homelessness; and other resources.

For more specific information related to this topic, contact Fran Randolph at the CMHS Homeless Branch at (301) 443-3706.

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