Journal Title
Title of Journal: J Behav Health Serv Res
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Abbravation: The Journal of Behavioral Health Services & Research
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Authors: Susan Foster Charlene LeFauve Marilyn KreskyWolff Lawrence D Rickards
Publish Date: 2009/09/19
Volume: 37, Issue: 2, Pages: 239-251
Abstract
Cooccurring mental health and substance use disorders are highly prevalent among individuals experiencing longterm homelessness This paper describes strategies used by 11 projects funded by the Federal Collaborative Initiative to Help End Chronic Homelessness CICH to serve individuals with cooccurring disorders COD as they transition from homelessness to permanentsupported housing Findings are based on the observations of clients program team members and administrators This paper presents findings organized around three themes characteristics and needs of CICH clients with COD strategies employed to respond to those needs and challenges associated with implementing an integrated approach to COD Client characteristics include histories of untreated or intermittently treated mental health and substance use disorders often further complicated by trauma and chronic illness Project teams endorsed a variety of services and supports such as engagement stabilization motivational techniques groups and traumainformed interventions as useful for their clients with COD Challenges identified include difficult client behavior the extended time required for change to occur within this population inadequate staffing and community resources and system barriers The paper concludes with recommendations for further research into the effectiveness of various combinations of service strategies for this population in nontraditional settings during the earliest stage of recovery along with a call for overcoming workforce and systemlevel barriers to providing integrated careThe authors wish to thank the staff of the 11 projects of the Collaborative Initiative to Help End Chronic Homelessness CICH who shared their insights about their work and the men and women who shared their stories about their experiences with homelessness and with the services they received as CICH program participants The authors also acknowledge James Herrell PhD of SAMHSA and Sarah McGraw PhD of New England Research Institutes NERI for their ongoing support and direction
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