Homelessness and Mental Illness in a Professional- and Peer-Led Cocaine Treatment Clinic

• Published in: Psychiatric services (Washington, D.C.) Vol. 49; no. 4; pp. 533 - 535
• Main Authors: Galanter, Marc, Dermatis, Helen, Egelko, Susan, Leon, George De
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.04.1998; American Psychiatric Association
• Subjects: Adult; Biological and medical sciences; Chi-Square Distribution; Confidence Intervals; Crack Cocaine; Desintoxication. Drug withdrawal; Diagnosis, Dual (Psychiatry); Female; Homeless Persons - psychology; Homeless Persons - statistics & numerical data; Humans; Male; Medical sciences; Mental Disorders - complications; Odds Ratio; Patient Participation; Professional-Patient Relations; Program Evaluation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy, Group - methods; Psychotherapy, Group - standards; Regression Analysis; Self-Help Groups - standards; Substance Abuse Treatment Centers - standards; Substance Abuse Treatment Centers - utilization; Substance-Related Disorders - complications; Substance-Related Disorders - therapy; Time Factors; Treatment Outcome; Treatments; Urban Health Services - standards; Urban Health Services - utilization; Human; Drug addiction; Concomitant disease; Homeless; Poison withdrawal; Treatment; Dependence; Mental disorder; Cocaine; Peer review
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/ps.49.4.533

The combined problems of substance abuse, mental illness, and homelessness among the urban poor represent a major public health issue. The study evaluated 340 patients attending a cocaine day treatment program that integrates peer leadership and professional supervision. Thirty-six percent of the sample had a major mental illness, and 39 percent were homeless. Sixty-nine percent achieved an acceptable final urine toxicology status, and the median number of program visits was 46. Homelessness, a longer history of cocaine use, and a diagnosis of schizophrenia were associated with positive treatment outcomes. The results support the feasibility of a cocaine abuse treatment model combining professional and peer leadership.