Treating homeless clients with severe mental illness and substance use disorders: costs and outcomes

• Published in: Community mental health journal Vol. 42; no. 4; pp. 377 - 404
• Main Authors: Morse, Gary A, Calsyn, Robert J, Dean Klinkenberg, W, Helminiak, Thomas W, Wolff, Nancy, Drake, Robert E, Yonker, Robert D, Lama, Gyanesh, Lemming, Matthew R, McCudden, Suzanne
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.08.2006
• Subjects: Adolescent; Adult; Aged; Assertive community treatment; Case management; Clinical outcomes; Community health care; Costs; Design; Drug abuse; Drug use; Female; Health Care Costs - trends; Health care delivery; Health care expenditures; Historical cost accounting; Homeless people; Homeless Persons; Humans; Integrated care pathways; Intervention; Male; Mental Disorders; Mental health; Mental health care; Mental illness; Middle Aged; Outcome Assessment (Health Care); Substance abuse; Substance abuse treatment; Substance use disorder; Substance-Related Disorders
• ISSN: 0010-3853; 1573-2789
• DOI: 10.1007/s10597-006-9050-y

This study compared the costs and outcomes associated with three treatment programs that served 149 individuals with dual disorders (i.e., individuals with co-occurring severe mental illness and substance use disorders) who were homeless at baseline. The three treatment programs were: Integrated Assertive Community Treatment (IACT), Assertive Community Treatment only (ACTO), and standard care (Control). Participants were randomly assigned to treatment and followed for a period of 24 months. Clients in the IACT and ACTO programs were more satisfied with their treatment program and reported more days in stable housing than clients in the Control condition. There were no significant differences between treatment groups on psychiatric symptoms and substance use. The average total costs associated with the IACT and Control conditions were significantly less than the average total costs for the ACTO condition.