An experimental comparison of three types of case management for homeless mentally ill persons

Morse, Gary A.; Calsyn, Robert J.; Klinkenberg, W. Dean; Trusty, Michael L.; Gerber, F; Smith, Roger H.; Tempelhoff, Betty; Ahmad, Liaquat

doi:10.1176/ps.48.4.497

Cited by 111 publications

(27 citation statements)

References 6 publications

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“…Finally, three trials reported no effect of ACT on income outcomes over usual or supportive services [56,61,62]. No trials measured employment outcomes.…”

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 98%

“…One trial showed that ACT participants with more severe alcohol use disorder experienced faster and earlier improvements in substance use compared to those with less severe alcohol-use disorder or those randomized to usual or supportive services (p<0.01) [25]; however, this difference was not significant by the end of three years. Four trials reported no additional benefits of ACT on substance use outcomes over usual or supportive services [57,59,61,62].…”

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 98%

“…The effects of ACT on mental health outcomes were moderately positive. In one trial, ACT interventions were associated with fewer psychological symptoms in the areas of unusual activity levels (p<0.03) and thought disorder (p<0.02) compared to other supportive services [62]. Six other trials reported no additional effects of ACT on mental health compared to usual or supportive services [25,[56][57][58][59]61].…”

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 99%

“…Participants who received ACT reported significantly more days in community housing (p = 0.006) [58], and fewer days homeless (p<0.01) compared to usual or supportive services [61]. ACT marginally improved the number of days participants spent in stable housing compared to supportive services (p = 0.032) [62], and usual services (p = 0.09) [57]. However, two trials, one of which included a follow-up study, did not identify any housing-stability benefits of ACT over usual or supportive services [55,59,60].…”

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 99%

“…Assertive community treatment showed promising effects on housing stability in five of seven trials that measured this outcome [56][57][58]61,62]. Participants who received ACT reported significantly more days in community housing (p = 0.006) [58], and fewer days homeless (p<0.01) compared to usual or supportive services [61].…”

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 99%

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The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review

et al. 2020

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Background Individuals who are homeless or vulnerably housed are at an increased risk for mental illness, other morbidities and premature death. Standard case management interventions as well as more intensive models with practitioner support, such as assertive community treatment, critical time interventions, and intensive case management, may improve healthcare navigation and outcomes. However, the definitions of these models as well as the fidelity and adaptations in real world interventions are highly variable. We conducted a systematic review to examine the effectiveness and cost-effectiveness of case management interventions on health and social outcomes for homeless populations. Methods and findings We searched Medline, Embase and 7 other electronic databases for trials on case management or care coordination, from the inception of these databases to July 2019. We sought outcomes on housing stability, mental health, quality of life, substance use, hospitalization, income and employment, and cost-effectiveness. We calculated pooled random effects estimates and assessed the certainty of the evidence using the GRADE approach. Our search identified 13,811 citations; and 56 primary studies met our full inclusion criteria. Standard case management had both limited and short-term effects on substance use and housing outcomes and showed potential to increase hostility and depression. Intensive case

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“…Finally, three trials reported no effect of ACT on income outcomes over usual or supportive services [56,61,62]. No trials measured employment outcomes.…”

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 98%

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 98%

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 99%

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 99%

Section: Effects Of Assertive Community Treatment (Act)mentioning

confidence: 99%

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The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review

et al. 2020

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Racial Health Equity and Social Needs Interventions

et al. 2023

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ImportanceSocial needs interventions aim to improve health outcomes and mitigate inequities by addressing health-related social needs, such as lack of transportation or food insecurity. However, it is not clear whether these studies are reducing racial or ethnic inequities.ObjectiveTo understand how studies of interventions addressing social needs among multiracial or multiethnic populations conceptualize and analyze differential intervention outcomes by race or ethnicity.Evidence ReviewSources included a scoping review of systematic searches of PubMed and the Cochrane Library from January 1, 1995, through November 29, 2021, expert suggestions, and hand searches of key citations. Eligible studies evaluated interventions addressing social needs; reported behavioral, health, or utilization outcomes or harms; and were conducted in multiracial or multiethnic populations. Two reviewers independently assessed titles, abstracts, and full text for inclusion. The team developed a framework to assess whether the study was “conceptually thoughtful” for understanding root causes of racial health inequities (ie, noted that race or ethnicity are markers of exposure to racism) and whether analyses were “analytically informative” for advancing racial health equity research (ie, examined differential intervention impacts by race or ethnicity).FindingsOf 152 studies conducted in multiracial or multiethnic populations, 44 studies included race or ethnicity in their analyses; of these, only 4 (9%) were conceptually thoughtful. Twenty-one studies (14%) were analytically informative. Seven of 21 analytically informative studies reported differences in outcomes by race or ethnicity, whereas 14 found no differences. Among the 7 that found differential outcomes, 4 found the interventions were associated with improved outcomes for minoritized racial or ethnic populations or reduced inequities between minoritized and White populations. No studies were powered to detect differences.Conclusions and RelevanceIn this review of a scoping review, studies of social needs interventions in multiracial or multiethnic populations were rarely conceptually thoughtful for understanding root causes of racial health inequities and infrequently conducted informative analyses on intervention effectiveness by race or ethnicity. Future work should use a theoretically sound conceptualization of how race (as a proxy for racism) affects social drivers of health and use this understanding to ensure social needs interventions benefit minoritized racial and ethnic groups facing social and structural barriers to health.

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Duration of homeless spells among severely mentally ill individuals: A survival analysis

McBride

Calsyn

Morse

et al. 1998

J. Community Psychol.

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An experimental comparison of three types of case management for homeless mentally ill persons

Abstract: Assertive community treatment is superior to broker case management in assisting individuals with serious mental illness who are at risk of homelessness.

Cited by 111 publications

References 6 publications

The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review

The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review

Racial Health Equity and Social Needs Interventions

Duration of homeless spells among severely mentally ill individuals: A survival analysis

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