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

McBride, Timothy D.; Calsyn, Robert J.; Morse, Gary A.; Klinkenberg, W. Dean; Allen, Gary

doi:10.1002/(sici)1520-6629(199809)26:5<473::aid-jcop6>3.0.co;2-s

Cited by 15 publications

(10 citation statements)

References 19 publications

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“…On gender, although men are much more likely than women to enter homelessness, no clear pattern emerges from the studies: Piliavin et al (1993) find that gender makes no difference; Piliavin et al (1996), Culhane and Kuhn (1998) for New York, and Allgood and Warren (2003) find that men stay longer; Culhane and Kuhn (1998) for Philadelphia and Poulin (2007) for New York find that women stay longer. Similarly for mental illness: although people who are mentally ill are more likely to become homeless than people who are not, no clear pattern emerges from the studies on whether mental illness prolongs shelter stays: Culhane and Kuhn (1998) and Allgood and Warren (2003) find no effect of serious mental illness; Piliavin et al (1993) find that prehomeless psychiatric hospitalization leads to shorter spells; while McBride et al (1998) find that mentally ill women stay longer.…”

Section: Empirical Consequences and Testsmentioning

confidence: 99%

Individual homelessness: Entries, exits, and policy

O’Flaherty¹

2012

Journal of Housing Economics

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a b s t r a c tHomelessness is part of the lives of many people. But almost no one is homeless for all or most of his or her life. The median shelter homeless spell is well under a month, and even ''chronic homelessness'' officially entails spells of a year or so. I model homelessness as part of people's lives in a dynamic stochastic framework in continuous time. I can explain many empirical regularities with a parsimonious model: for instance, why the last addresses of homeless people are concentrated in a few low-rent neighborhoods, why homeless entries are hard to predict, why recidivism is common and past homelessness is a good predictor of future homelessness, why some groups recidivate more often than others, why the hazard rate for shelter exit is single-peaked, why effective homelessness prevention programs do not alter the average length of homeless spells. I also examine policy. The optimal homelessness prevention program is Pigouvian and starkly simple. With an optimal prevention program in place, optimal shelter quality maximizes a simple and intuitive expression, and insurance programs always raise social welfare. Most of the previous economics literature about homelessness has been static, but most literature about homelessness outside economics has been dynamic. This paper tries to bring the two strands of literature closer together.

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Section: Empirical Consequences and Testsmentioning

confidence: 99%

Individual homelessness: Entries, exits, and policy

O’Flaherty¹

2012

Journal of Housing Economics

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“…Caton, et al, 2005;McBride et al, 1998). The mental health and substance-related characteristics of our sample also differ from those reported previously, due to our use of psychiatric illness as an inclusion criterion.…”

Section: Discussionmentioning

confidence: 99%

“…Despite evidence linking homelessness to broader social determinants of health (Raphael, 2008), policy makers often attribute the causes of homelessness to individual factors and interventions tend to focus narrowly on individuals who display ''high risk'' characteristics (Shinn, 2007;Wright, Rubin, & Devine, 1998). Several categories of risk factors have been associated with vulnerability to repeated homelessness, including criminal justice contact, mental illness, substance dependence, ethnicity, and social networks (Caton et al, 2000(Caton et al, , 2005McBride, Calsyn, Morse, Klinkenberg, & Allen, 1998;North, Pollio, Smith, & Spitznagel, 1998;Sosin & Bruni, 1997). These factors are themselves a function of poor access to the social determinants of health (Raphael, 2008), illustrating an interaction that cannot be fully understood by studying individual or structural variables independently.…”

Section: Introductionmentioning

confidence: 99%

“…Twenty-nine percent of their sample met criteria for a current mental disorder and 22% met criteria for a current substance use disorder, however, neither of these variables was associated with duration of homelessness. Using survival analysis with a prospective design, McBride et al (1998) included age, gender, race, income, psychiatric diagnosis, and severity of symptoms at intake to predict duration of homelessness within a sample of 215 participants. They found no effect of age or race; males were homeless for longer durations than females; and those with more severe psychiatric symptoms were more likely to be homeless for longer durations, regardless of specific diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia

Patterson

Somers

Moniruzzaman

2012

Mental Health and Substance Use

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Recent research and policy making concerning homelessness has focused on the particular challenges associated with ending chronic homelessness. It is generally assumed that individuals who have been homeless for longer durations have a greater impact on the public system of care and are in need of the most assistance. The aim of this study was to examine key sample characteristics by duration of homelessness (total lifetime duration and longest single episode) using bivariate and multivariable regression analysis. Participants (n ¼ 425) were adults recruited in Vancouver, BC on the basis of absolute homelessness or precarious housing and a current mental disorder. Interviewer-administered questionnaires elicited details concerning demographics, mental illness, substance use, service use, and duration of homelessness. In multivariable models, ''persistent'' homelessness (lifetime duration of three or more years) was independently predicted by male gender, older age, younger age when first homeless, incomplete high school, past month alcohol use, and daily illicit drug use. ''Prolonged'' homelessness, a single episode of one year or more, was independently predicted by older age, younger age when first homeless, current substance dependence, daily illicit drug use, and not seeing a psychiatrist in the past month. Substance use is strongly associated with prolonged and persistent homelessness among people with mental disorders, as is the early experience of first becoming homeless. Our findings replicate and extend those of previous studies, and are discussed in terms of their implications for service delivery and the broader construct of social inclusion.

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“…All participants who receive smart phones will be prompted by the phone to complete one EMA 30 minutes after waking each day for 6 months beginning on the day of the randomization visit. EMA data, collected over a 6-month period, will be used to identify factors that significantly contribute to alcohol/drug use, quality of life, social support, distress, re-arrest (i.e., because re-arrest rates tend to peak within 6-12 months of jail discharge [62]) and continued homelessness (homeless episode duration peaks at 180-190 days [63,64]). …”

Section: Methodsmentioning

confidence: 99%

Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial (Preprint)

Gonzalez¹,

Businelle²,

Kendzor³

et al. 2018

Preprint

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Background. There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive the professional coordination of individualized care (i.e., case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be re-incarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (e.g., food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, legal aid). Many barriers (e.g., limited transportation, inability to schedule appointments, limited knowledge of available services) prevent homeless adults who were recently released from incarceration from obtaining available case management, crisis management, substance abuse, and mental health services.

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

Cited by 15 publications

References 19 publications

Individual homelessness: Entries, exits, and policy

Individual homelessness: Entries, exits, and policy

Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia

Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial (Preprint)

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