Reliability and validity of the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT) in real-world implementation

Placement of chronically homeless into different types of permanent supportive housing before and after a coordinated entry system: The influence of severe mental illness, substance use disorder, and dual diagnosis on housing configuration and intensity of services

“…Our equivocal findings regarding placement after implementation of the CES may also have to do with problems that have been identified in the vulnerability screening instrument and its implementation (Balagot et al, 2019; Brown et al, 2018). SMI and SUD assessments at screening may be particularly unreliable.…”

“…Demand far outmatches supply of PSH, so only those with highest vulnerability scores are likely to be placed in PSH and many eligible people who experience chronic homelessness must wait for places in PSH programs to open. Some changes to screening instruments may help eliminate some of the reliability and validity issues, for example, verifying mental health, substance use, or health problems or eliminating the observer‐rated items that showed poor reliability (Brown et al, 2018). However, this would likely increase the time required to establish eligibility for PSH and thus the time to house those in need.…”

“…Longitudinal research is needed to determine whether the vulnerability indexes used by CES to house the chronically homeless can predict who will benefit most from supportive housing and what kinds of supportive housing best meet the needs for the homeless with different characteristics. The little research that exists suggests that the type of housing that homeless people are placed in is a better predictor of exiting homelessness than the vulnerability index (Brown et al, 2018). Those who received temporary housing subsidies were much more likely to enter the homeless database again than those who received PSH or were housed in mainstream affordable housing.…”

“…The VI‐DSAT is a 50‐item assessment primarily composed of frequency and yes/no questions grouped into four thematic domains including history of housing and homelessness, risks, socialization, and daily functioning. Participants are then scored according to their level of vulnerability (Balagot, Lemus, Hartrick, Kohler, & Lindsay, 2019; Brown, Cummings, Lyons, Carrion, & Watson, 2018). When a supportive housing unit becomes available, participants with the highest vulnerability scores are drawn from the CES, outreach is conducted to locate the individual, intake paperwork is completed, and they are placed in the available unit if the individual desires (AIDS Foundation of Chicago, 2014).…”

“…One study showed that the reliability, internal and predictive validity of the VI‐SPDAT was very poor (Brown et al, 2018). Furthermore, type of housing was a better predictor of returning to homelessness than scores on the vulnerability index with those who received short‐term housing subsidies more likely to return to homelessness than those who received PSH or were housed in the mainstream housing market (Brown et al, 2018). Other research has shown that those who scored higher on the VI‐SPDAT had their eligibility established for PSH more quickly than those who scored lower, but veterans established eligibility faster and more frequently than others regardless of vulnerability scores (Balagot et al, 2019).…”