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Services and Supports for Individuals With Co-Occurring Disorders and Long-Term Homelessness: Lessons Learned From the Collaborative Initiative to Help End Chronic Homelessness
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| Presenter(s):
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| Susan Foster, Independent Consultant, sefoster@rcn.com
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| Charlene LeFauve, United States Department of Health and Human Services, charlene.lefauve@samhsa.hhs.gov
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| Marilyn Kresky-Wolff, The CDM Group Inc, marilyn.kresky-wolff@cdmgroup.com
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| Lawrence D Rickards, Center for Mental Health Services, ldrickards@msn.com
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| Abstract:
In 2002, four federal agencies funded the Collaborative Initiative to Help End Chronic Homelessness (CICH). Eleven communities provided housing and supportive services to individuals experiencing long-term homelessness, over half of whom were diagnosed with co-occurring mental health and substance use disorders (COD). Evaluators gathered qualitative data from clients, program team members, and administrators in order to assess lessons learned as grantees implemented treatment strategies. Data were collected from program documents, interview notes, grantee meetings, and conference calls. Atlas.tiG™ software facilitated the text search and coding procedures. This paper presents findings organized around three themes: characteristics and needs of homeless clients with COD; strategies employed to respond to those needs; and challenges associated with implementing an integrated approach to COD. It concludes with recommendations for intervention strategies with clients with COD in non-traditional settings and a call for overcoming workforce and system-level barriers to providing integrated care.
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Comorbid Patients Improve on Substance Use and Psychological Symptoms in Psychiatric Day Treatment
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| Presenter(s):
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| Stephen Magura, Western Michigan University, stephen.magura@wmich.edu
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| Andrew Rosenblum, National Development and Research Institutes Inc, rosenblum@ndri.org
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| Daniela C Schroeter, Western Michigan University, daniela.schroeter@wmich.edu
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| Abstract:
To determine outcomes for drug-using vs. non-drug using patients in a psychiatric day treatment program. New admissions (N=229) to continuing psychiatric day treatment were recruited during 2003-2005. Subjects positive by self-report or urinalysis were categorized as drug users. Six-month follow-up interviews and urinalysis were conducted (82% response). For cocaine, marijuana and opiates, the percentage of patients positive at admission who remitted from drug use at six months after admission significantly exceeded the percentage negative at baseline who initiated drug use (p <.05). Drug and non-drug users experienced similar amounts of decrease in psychiatric symptoms, but drug users did not improve on Quality of Life, whereas non-drug users did. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use drugs over time and by decreasing psychological distress to about the same degree as for non-drug using patients. Support: NIDA R01DA015912.
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