Time-Limited Case Management for Homeless Mothers With Mental Health Problems: Effects on Maternal Mental Health
Time-Limited Case Management for Homeless Mothers With Mental Health Problems: Effects on Maternal Mental Health
复制标题
DOI：
10.1086/684122
复制
发表时间：
2015-12-01
影响因子：
1.8
通讯作者：
Marcal, Katherine
中科院分区：
文献类型：
--
作者：
Samuels, Judith;Fowler, Patrick J.;Marcal, Katherine
目的：在本研究中，我们测试了一种针对有心理健康问题的无家可归母亲的限时病例管理模式的效果。“家庭关键时间干预”（FCTI）是根据一项经验知情的干预措施改编的，旨在防止个人再次无家可归，该措施为带孩子的母亲提供为期9个月的支持，帮助她们从无家可归者收容所搬进经济适用房。个案管理小组采用结构化的干预措施，鼓励母亲在社区中建立和维持必要的联系，以获得关键的家庭支持。方法：我们采用一项纵向随机对照试验（N = 210）来测试接受FCTI治疗的无家可归母亲是否比接受常规无家可归服务的母亲在精神病理方面有更大的下降。所有家庭都能获得经济适用房。分层线性模型检查进入收容所时以及3、9和15个月后症状的变化。结果：结果表明，随着时间的推移，无论干预条件如何，所有无家可归的母亲都报告了显著的、临床上有意义的精神痛苦下降。治疗效果不会因先前的无家可归经历或接受心理健康服务而有所不同。结论：无家可归给母亲带来了严重的压力，随着家庭重新安置的时间而减少。此外，孕产妇心理健康的改善并不能解释先前的发现，即FCTI与儿童和青少年行为的益处有关。总而言之，FCTI与经济适用房的联系为无家可归的家庭提供了一个有用的方法；然而，需要更多的研究来阐明干预所涉及的机制。
Objective: In this study we test the effect of a time-limited case management model targeting homeless mothers who are experiencing mental health problems. Adapted from an empirically informed intervention to prevent recurrent homelessness among individuals, the Family Critical Time Intervention (FCTI) supports mothers with children for a 9-month period as they move from homeless shelters into affordable housing. The case management team uses a structured intervention to encourage mothers to create and maintain necessary connections in the community for key family supports. Method: We use a longitudinal randomized controlled trial (N = 210) to test whether homeless mothers referred to FCTI experience greater declines in psychopathology compared with those receiving homeless services-as-usual. All families receive access to affordable housing. Hierarchical linear models examine changes in symptomatology at shelter entry and 3, 9, and 15 months later. Results: Results suggest all homeless mothers report significant and clinically meaningful declines in mental distress over time, regardless of intervention condition. Treatment effects do not vary by prior homelessness experiences or receipt of mental health services. Conclusions: Homelessness presents acute stress for mothers that diminishes over time after families rehouse. In addition, improvements in maternal mental health fail to explain prior findings that associated FCTI with benefits in child and adolescent behavior. Taken together, FCTI with connection to affordable housing provides a useful approach with homeless families; however, additional research needs to articulate mechanisms involved in the intervention.