HOMELESS M. I. HOUSING AND CASE MANAGEMENT EVALUATION

拟议研究的主要目的是继续评价 麦肯尼研究示范计划对无家可归者的影响。这个 圣地亚哥项目是NIMH在#年资助的六个McKinney项目站点之一 1990年10月。其目的是评估提供 独立住房配套的综合配套服务 为患有严重和长期精神疾病的无家可归者提供替代方案。 共有362名客户被招募到该项目，并被随机 被分配到四个条件：(L)综合病例管理和 住房；(2)传统病例管理(TRDCM)和住房；(3)CCM和 没有住房；和(4)TRDCM和没有住房。到03年年底(93年9月)， 该项目将收集基线和6个月和12个月的后续行动 所有受试者的访谈数据和18个月的随访数据 大约50%。每月案件经理报告和案件档案 将至少收集所有受访者的摘要数据 十二个月。 这项提议将在三年内继续评价后续行动-- 所有科目的项目条目。主要的研究假设是 与最初的拨款相同-全面和 灵活的支持服务和永久住房将产生更好的效果 客户结果包括：a)精神病理学的严重程度；b) 住房稳定性增强；c)功能状况得到改善；d)有所改善 生活质量和生活满意度；e)改善身体健康 以及f)更有效地利用心理健康服务。更多 具体地说，研究人员假设，全面的支持服务 住房将各自产生比比较更好的结果 传统流浪汉病例管理的现状。该设计允许 两种实验条件的相加效应检验 对于交互效果也是如此。 拟议的项目还打算评估“下台”的影响。 最初分配给CCM条件的人员的服务级别(L 和3)。关于CCM是否取得了原始收益，我们知之甚少 在减少或移除支持级别时保持。什么时候 在这两种情况下，客户将完成18个月的全面 案例管理，他们被随机分配到(A)继续 原来的全面案件管理再延长12个月或(B)a 与传统相似的过渡性病例管理条件 无家可归者案例管理。将跟踪与上述相同的结果。

The main purpose of the proposed research is to continue evaluation of the effects of a McKinney Research Demonstration Program for the Homeless. The San Diego Project was one of six McKinney program sites funded by NIMH in October, 1990. Its purpose was to evaluate the effectiveness of providing comprehensive supportive services coordinated with independent housing alternatives for severely and persistently mentally ill homeless persons. A total of 362 clients were recruited to the project and were randomly assigned to four conditions: (l) comprehensive case management (CCM) and housing; (2) traditional case management (TRDCM) and housing; (3) CCM and no housing; and (4) TRDCM and no housing. By the end of year 03 (9/93), the project will have collected baseline and six and twelve month followup interview data on all subjects and eighteen month followup data on approximately 50 percent. Monthly case manager reports and case file abstraction data will have been collected on all respondents for at least twelve months. This proposal is to continue evaluation followup through three years post- project entry for all subjects. The primary research hypothesis is the same as in the original grant - that the combination of comprehensive and flexible supportive services with permanent housing will produce better client outcomes including: a) level of severity of psychopathology; b) increased stability of housing; c) improved functional status; d) improved quality of life and life satisfaction; e) improved physical health condition; and f) more effective use of mental health services. More specifically, researchers hypothesize that comprehensive support services and housing will each produce better outcomes than the comparison condition of traditional homeless case management. The design allows testing for the additive effects of the two experimental conditions and for interactive effects as well. The proposed project also intends to evaluate the effects of a "step down" of service level for those originally assigned to the CCM conditions (l and 3). Little is known concerning whether original gains achieved in CCM are maintained when the level of support is decreased or removed. When clients in those two conditions finish eighteen months of comprehensive case management, they are being randomly assigned to (a) a continuation of the original comprehensive case management for another 12 months or (b) a transitional case management condition which closely resembles traditional homeless case management. The same outcomes as above will be tracked.