HOMELESS MI HOUSING AND CASE-MANAGEMENT EVALUATION

拟议研究的主要目的是继续评价 麦金尼无家可归者研究示范计划的影响。的 圣地亚哥项目是年由NIMH资助的六个麦金尼项目地点之一。 1990年10月 其目的是评估提供 与独立住房相协调的综合支助服务 为患有严重和持续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，并随机 （l）全面个案管理（CCM）; 住房;（2）传统病例管理（TRDCM）和住房;（3）CCM和 无住房;（4）TRDCM和无住房。到03年底（9/93）， 该项目将收集基线以及6个月和12个月随访数据 所有受试者访谈数据和18个月随访数据， 大约50%。每月个案经理报告和个案档案 将收集所有受访者至少 十二个月。 这项建议是在评估结束后的三年内继续开展评估后续行动。 所有科目的项目输入。主要的研究假设是 与最初的补助金相同-综合和 灵活的支持性服务和永久性住房将产生更好的 患者结局包括：a）精神病理学的严重程度; B） 提高住房的稳定性; c）改善功能状态; d）改善 生活质量和生活满意度; e）改善身体健康 （f）更有效地利用心理健康服务。 更 特别是，研究人员假设，全面的支持服务， 和住房都会产生更好的结果 传统的无家可归者管理。 该设计允许 测试两个实验条件的加和效应， 互动效果也是如此。 拟议的项目还打算评估"下台"的影响 最初分配给CCM条件的服务级别（l 和3）。很少有人知道CCM是否取得了原始增益 当支持水平降低或移除时，当 在这两种情况下的客户完成18个月的综合 案件管理，他们被随机分配到（a）继续 原有的全面个案管理再延长12个月或（B）a 与传统的个案管理模式极为相似的过渡性个案管理模式 流浪汉案件管理将跟踪上述相同的结果。

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.