Sidewalk Asylums: A History of Homelessness and Mental Illness in New York and LA

描述（由申请人提供）： 成功地预防无家可归现象需要了解无家可归现象发生的广泛背景和采取干预措施消除无家可归现象。本研究的目的是进一步了解这种情况下，特别是要阐明如何在美国城市无家可归的严重精神疾病（SMI）人群中出现。该研究将使用历史方法来描述和比较纽约和洛杉矶的心理健康和住房政策的演变，并在国家政策发展的背景下。我们将参考主要的书面和口头资料，以记录影响不同地区城市无家可归者的政策，特别是关于重度精神障碍患者的政策，以及当地政策应对中涉及的问题和决定。一个核心问题将是住房与精神卫生服务在地方政策应对重度精神障碍者无家可归问题中的相对突出地位。通过阐明关键政策和方案规划决策的背景，本研究的结果有可能提高相关有效干预措施实际到达需要帮助者的可能性。 这项研究建立在2006年由美国国立卫生研究院资助的哥伦比亚无家可归预防研究中心主持的一项试点研究的基础上。在这项研究中，研究人员使用滚雪球抽样技术对纽约和其他城市的政策制定者、心理健康专业人员和社区领袖进行了非结构化访谈，这些人在20世纪60年代至90年代期间塑造了对无家可归和精神疾病的反应。从这些访谈中得出了一些初步结论：（a）人们并不认为精神病患者中的无家可归现象是非机构化的直接结果;（B）决策者直到1970年代末才对无家可归现象予以命名和承认; c）不同城市对重度精神病患者无家可归者的政策差异是由不同的法律的、政治的、以及政策形成的地理环境。该研究将更深入地研究这些初步发现，并将进一步追踪特定条件和精神疾病治疗方法如何与政治社会环境相互作用，以产生当前的无家可归，精神疾病政策和住房干预措施。

DESCRIPTION (provided by applicant): The successful prevention of homelessness demands an understanding of the broad context within which homelessness and interventions to combat it occur. The purpose of this study is to further our understanding of this context, and specifically to elucidate how homelessness in United States cities emerged among severely mentally ill (SMI) populations. The study will use historical methods to describe and compare the evolution of mental health and housing policies in New York and Los Angeles, and in the context of national policy development. We will consult primary written and oral sources to document the policies that have influenced urban homelessness in different locales, especially with regard to people with SMI, as well as the issues and decisions involved in local policy responses. A central concern will be the relative prominence of housing versus mental health services in local policy responses to homelessness among people with SMI. By illuminating the context within which key policy and program planning decisions are made, findings from this study have the potential to improve the likelihood that relevant, effective interventions will actually reach those in need. The study builds upon a pilot study conducted in 2006 under the auspices of the NIH-funded Columbia Center for Homelessness Prevention Studies. In this study the researchers used snowball sampling techniques to conduct unstructured interviews with policymakers, mental health professionals, and community leaders, in New York and other cities, who shaped responses to homelessness and mental illness between the 1960s and 1990s. Several preliminary findings have emerged from these interviews: a) that homelessness among the mentally ill was not perceived to result directly from deinstitutionalization; b) that homelessness was not named and recognized by policymakers until the late 1970s; and c) that diversity in policy toward SMI homeless populations in different cities resulted from the diverse legal, political, and geographical environments in which the policies were formed. The study will examine these initial findings in greater depth and will further trace how specific conditions and mental illness treatment approaches interacted with politico-social environments to produce the current landscape of homelessness, mental illness policy, and housing interventions.