Serving Homeless Welfare Clients With ADM Problems

描述(由申请人提供)：我们提交此提案是为了回应PA-02-150，“对有酗酒、药物滥用或精神(ADM)障碍的无家可归者的服务和干预研究”。该项目旨在更好地了解在不断变化的福利体系中应对酒精、毒品和精神健康(ADM)问题和无家可归问题的障碍。公共援助方案是向需要收入支持、住房、职业康复、保健和行为保健的无家可归者和其他贫困成年人提供服务的重要途径。福利改革下的全面政策变化正在以一种尚未完全理解的方式影响着为无家可归者提供的公共服务。 该项目利用了NIAAA资助的福利受助人纵向研究的二次分析，其中包括向贫困家庭和当地一般援助受助人提供临时援助的代表性样本。在福利改革之后，研究参与者在五年多的时间里被跟踪和重新采访。该项目用新的人种学数据补充了这些二次分析，即服务提供者如何应对为无家可归者提供中介服务的两难境地，以及无家可归的成年人如何遇到服务障碍。拟议的分析建立了无家可归成年人对公共援助的各种服务需求的概况，审查了服务提供者如何在现实世界环境中对这些需求做出反应，研究了福利改革政策随着时间的推移对无家可归者的影响，并确定了无家可归者更广泛地使用公共服务的障碍。该项目利用事件历史分析来研究不稳定的住房、行为健康问题和服务使用如何随着时间的推移在受助者的生活中共同演变。来自人种学观察和对服务提供者的访谈的数据为满足无家可归者的公共援助需求方面的组织挑战提供了更广泛的视角。

DESCRIPTION (provided by applicant): We are submitting this proposal in response to PA-02-150, "Services and Intervention Research with Homeless Persons Having Alcohol, Drug Abuse, or Mental (ADM) Disorders." This project seeks to better understand the barriers to responding to alcohol, drug and mental health (ADM) problems and homelessness within the changing welfare system. Public aid programs represent an important gateway into services for homeless and other indigent adults needing income support, housing, vocational rehabilitation, health care and behavioral health care. Sweeping policy changes under welfare reform are affecting public services for the homeless in ways that are not fully understood. The project utilizes secondary analyses of the NIAAA-funded Welfare Client Longitudinal Study, which includes representative samples of Temporary Aid to Needy Families and local General Assistance recipients. Study participants are being followed and re-interviewed over five years in the aftermath of welfare reform. The project supplements these secondary analyses with new ethnographic data on how service providers cope with the dilemmas of brokering services for the homeless, and on how homeless adults experience barriers to services. Proposed analyses develop profiles of the diverse service needs of homeless adults on public aid, examine how service providers respond to these needs in a real world setting, study the consequences of welfare reform policies for homeless clients over time, and identify barriers to the wider use of public services by homeless aid recipients. The project utilizes event history analysis to study how unstable housing, behavioral health problems and the use of services co-evolve over time in the lives of aid recipients. Data from ethnographic observation and interviewing of service providers offer a broader perspective on the organizational challenges to meeting the needs of homeless people on public aid.