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SAMHSA News - November/December 2005, Volume 13, Number 6

Conference Addresses Homelessness

People with serious mental illnesses and co-occurring substance use disorders are especially vulnerable to becoming homeless during the transition from institutions such as inpatient treatment or jail to community-based care.

A workshop on transition planning was one of more than 65 sessions offered at SAMHSA's third national conference on ending homelessness among persons with mental illnesses and/or substance use disorders, Preparing People for Change: Knowledge & Choice. The conference convened in Washington, DC, at the end of October.

"We wanted everyone to come away from the conference with new skills and information about new approaches," said Lawrence D. Rickards, Ph.D., Chief of the Homeless Programs Branch of the Division of Service and Systems Improvement at SAMHSA's Center for Mental Health Services.

More than 800 service providers, consumers, and Federal staff participated in the conference, according to Dr. Rickards. "A learning community was established here," he said. "Participants had the opportunity to network and exchange perspectives with colleagues from across the Nation."

In addition, SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W., presented Exemplary Program Awards to 12 organizations that serve the homeless population in cities across the Nation.

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Transition Planning

Panelists from SAMHSA's National Resource and Training Center on Homelessness and Mental Illness (NRTC), the National GAINS Center, and the Massachusetts Department of Mental Health shared their strategies for preventing homelessness during transition periods.

Inadequate planning time, stigma and discrimination, lack of accountability and incentives, and even differences in language among service systems are significant challenges to effective transition planning for persons with mental illnesses and/or substance use disorders, according to Francine Williams, M.A. "But the greatest challenge," she said, "is not in the discharge planning process, it is in the development of available housing." As a result, creating a variety of housing options is one of eight principles of effective discharge planning that NRTC supports.

Panelists from the New York State prison system and the Massachusetts Department of Health shared their strategies for success.

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New York State

Daniel Abreu, M.S., C.R.C., of the GAINS Center, described the barriers to effective transition planning for persons with mental illnesses discharged from New York State prisons and jails. These include a fear of ex-offenders (even among service providers); the difficulty in coordinating the criminal justice and mental health service systems; and negotiating Social Security and Medicaid for people in transition.

In New York State, planning for prison discharge can begin as early as admission.

Pre-release counselors seek to develop a discharge plan, link individuals in prison to services within the communities to which they will be released, and begin the process of securing benefits well in advance of the day of discharge.

Service providers are invited to the prison or jail to meet with individuals in person. Video-conference sites allow housing interviews to be held before the release date, and a medication grant program provides prescription cards for released prisoners, so that they can fill prescriptions during the time between release and Medicaid approval.

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Massachusetts recognizes that "housing is a clinical issue," according to Peggy Lester, M.P.A., M.Ed., Director of Housing for the Massachusetts Department of Mental Health. A housing specialist works to promote the development of community-based housing in each of the department's geographic service areas, and the department has developed more than 3,000 beds for persons with serious mental illnesses. These facilities include supportive housing units, group homes, safe havens, and other housing models.

Policy and legislation have played a significant role in the state's success in reducing homelessness among persons released from inpatient services. Through the Special Initiative to House the Homeless Mentally Ill, the state legislature supports more than 1,000 beds for homeless persons with mental illnesses.

"With Hurricane Katrina, the sheer number of people affected by this lethal storm has directed a very powerful spotlight on the challenges that you in this room have been wrestling with for a long time," said Kathryn Power, M.Ed., Director of SAMHSA's Center for Mental Health Services.

"This disaster has elevated the 'issue' of homelessness to dramatic new heights of awareness," she said.

For more information, visit the SAMHSA Web site at

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