SAMHSA Offers New Resource for Helping Homeless Persons with Mental Disorders
By Rebecca A. Clay
With a scar on her face betraying a history of physical abuse,
Helen reported being homeless for 3 years. She had experienced audio
hallucinations since girlhood. And, she never received any mental
health treatment or managed to benefit from substance abuse treatment.
People like Helen were once thought to be unreachable. But after
more than 15 years of study, research shows that homeless people
who have mental illness and/or co-occurring substance abuse disorders
can indeed benefit from integrated mental health services, substance
abuse services, and supportive housing. Now, a forthcoming publication
from SAMHSA's Center for Mental Health Services (CMHS) gathers
that evidence and offers practical advice for planning, organizing,
and sustaining comprehensive services designed to end homelessness.
Featuring Helen's story, Blueprint for Change: Ending
Chronic Homelessness for Persons with Serious Mental Illnesses and/or
Co-Occurring Substance Use Disorders is available in an online
version on SAMHSA's Web site. The print version of the book
should be available early this year.
"We know what works," said Frances L. Randolph, Dr.P.H.,
Chief of the Homeless Programs Branch at CMHS, noting that
the book will be sent to state officials nationwide. "Now
we must put what we know to work. This book will be a useful roadmap
for states and communities that are serious about ending chronic
Back to Top
An estimated 200,000 Americans experience chronic homelessness.
More than 40 percent may have substance use disorders, and 20 percent
have serious mental disorders. Some homeless persons have both.
Over the years, SAMHSA and other Federal Agencies sponsored research
and demonstration programs to determine how to best serve this complex
population. In addition, hundreds of community-based providers continue
to work on the problem. Together, they have replaced many misconceptions
with evidence-based findings.
Consider outreach to homeless people with mental illness and/or
substance abuse disorders. Once thought of as a non-traditional
service, outreach is now recognized as the most important step in
connecting such individuals to the services they need. Housing is
another consideration. In the past, group homes for people with
mental illness were the norm. Now, researchers know that these individuals
prefer regular housing and that housing with supportive services
can help them recover. What's more, researchers discovered
that providing regular housing is actually cheaper than allowing
people to remain homeless.
Getting states and communities to put those kind of research findings
to work is the goal of Blueprint for Change.
The book comprises four main sections:
- Before You Begin. In this section, readers learn
more about the changing context of care and our Nation's response.
Risk factors for homelessness and challenges in serving this population
are described. And, the principles needed for a comprehensive system
of care are explained.
- Plan for Services. This section provides detailed
suggestions for how to establish and finance a comprehensive,
integrated system of care.
- Organize Services. Communities don't
have to start from scratch to organize services to help homeless
people with mental illnesses and substance abuse. This section
offers an overview of proven practices that have worked in the field in
the past. Also, specific tips are provided on how to make the best
use of Federal resources.
- Sustain Services. It's often easier to
create a new program than it is to sustain an existing program
once the original funding ends. Evaluation is a critical step
because funding entities need to see that a program is actually
achieving its goals. It's also important to know how to
put the wide array of mainstream resources to work for people
who are homeless.
Blueprint for Change also includes a comprehensive list
of additional resources.
According to Blueprint, these types of integrated services
helped Helen regain control of her life. Referred by a homeless
shelter, she moved into a supportive residential program at the
local YMCA. There, she worked with staff on basic life skills like
hygiene and food preparation, started seeing a psychiatrist at the
on-site mental health clinic, and stopped drinking. Today, she lives
in a large studio apartment, happy to be cooking her own meals again
and enjoying her own space.
Blueprint for Change: Ending Chronic Homelessness for Persons
with Serious Mental Illnesses and/or Co-Occurring Substance Use
Disorders is available from SAMHSA's
National Resource Center on Homelessness and Mental Illness.
Call the Center at 1 (800) 444-7415 for
free copies. Also visit the Center's Web site at www.nrchmi.samhsa.gov.
The site features fact sheets; additional publications; information
about training and technical assistance opportunities; bibliographies;
contact information for national organizations concerned with mental
illness, housing, and homelessness; and other resources.
For more specific information related to this topic, contact Fran
Randolph at the CMHS Homeless Branch at (301) 443-3706.
Back to Top