This study tests a typology of homelessness using administrative data on public shelter use in New York City (1988–1995) and Philadelphia (1991–1995). Cluster analysis is used to produce three groups (transitionally, episodically, and chronically homeless) by number of shelter days and number of shelter episodes. Results show that the transitionally homeless, who constitute approximately 80% of shelter users in both cities, are younger, less likely to have mental health, substance abuse, or medical problems, and to overrepresent Whites relative to the other clusters. The episodically homeless, who constitute 10% of shelter users, are also comparatively young, but are more likely to be non‐White, and to have mental health, substance abuse, and medical problems. The chronically homeless, who account for 10% of shelter users, tend to be older, non‐White, and to have higher levels of mental health, substance abuse, and medical problems. Differences in health status between the episodically and chronically homeless are smaller, and in some cases the chronically homeless have lower rates (substance abuse in New York; serious mental illness in Philadelphia). Despite their relatively small number, the chronically homeless consume half of the total shelter days. Results suggest that program planning would benefit from application of this typology, possibly targeting the transitionally homeless with preventive and resettlement assistance, the episodically homeless with transitional housing and residential treatment, and the chronically homeless with supported housing and long‐term care programs.
This article assesses the impact of public investment in supportive housing for homeless persons with severe mental disabilities. Data on 4,679 people placed in such housing in New York City between 1989 and 1997 were merged with data on the utilization of public shelters, public and private hospitals, and correctional facilities. A series of matched controls who were homeless but not placed in housing were similarly tracked. Regression results reveal that persons placed in supportive housing experience marked reductions in shelter use, hospitalizations, length of stay per hospitalization, and time incarcerated. Before placement, homeless people with severe mental illness used about $40,451 per person per year in services (1999 dollars). Placement was associated with a reduction in services use of $16,281 per housing unit per year. Annual unit costs are estimated at $17,277, for a net cost of $995 per unit per year over the first two years.
Research on mental illness in relation to social problems such as crime, unemployment, and homelessness often ignores the broader social context in which mental illness is embedded. Policy, research, and practice will be improved if greater attention is given to social context. The authors critically analyze the approach used in much of the psychiatric services literature to infer links between mental illness and social problems. They compare these studies with studies that have been more validly conceptualized to account for social context. With this broader perspective, the impact of mental illness on crime, unemployment, and homelessness appears to be much smaller than that implied by much of the psychiatric services literature. Poverty moderates the relationship between serious mental illness and social problems. Factors related to poverty include lack of education, problems with employment, substance abuse, and a low likelihood of prosocial attachments. This relationship is often complicated and is not amenable to simple explanations. Research and policy that take this complexity into account may lead to greater effectiveness in interventions for persons with serious mental illness.
Research Summary: This paper examines the incidence of and interrelationships between shelter use and reincarceration among a cohort of 48,424 persons who were released from New York State prisons to New York City in 1995–1998. Results show that, within two years of release, 11.4% of the study group entered a New York City homeless shelter and 32.8% of this group was again imprisoned. Using survival analysis methods, time since prison release and history of residential instability were the most salient risk factors related to shelter use, and shelter use increased the risk of subsequent reincarceration. Policy Implications: These findings show both homelessness and reincarceration to be substantial problems among a population of released prisoners, problems that fall into the more general framework of community reintegration. They also suggest that enhanced housing and related services, when targeted to a relatively small at‐risk group among this population, have the potential to substantially reduce the overall risk for homelessness in the group.
This study tests a typology of family homelessness based on patterns of public shelter utilization and examines whether family characteristics are associated with those patterns. The results indicate that a substantial majority of homeless families stay in public shelters for relatively brief periods, exit, and do not return. Approximately 20 percent stay for long periods. A small but noteworthy proportion cycles in and out of shelters repeatedly. In general, families with long stays are no more likely than families with short stays to have intensive behavioral health treatment histories, to be disabled, or to be unemployed. Families with repeat stays have the highest rates of intensive behavioral health treatment, placement of children in foster care, disability, and unemployment. The results suggest that policy and program factors, rather than family characteristics, are responsible for long shelter stays. An alternative conceptual framework for providing emergency assistance to homeless families is discussed. This study tests a typology of family homelessness based on patterns of public shelter utilization and examines whether family characteristics are associated with those patterns. The results indicate that a substantial majority of homeless families stay in public shelters for relatively brief periods, exit, and do not return. Approximately 20 percent stay for long periods. A small but noteworthy proportion cycles in and out of shelters repeatedly. In general, families with long stays are no more likely than families with short stays to have intensive behavioral health treatment histories, to be disabled, or to be unemployed. Families with repeat stays have the highest rates of intensive behavioral health treatment, placement of children in foster care, disability, and unemployment.The results suggest that policy and program factors, rather than family characteristics, are responsible for long shelter stays. An alternative conceptual framework for providing emergency assistance to homeless families is discussed. Keywords IntroductionResearch on typologies of homelessness among unaccompanied or single adults has identified distinct patterns of shelter utilization that are associated with theoretically consistent population characteristics (Kuhn and Culhane 1998). The identification of a pattern of chronic homelessness, in particular, has shown that a small subset (10 percent) of single adults who become homeless stay in shelters over extended periods. Nearly all of them have some disability or significant behavioral health problem that limits their ability to make a stable exit from homelessness without subsidized housing and social supports. Another group (10 percent) uses shelters episodically over several years, and half of that group also has potentially disabling behavioral health problems. Alternatively, most adults (80 percent) experience short-term, temporary homelessness and would appear to be candidates for prevention or rapid relocation programs. Most of them make sustained and independ...
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