Risk Factors and the Duration of Homelessness among Drug-Using Arrestees: Evidence from 30 American Counties

Abstract

We examined risk factors influencing length of homelessness among a sample of drug-using adults booked into jails in 30 American counties during the years 2002-2003. Interviews were conducted with 30,634 arrestees. Multinomial logistic regression (MLR) explored the impact of arrestees' drug use histories, prior experiences with alcohol and drug treatment, prior mental health experiences, and previous criminal justice experiences on membership in one of three housing stability categories. MLR results showed that, in comparison to the sporadic homeless, the persistent homeless were a demographically distinct group with significant social and human capital deficits and distinct health risk profiles, including drug use behavior, mental health status, and criminal offending. We argue thatjails are well positioned to serve as a focal point for the delivery ofpublic health and psychiatric services to homeless persons.

Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial

“…Furthermore, homeless adults are more likely to return to jail after incarceration than domiciled adults [ 10 ]. In Texas, more than half of adults released from county jails are rearrested within 1 year [ 11 ], and many of those rearrested are homeless [ 12 ]. In Dallas County alone, 5530 homeless adults were incarcerated in 2013 at an estimated cost of US$12,557,406 (calculated in 2014) [ 13 ].…”

“…Incarcerated homeless adults have a variety of risk factors that increase the likelihood of rearrest. For instance, homeless inmates are more likely than domiciled inmates to have histories of mental illness or substance use disorders [ 9 , 12 ]. The research team’s preliminary studies indicated that homeless adults released from jail in the past year were more likely than those not recently incarcerated to have a history of substance use or mental health problems [ 14 ].…”

Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial (Preprint)

“…[10] In Texas, more than half of adults released from county jails are re-arrested within one year, [11] and many of those re-arrested are homeless. [12] In Dallas County alone, 5530 homeless adults were incarcerated in 2013 at an estimated cost of $12,557,406. [13] Incarcerated homeless adults have a variety of risk factors that increase the likelihood of rearrest.…”

“…For instance, homeless inmates are more likely than domiciled inmates to have histories of mental illness and/or substance use disorders. [9,12] The research team's preliminary studies indicated that homeless adults released from jail in the past year were more likely than those not recently incarcerated to have a history of substance use and/or mental health problems. [14] Thus, there is a strong need for mental health and substance abuse treatment among homeless adults following their release from jail.…”

“…[15][16][17][18] The overall significance and scope of this issue was eloquently stated by Kushel and colleagues in their evaluation of the "revolving door" of homeless incarceration, [16] "High rates of imprisonment among homeless populations may be the end result of a system that does not provide access to timely services, including access to housing, health care, mental health care, and substance abuse treatment, and systems that have obstacles preventing receipt of these services by people exiting prison" (p. 1751). Thus, individuals who leave jail and return to the community without stable housing are at increased risk for premature mortality, [19,20] and re-arrest, [10,12] and are critically in need of interventions that increase access to services. [15] Case Management Case management is the professional coordination of individualized care.…”