Time-Limited Case Management for Homeless Mothers With Mental Health Problems: Effects on Maternal Mental Health

Samuels, Judith; Fowler, Patrick J.; Ault-Brutus, Andrea; Tang, Dein-In; Marçal, Katherine E.

doi:10.1086/684122

Cited by 36 publications

(70 citation statements)

References 31 publications

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“…Another interpretation is that homeless shelters provide the equivalent of all mainstream services “in house,” eliminating the need for outside services during a shelter stay. Many shelters do provide a number of services to families, but type and quality of services differ widely by shelter and city (Lorelle and Grothaus 2015; Samuels et al 2015). A third interpretation is that upon shelter entry and throughout the duration of a shelter stay, families are unable to maintain contact with mainstream services, even when services are still needed.…”

Section: Homelessness and Child Mental Healthmentioning

confidence: 99%

A Theory of Mental Health and Optimal Service Delivery for Homeless Children

Marçal

2016

Child Adolesc Soc Work J

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Homeless children are a vulnerable group with high risk for developing mental health disorders. The pathways to disorders among homeless children have not been fully elucidated, with significant logistical and measurement issues challenging accurate and thorough assessment of need. The environments of homeless children are uniquely chaotic, marked by frequent moves, family structure changes, household and neighborhood disorder, parenting distress, and lack of continuous services. Despite high rates of service use, mental health outcomes remain poor. This paper reviews the literature on homeless children’s mental health, as well as prior theoretical explorations. Finally, the paper proposes a theoretical model that explains elevated rates of mental health problems among homeless children as consequences of harmful stress reactions triggered by chronic household instability along with repeated service disruptions. This model draws upon existing conceptual frameworks of child development, family poverty, health services utilization, and the biology of stress to clarify the role of environmental chaos in the development of child emotional and behavioral problems. Potential strategies to mitigate the risk for mental health disorders among homeless children and future research directions are discussed.

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Section: Homelessness and Child Mental Healthmentioning

confidence: 99%

A Theory of Mental Health and Optimal Service Delivery for Homeless Children

Marçal

2016

Child Adolesc Soc Work J

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“…A randomized controlled trial in Westchester, NY assigned mothers with mental health problems entering homeless shelter to permanent housing plus time-limited case management adapted from the Critical Time Intervention ( n = 97) or permanent housing ( n = 110). Results suggested families assigned to supportive housing housed more quickly and children experienced more positive well-being over a 2-year follow-up; however, no differences emerged on child out-of-home placement (Samuels et al, 2015; Shinn, Samuels, Fisher, Thompkins, & Fowler, 2015). The large-scale randomized controlled trial of homeless services also showed no impact of transitional housing that provided housing up to 24 months plus case management on formal or informal out-of-home placements (Gubits et al, 2016; Shinn et al, in press).…”

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 89%

Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Fowler

Farrell

Marçal

et al. 2017

American J of Comm Psychol

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Inadequate housing threatens family stability in communities across the United States. This study reviews emerging evidence on housing interventions in the context of scale-up for the child welfare system. In child welfare, scale-up refers to the extent to which fully implemented interventions sustainably alleviate family separations associated with housing instability. It incorporates multiple aspects beyond traditional measures of effectiveness including costs, potential reach, local capacities for implementation, and fit within broader social services. The framework further encompasses everyday circumstances faced by service providers, program administrators, and policymakers who allocate resources under conditions of scarcity and uncertainty. The review of current housing interventions reveals a number of systemic constraints for scale-up in child welfare. Reliance on rental assistance programs limits capacity to address demand, while current practices that target the most vulnerable families may inadvertently diminish effectiveness of the intervention and increase overall demand. Alternative approaches that focus on homelessness prevention and early intervention must be tested in conjunction with community initiatives to increase accessibility of affordable housing. By examining system performance over time, the scalability framework provides an opportunity for more efficient coordination of housing services within and outside of the child welfare system.

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“…78,85 Critical time intervention was beneficial in reducing the number of homeless nights (mean difference -591, p < 0.001) and the odds of homelessness (OR 0.23, 95% CI 0.06 to 0.90) during the final 18 weeks of follow-up. 91 Participants receiving the treatment were rehoused sooner than those receiving standard care, 95 but did not spend more days rehoused. 90 Adults receiving critical time intervention showed significant improvements in psychological symptoms (mean difference -0.14, 95% CI -0.29 to 0.01).…”

Section: 29mentioning

confidence: 99%

“…A scoping review of the literature on interventions for homeless women (Christine Mathew, Bruyère Research Institute, Ottawa, Ont. : unpublished data, 2020) yielded 4 systematic reviews [153][154][155][156] and 9 randomized controlled trials (RCTs) 36,60,92,95,[157][158][159][160][161] that focused specifically on homeless and vulnerably housed women. Findings showed that PSH was effective in reducing the risk of intimate partner violence and improving psychological symptoms.…”

Section: Womenmentioning

confidence: 99%

Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

Pottie

Kendall²,

Aubry³

et al. 2020

CMAJ

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H omeless and vulnerably housed populations are heterogeneous 1 and continue to grow in numbers in urban and rural settings as forces of urbanization collide with gentrification and austerity policies. 2 Collectively, they face dangerous living conditions and marginalization within health care systems. 3 However, providers can improve the health of people who are homeless or vulnerably housed, most powerfully by following evidence-based initial steps, and working with communities and adopting anti-oppressive practices. 1,4,5 Broadly speaking, "homelessness" encompasses all individuals without stable, permanent and acceptable housing, or lacking the immediate prospect, means and ability of acquiring it. 6 Under such conditions, individuals and families face intersecting social, mental and physical health risks that significantly increase morbidity and mortality. 7,8 For example, people who are homeless and vulnerably housed experience a significantly higher prevalence of trauma, mental health conditions and substance use disorders than the general population. 7,9 Canadian research reports that people who experience homelessness face life expectancies as low as 42 years for men and 52 years for women. 7 A generation ago, homeless Canadians were largely middleaged, single men in large urban settings. 10 Today, the epidemiology has shifted to include higher proportions of women, youth, Indigenous people (Box 1), immigrants, older adults and people from rural communities. 13,14 For example, family homelessness (and therefore homelessness among dependent children and youth) is a substantial, yet hidden, part of the crisis. 15 In 2014, of the estimated 235 000 homeless people in Canada, 27.3% were women, 18.7% were youth, 6% were recent immigrants or migrants, and a growing number were veterans and seniors. 10

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Time-Limited Case Management for Homeless Mothers With Mental Health Problems: Effects on Maternal Mental Health

Cited by 36 publications

References 31 publications

A Theory of Mental Health and Optimal Service Delivery for Homeless Children

A Theory of Mental Health and Optimal Service Delivery for Homeless Children

Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

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