CHARACTERISTICS AND TREATMENT OF HOMELESS, MENTALLY-ILL, CHEMICAL-ABUSING MEN

Comparing two types of treatment modalities in treating homeless, ment ally ill, chemical-abusing (HMICAs) men and studying their characteris tics, 723 HMICAs were interviewed on their childhood and family backgr ound and their psychiatric and substance abuse disorders, and then ran domly assigned into either therapeutic community (TC) or community res idence (CR) programs. The TC and CRs were found to differ from one ano ther in their intake and admission procedures, their preadmission and postadmission dropout rates, and the effects of treatment on psycholog ical status. The TC admitted their clients into treatment faster, tend ed to take more impaired clients, and had a lower preadmission dropout rate than the CRs did. The CRs had a lower postadmission dropout rate and were able to retain clients longer than the TC did. Comparing cli ents who stayed in treatment one year or longer, the TC appears to be more effective than the CRs in reducing depressive, psychotic, and fun ctional symptoms. HMICAs' childhood and family background reveal sever e parental deprivations and high prevalence of alcohol and other drug abuse, mental illness, and criminal behavior among the clients' parent s. HMICAs' characteristics suggest that these men are completely outsi de mainstream society. They are severely impaired psychiatrically, chr onically addicted, and often involved with the criminal system, thus o ccupying multiple deviant roles.