CASE MANAGED RESIDENTIAL CARE FOR HOMELESS ADDICTED VETERANS - RESULTS OF A TRUE EXPERIMENT

OBJECTIVES. The effectiveness of case-managed residential care (CMRC) in reducing substance abuse, increasing employment, decreasing homeles sness, and improving health was examined. METHODS. A five-year prospec tive experiment included 358 homeless addicted male veterans 3, 6, and 9 months during their enrollment and at 12, 18, and 24 months after t he completion of the experimental case-managed residential care progra m. The customary control condition was a 21-day hospital program with referral to community services. RESULTS. The experimental group averag ed 3.4 months in transitional residential care with ongoing and follow -up case management for a total of up to 1 year of treatment. The expe rimental group showed significant improvement compared with the contro l group on the Medical, Alcohol, Employment, and Housing measures duri ng the 2-year period. An examination of the time trends indicated that these group differences tended to occur during the treatment year, ho wever, and to diminish during the follow-up year. CONCLUSIONS. Within groups, significant improvements were observed with time from baseline to all posttests on the four major outcomes. We learned, however, tha t veterans had access to and used significant amounts of services even without the special case-managed residential care program. This parti ally may account for improvements in the control group and may have mu ted the differences between groups.