OUTCOMES OF HOMELESS MENTALLY-ILL CHEMICAL ABUSERS IN COMMUNITY RESIDENCES AND A THERAPEUTIC-COMMUNITY

Objective: The feasibility and effectiveness of treating homeless ment ally ill chemical abusers in community residences compared with a ther apeutic community were evaluated. Methods: A total of 694 homeless men tally ill chemical abusers were randomly referred to two community res idences or a therapeutic community. All programs were enhanced to trea t persons with dual diagnosis. Subjects' attrition, substance use, and psychopathology were measured at two, six, and 12 months. Results: Fo rty-two percent of the 694 referred subjects were admitted to their as signed program and showed up for treatment, and 13 percent completed 1 2 months or more. Clients retained at both types of program showed red uctions in substance use and psychopathology, but reductions were grea ter at the therapeutic community. Compared with subjects in the commun ity residences, those in the therapeutic community were more likely to be drug free, as measured by urine analysis and self-reports, and sho wed greater improvement in psychiatric symptoms, as measured by the Ce nter for Epidemiological Studies-Depression Scale and the Brief Psychi atric Rating Scale. Their functioning also improved, as measured by th e Global Assessment of Functioning scale. Conclusion: Homeless mentall y ill chemical abusers who are retained in community-based residential programs, especially in therapeutic communities, can be successfully treated.