SERVICE SYSTEM INTEGRATION, ACCESS TO SERVICES, AND HOUSING OUTCOMES IN A PROGRAM FOR HOMELESS PERSONS WITH SEVERE MENTAL-ILLNESS

Objectives. This study evaluated the hypothesis that greater integrati on and coordination between agencies within service systems is associa ted with greater accessibility of services and improved client housing outcomes. Methods. As part of the Access to Community Care and Effect ive Services and Supports program, data were obtained on baseline clie nt characteristics, service use, and 3-month and 12-month outcomes fro m 1832 clients seen at 18 sites during the first year of program opera tion. Data on interorganizational relationships were obtained from str uctured interviews with key informants from relevant organizations in each community (n = 32-82 at each site). Results. Complete follow-up d ata were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superi or housing outcomes at 12 months, and this relationship was mediated t hrough greater access to housing agencies. Conclusions. Service system integration is related to improved access to housing services and bet ter housing outcomes among homeless people with mental illness.