Housing placement and subsequent days homeless among formerly homeless adults with mental illness

Objective: The study examined the influence of group or individual housing placement and consumer characteristics on the number of days subsequently:h omeless among formerly homeless mentally ill persons. Methods: A total of 3 03 homeless shelter residents with severe mental illness were screened for dangerousness, 118 were randomly assigned to either independent apartment o r staffed group living sites, and 110 were followed for 18 months. Study pa rticipants' sociodemographic characteristics, diagnosis, and residential pr eferences and the residential recommendations made by clinicians were measu red at baseline. Results: Overall, 76 percent of the study participants wer e housed at the end of the 18-month follow-up period, although 27 percent h ad experienced at least one episode of homelessness during the period. The number of days homeless was greater for individuals assigned to independent apartments than for those placed in staffed group homes, but only for memb ers of minority groups. Substance abuse was the strongest individual-level predictor of days homeless. Individuals whom clinicians identified as needi ng group living experienced more days homeless, irrespective of the type of housing they received. Consumers who stated a strong preference for indepe ndent living had more days homeless than those who were amenable to staffed group homes. Conclusions: Although consumers more frequently prefer indepe ndent living, placement in staffed group housing:resulted in somewhat fewer days homeless for some groups of consumers. Further experience of-homeless ness by formerly homeless mentally ill individuals may be reduced by provid ing effective substance abuse treatment and by paying special attention to consumers identified by clinicians to be at particular risk for housing los s.