Effectiveness of outreach to homeless substance abusers

Substance abuse is a frequent and complicating feature of homelessness. Bar riers to service access have prevented homeless individuals from receiving substance abuse care. Outreach to homeless persons is a mechanism for ident ifying homeless substance abusers and engaging them in treatment. This stud y describes a program of substance abuse treatment conducted by a medical c are provider for homeless persons in Baltimore, Maryland and compares chara cteristics of outreach recipients to those of walk-in clients. The study al so examines the differences in drug abuse pathology and selected treatment outcomes among homeless and non-homeless clients and the extent to which ho meless persons are unidentified in the drug abuse treatment reporting syste m of the state. Homelessness is about 5.5 times more prevalent in the clien tele of drug abuse treatment programs than is reflected in the statewide su bstance abuse management information system of Maryland. Composite scores o n the Addiction Severity Index for homeless individuals are significantly h igher (reflecting more serious problems) on every measure in the interview, compared to non-homeless individuals. Except for residential treatment set tings, homeless persons demonstrate a shorter length-of-stay in substance a buse treatment than housed clients. Our outreach effort successfully locate d its targets. Outreach clients reported significantly higher levels of sub stance abuse than walk-in clients. In addition 42.3% of outreach contacts b ecame service recipients. These findings indicate that outreach can be a su ccessful method of targeting and engaging a segment of homeless substance a busers who are otherwise difficult to engage in treatment. (C) 1999 Publish ed by Elsevier Science Ltd. All rights reserved.