Housing First for Severely Mentally Ill Homeless Methadone Patients

Abstract

The Housing First approach used by Pathways to Housing, Inc., was used to enhance residential independence and treatment retention of homeless, seriously mentally ill methadone patients. The Keeping Home project first secured scattered-site apartments and assertive community treatment services and then addressed patients’ service needs. Three years post-implementation, methadone treatment retention for 31 Keeping Home patients versus 30 comparison participants (drawn from an administrative database) was 51.6% vs. 20% (p < .02); apartment/independent housing retention was 67.7% vs. 3% or 13% (both p's < .01). Although results firmly support Keeping Home, future research needs to address study's possible database limitations.

KEYWORDS:

• Homelessness
• methadone patients
• mental illness
• independent housing

Acknowledgments

This project was funded in 2003 by a contract from the United States Department of Housing and Urban Development's (HUD) Shelter Plus Care, Supported Housing Program (SHP), to Pathways to Housing, Inc., (PTH), Sam Tsemberis, PhD, Principal Investigator. Additional support was provided by the New York State Office of Mental Hygiene (OMH).

Mr. Karl Loutsis and Mr. William Griffin of OASAS were instrumental in providing support by coordinating the relationship between Mt. Sinai Hospital's Narcotic Rehabilitation Center (NRC), the methadone maintenance treatment program for most of the Keeping Home patients, and PTH's ACT team staff and central office, arranging in-kind support to meet HUD's state fiscal matching requirement. OMH provided direct fiscal support when the in-kind match was disallowed.

Many agencies and individuals contributed to this demanding, complicated effort including the Commissioner of the NYC Department of Correctional Services (DOCS), Mr. Martin Horn, who vigorously supported the project, Kathleen Coughlin, Assistant Commissioner of Discharge Planning, NYC DOCS. The NYC Department of Health and Mental Hygiene, the NYS Department of Mental Health, Prison Health Services in the Riker's Island Jail, the successful efforts of PTH's staff to gain patients’ acceptance for the project, the ACT team members, and the committed staff of Mt. Sinai's NRC and Dr. Bryan Fallon, in working with the serious problems patients presented. It is troubling and sad that for institutional-economic reasons, the NRC was closed after many years of quality community service.