Comparing Two Service Delivery Models for Homeless Individuals With Complex Behavioral Health Needs: Preliminary Data From Two SAMHSA Treatment for Homeless Studies

Abstract

Assertive Community Treatment (ACT) and the Comprehensive, Continuous, Integrated System of Care (CCISC) are two models for delivering services to homeless persons with complex behavioral health needs. This quasi-experimental study presents preliminary data comparing these two programs. The first program was based out of a community mental health center and utilized the ACT model of care with supported housing (ACT-SH), and the second program was based out of a substance abuse treatment agency and used the CCISC model of care in a residential treatment facility (CCISC-RT). Participants completed clinical assessment interviews at baseline before being admitted to the programs and then 6 months later. Measures included the Brief Symptom Inventory (BSI) to measure mental health symptoms; the Treatment Services Needed and Received (TSNR) to assess service needs, utilization, and levels of unmet needs; and a tool assessing employment, housing, and past-month substance use. Results indicated that participants in both interventions reported significant reductions in substance use and mental health symptoms, although the CCISC-RT program was associated with slightly greater reductions in mental health symptoms. Both programs were also associated with significant improvements in residential stability, although participants in the ACT-SH program were more likely to own or rent their own residence 6 months following program enrollment. This study indicates that both the ACT and CCISC models of care can be successfully implemented to serve homeless individuals with behavioral health needs. Although the CCISC-RT program was based in a residential treatment facility and delivered a greater intensity of behavioral health services than the ACT-SH program, results indicate that either approach can successfully be used to assist homeless individuals in obtaining a variety of needed services, reducing their substance use and mental health symptoms, and attaining a stable residence.

KEYWORDS:

• Homelessness
• co-occurring disorders
• supported housing
• integrated treatment
• assertive community treatment
• CCISC

This study was supported by the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services Grant Numbers TI13952 and TI16630. The views and opinions expressed in this manuscript are those of the authors and do not necessarily reflect those of the funding institution.

Notes

∗p < .05.