Marjorie J. Robertson

Getting off the streets: Economic resources and residential exits from homelessness

Based on a 15-month prospective study, the following variables demonstrated an association with residential stability in a countywide probability sample of 397 homeless adults: female gender, a history of less than 1-year homelessness, absence of a health problem that limited work ability, entitlement-benefit income, and use of subsidized housing. Multivariate analyses show that two forms of public support—entitlement income and subsidized housing—were the most important variables associated with exits from homelessness into stable housing. Homeless adults with substance use disorders were more likely than other homeless adults to obtain unstable, but not stable housing. Homeless adults with mental disorders were no less likely than other homeless adults to report stable housing. Stable housing is necessary to break the cycle of homelessness, and economic resources such as entitlement income and subsidized housing are associated with stable housing for homeless adults.© 1999 John Wiley & Sons, Inc.

Disaffiliation, Substance Use, and Exiting Homelessness

This study tested whether social affiliation was associated with exits from homelessness for a county-wide probability sample of 397 homeless adults who were followed over a 15-month period culminating in 1992. For the total sample, support from family or friends and service use were related to an increased likelihood of exiting from homelessness. Surprisingly, exits from homelessness were associated with social affiliation (i.e., support from family/friends and services use) only among homeless adults who did not have current substance-use disorders. This relationship did not hold for those with current substance-use disorders. Findings suggest that homeless adults without current substance-use disorders may be better able to engage services and support from family/friends to exit homelessness than homeless adults who have current substance-use disorders. Perhaps service providers who are targeting homeless adults with substance-use disorders and want to help them exit homelessness need to emphasize initiating substance-use treatment before addressing other issues.

Homeless women with children. The role of alcohol and other drug abuse.

For some women with children, alcohol and other drug use may be an important risk factor for homelessness because it may interfere with a womans capacity to compete for scarce resources such as housing, employment, or services. The impact of various policy decisions on homeless women, their dependent children, and the family unit is considered, including womens right to privacy, criminalization of drug use, and scarcity of appropriate treatment programs for homeless women.

Longitudinal perspective: adverse childhood events, substance use, and labor force participation among homeless adults

Objectives: We examined the long‐term effects of adverse childhood events on adulthood substance use, social service utilization, and subsequent labor force participation. Methods: A county‐wide probability sample of 397 homeless adults was interviewed three times in a 15‐month period. By using a path model, literature‐based relationships between adverse childhood events and labor force participation with the mediating effects of adulthood substance use and service use were tested. Results: Adverse childhood events were precursors to adulthood alcohol and drug use. Consistent substance use was negatively associated with long‐term labor force participation and with social service utilization among homeless adults. Adverse events at childhood, however, were positively associated with service use. Conclusions: Adverse childhood events may contribute to negative adulthood consequences, including consistent substance use and reduced labor force participation. Agencies that are involved in halting the abuse or neglect also should participate in more preventive interventions. Job‐related assistance is particularly important to facilitate employment and labor force participation among homeless adults.

Substance use and separation of homeless mothers from their children.

OBJECTIVES This study examined whether homeless mothers with substance use problems were more likely to experience separations from their children and whether recent substance use had an impact on the familys ability to receive public entitlement income consistently over the 15-month study period. METHODS This study used an existing longitudinal data set consisting of a county-wide probability sample of 104 homeless women who had children under 18 years old. RESULTS Only 29.1% of women had all their children with them throughout the 15-month study period. Mothers who had been separated from their children were more likely to have a current substance use disorder and to have been homeless for at least a year compared to other homeless mothers. CONCLUSIONS Because many women with recent substance use had already had lost custody of their children, substance use contributed to loss of child custody among mothers who did not have substance use disorders.

Substance use and labor force participation among homeless adults

Objectives: We measured the proportion of homeless adults in the labor force and examined the impact of substance use on labor force participation. Methods: A county-wide probability sample of 397 homeless adults was interviewed three times in a 15-month period. Results: Almost 80% of homeless adults were employed or looking for work at one point in time; however, only 47.7% remained in the labor force over the 15-month study period. Recent drug users were only 5% as likely as other homeless adults to be in the labor force; and consistent public entitlement recipients were only 18% as likely as other homeless adults to be in the labor force. Conclusions: Recent illicit drug use posed a deterrent to labor force participation among homeless adults, but heavy alcohol use did not. Most homeless adults were not consistently in the labor force and those who were, did not receive public entitlement benefits. This finding poses an interesting dilemma since previous studies indicated that homeless adults, who are consistent public entitlement recipients, were more likely to get housed than those who are not.

CMHS/CSAT Collaborative Demonstration Program for Homeless Individuals

The Collaborative Demonstration Program for Homeless Individuals is providing an opportunity for several community agencies in the United States to explore innovative intervention and treatment strategies to address the needs of homeless people with co-occurring (mental illness and substance abuse) disorders. This cooperative agreement, funded jointly by the Center for Mental Health Services (CMHS) and the Center for Substance Abuse Treatment (CSAT), is a

The impact of childhood foster care and other out-of-home placement on homeless women and their children.

3 million project supporting programs in various community agencies to develop, document, and evaluate programs for persons who are homeless with co-occurring disorders to be used as models in other communities. The program models include: Assertive Community Treatment, Psychosocial Rehabilitation, Therapeutic Community, and an integrated treatment model. The first phase of the two-phase project funded 16 programs in the U.S. to develop manuals within their primary treatment modalities for homeless people with co-occurring disorders. For Phase II of the project, six of the 16 model programs were competitively selected to demonstrate program impact through formal program evaluation efforts. The data derived from the various projects will be compiled into a compendium of information for state agencies and community service providers throughout the U.S.