RESEARCH INFORMATION ON INDEPENDENT LIVING
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Volume 1, Issue 4

Homelessness & Psychiatric Disabilities

The last century saw the shift from institutionalization of people with psychiatric disabilities to the community. While this was a major step forward for independent living, it still remains that the population of people with psychiatric disabilities needs a wide range of community-based services, intensive outreach, acute care services, and income support.

The need for support is clear: one recent study found that 36% of people who left psychiatric institutions were homeless within six months. Once on the streets, the trauma and stress of street life can increase psychiatric symptoms.

Homelessness also can worsen health problems, too, such as diabetes, AIDS, asthma, and physical disabilities.

Getting support services to people with psychiatric disabilities in general can be hard and is especially so when they lack permanent housing. One reason for the difficulty is the homeless population with psychiatric disabilities often distrusts large agencies and lack family members to help them understand the bureaucratic process. This population also has thinking and perception problems.

Here are findings from recent studies that show how services can better reach and assist homeless people with psychiatric disabilities.

• Assertive community treatment programs in which a team of case managers act as around-the-clock consumer advocates have proven more effective than traditional programs.
• Two service programs housed at one place improve access to disability entitlements.
• Services are better provided when programs cooperate and communicate with each other. For example, a team of people from agencies offering assistance is easier for a person with psychiatric disability to use than dealing with an individual from each agency.
• Mobile case management — a team formed of a psychiatric nurse, two case managers, and a project director — has been effective in service provision. In this form of service delivery, the team goes to the individual rather than requesting the individual coming to it for assistance.

Because centers for independent living have the potential to help, the Research and Training Center on Independent Living at the University of Kansas hosted a conference to look closer at the population's needs. Affordable, decent housing was one of the greatest needs noted at the conference and its lack was attributed to the population's low incomes and shortage of low-cost housing.     

Cindy Higgins, The Research and Training Center on Independent Living, The University of Kansas, 1000 Sunnyside Ave., Room 4089 Dole Center, Lawrence, KS 66045-7555, (785) 864-4095, E-mail: [email protected]. This project funded by National Institute on Disability Rehabilitation Research grant #H133A980048.

            Information for this review came from the interactive Research Information on Independent Living (RIIL) database at www.getriil.org, which contains research summaries related to independent living with disabilities. A special effort has been made to include information that independent leaders in the field said they wanted, namely topics regarding accessible, affordable housing, effective advocacy for rural areas, effective transition from schools and nursing homes, accessible, affordable transportation, reaching underserved populations, policies that impede independent living, rural health care services, and Medicaid/Medicare regulations for durable equipment.