A number of models of intensive case management have been promoted and are being used for persons who are homeless and suffer severe mental disability. This proposed study will test the efficacy of the team case management approach which includes assertive outreach and in vivo or in situ teaching of daily skills as compared with the prevailing specialized individual approach which provides advocacy for services well as monitoring and linking of services for persons with severe mental disability, homelessness and who are being released from Philadelphia County Prison system. 120 clients will be randomly assigned to one of these two approaches. The effectiveness of the approach as compared to the prevailing individual case management be assessed by measurement of the following outcome variables: 1) social skills and functioning; 2) client symptomatology, including and alcohol use; 3) medication compliance; 4) quality of life; length and number of hospitalizations; 6) number of emergency visits; 7) nature and frequency of social contacts/leisure activities; 8) nature and length of employment; 9) source and amount of employment income; 10) educational/vocational participation; 11) degree of independence of living arrangement; 12) nature and number of arrests and convictions; 13) degree of satisfaction with treatment. The outcomes will be assessed at 6 and 12 months during the program and at 6 month follow-up. A cost analysis of the two approaches will be conducted. In addition, the incidence of homelessness among a severally mentally disabled, jail population will be determined.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18MH046162-02
Application #
3442798
Study Section
Special Emphasis Panel (SRCM (08))
Project Start
1989-09-30
Project End
1992-08-31
Budget Start
1990-09-01
Budget End
1991-08-31
Support Year
2
Fiscal Year
1990
Total Cost
Indirect Cost
Name
Hahnemann University
Department
Type
Schools of Medicine
DUNS #
City
Philadelphia
State
PA
Country
United States
Zip Code
19129
Solomon, P; Draine, J (1995) Jail recidivism in a forensic case management program. Health Soc Work 20:167-73
Solomon, P; Draine, J (1995) Issues in serving the forensic client. Soc Work 40:25-33
Solomon, P; Rogers, R; Draine, J et al. (1995) Interaction of the criminal justice system and psychiatric professionals in which civil commitment standards are prohibitive. Bull Am Acad Psychiatry Law 23:117-28
Draine, J; Solomon, P; Meyerson, A (1994) Predictors of reincarceration among patients who received psychiatric services in jail. Hosp Community Psychiatry 45:163-7
Solomon, P; Draine, J; Meyerson, A (1994) Jail recidivism and receipt of community mental health services. Hosp Community Psychiatry 45:793-7
Solomon, P L; Draine, J N; Marcenko, M O et al. (1992) Homelessness in a mentally ill urban jail population. Hosp Community Psychiatry 43:169-71