This proposal will demonstrate the effects of two housing models for homeless mentally ill adults and determine the relationship between client characteristics, client preferences, clinician judgment and client outcomes in these residences. The study population will consist of homeless individuals from Boston's mental health """"""""transitional"""""""" shelters who suffer from severe and persistent mental illness. Sixty beds at each of two housing options will be available to study participants: independent living and specially designed group homes. The group homes will begin with 24-hour program staff but be designed to foster increased client participation in all aspects of program management with a gradual replacement of professional staff by resident consumers. Consumers experienced in self-help activities will provide on-site consultation and training. By the beginning of year 3 of the grant, it is expected that the residence will function as an autonomous, client-run home. Prior to random assignment to a housing option, we will assess the client's housing preference and the judgment of two clinicians regarding the best housing choice. In addition, each subject will be assigned an intensive clinical case manager, who will maintain ongoing contact with the client on at least a weekly basis and facilitate services provision. Subjects will be interviewed every six months to assess their current symptomatology, level of functioning, satisfaction with their living situation and changes in their housing preferences. Data will be collected on individual characteristics, frequency and intensity of contact with their case managers, use of other community-based mental health services, need for and use of physical health care providers, and psychiatric hospitalization. Subjects will be followed for eighteen months after entry into their housing alternative. The evolution of the consumer=run homes will be described.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Demonstration and Dissemination Projects (R18)
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Harvard University
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Schutt, Russell K; Goldfinger, Stephen M (2009) Fundamental Causes of Housing Loss among Persons Diagnosed with Serious and Persistent Mental Illness: A Theoretically Guided Test. Asian J Psychiatr 2:132
Schutt, Russell K; Seidman, Larry J; Caplan, Brina et al. (2007) The role of neurocognition and social context in predicting community functioning among formerly homeless seriously mentally ill persons. Schizophr Bull 33:1388-96
Caplan, Brina; Schutt, Russell K; Turner, Winston M et al. (2006) Change in neurocognition by housing type and substance abuse among formerly homeless seriously mentally ill persons. Schizophr Res 83:77-86
Seidman, Larry J; Schutt, Russell K; Caplan, Brina et al. (2003) The effect of housing interventions on neuropsychological functioning among homeless persons with mental illness. Psychiatr Serv 54:905-8
Goldfinger, S M; Schutt, R K; Turner, W et al. (1996) Assessing homeless mentally ill persons for permanent housing: screening for safety. Community Ment Health J 32:275-88
Goldfinger, S M; Schutt, R K (1996) Comparison of clinicians' housing recommendations and preferences of homeless mentally ill persons. Psychiatr Serv 47:413-5
Goldfinger, S M; Schutt, R K; Seidman, L J et al. (1996) Self-report and observer measures of substance abuse among homeless mentally ill persons in the cross-section and over time. J Nerv Ment Dis 184:667-72