This program seeks to provide a supportive, challenging, and sober peer-focused community that promotes a sense of belonging and self-worth and motivates residents toward recovery. In addition, the program provides an integrated continuum of services intended to help HDDVs recover from substance abuse, improve their mental health, and obtain the interpersonal and functional skills they need to progress to independent living. The short-term goals of the 1-year residential program are to decrease alienation and develop a sense of community and trust; improve self-esteem and confidence; build social support; stay sober and attend alcoholics anonymous/narcotics anonymous (AA/NA) meetings; make appropriate use of mental health resources and improve mental health status; improve physical health status; avoid criminal activities; obtain vocational and social skills training; find employment and income; and locate affordable, long-term housing in the community. The evaluation will involve the study of 224 subjects entering VVSD over the course of 18 months. Client progress will be assessed by using ongoing VVSD process data and client interviews as they progress through the five phases of the program. Clients referred out of the program or voluntarily withdrawing will be followed by interview at 6-month intervals. VVSD process data will also be gathered from clients, staff, and VVSD data information systems to document the process of service delivery (e.g., services delivered, attendance, and individual client participation). The comparison groups will include 270 veterans participating in Stand Down, an annual outreach project sponsored by VVSD, which recruits about 600 homeless veterans in San Diego. A few of the Stand Down control group are expected to enter VVSD's rehabilitation center and, therefore, be dropped from the control group. Approximately 50 percent are expected to make significant use of non-VVSD services for the homeless in San Diego county, thereby allowing comparison of the VVSD residential treatment group to the HDDVs obtaining a range of alternate outpatient services and to HDDVs receiving no services.These subjects will be brought into the research project at the same rate as the VVSD clients and will be interviewed at baseline, 6, 12, and 15 months post- entry.
