Order #: 15364

Authors:

Chen, J.H., Rosenheck, R.A., Greenberg, G.A., Seibyl, C.

Title:

Factors Associated with Receipt of Pension and Compensation Benefits for Homeless Veterans in the VBA/VHA Homeless Outreach Initiative

Source:

Psychiatric Quarterly 78(1): 63-72, 2007. (Journal Article: 10 Pages)

Abstract:

This article examines factors that affect the receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.  Public support payments may facilitate exit from homelessness for persons with mental illness.  The authors examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits.  Those who were awarded benefits were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past.  Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort (authors). 

Order #: 14953

Authors:

Stockdale, S.E., Klap, R., Belin, T.R., Zhang, L., Wells, K.B.

Title:

Longitudinal Patterns of Alcohol, Drug, and Mental Health Need and Care in a National Sample of U.S. Adults.

Source:

Psychiatric Services 57(1): 93-99, 2006. (Journal Article: 7 Pages)

Abstract:

This study examined the level of transient and persistent need and unmet need over time among respondents to a national survey and whether need was met by provision of mental health services or resolved without treatment.  Data from the longitudinal Health Care for Communities (HCC) household telephone survey were used to produce joint distributions of need status and care for two periods (wave 1 data collected in 1997 to 1998 and wave 2 data collected in 2000 to 2001; N=6,659).  Perceived need was measured as a self-report of need for help with a mental or substance abuse problem.  Probable clinical need was assessed with the Composite International Diagnostic Interview, the Alcohol Use Disorders Identification Test, and the 12-item Short Form Health Survey.  High levels of persistent unmet need for care (44 to 52 percent) were found among respondents who had probable clinical need in wave 1.  Although a majority of those with need received some care, an equal proportion (about 30 percent) of those with perceived need did not receive any care.  A substantial portion of need (22 to 26 percent) appears to have resolved without treatment , which may suggest high levels of transient need.  Persistent patterns of unmet need represent important targets for policy and programs that can improve utilization, including outreach, education, and improved insurance coverage (authors). 

Order #: 14731

Authors:

Bradford, D.W., Gaynes, B.N., Kim, M.M., Kaufman, J.S., Weinberger, M.

Title:

Can Shelter-Based Interventions Improve Treatment Engagement in Homeless Individuals With Psychiatric and/or Substance Misuse Disorders?

Source:

Medical Care 43(8): 763-768, 2005. (Journal Article: 5 Pages)

Abstract:

This study sought to evaluate the effectiveness of a shelter-based intervention, including intensive outreach by a psychiatric social worker and availability of weekly psychiatrist visits with continuity of care to engage homeless individuals with psychiatric and substance use problems. Individuals receiving the intervention were more likely to attend and to participate in a substance abuse program than those in the control group. Shelter-based interventions hold promise for improving treatment engagement in homeless populations with psychiatric and substance use problems. Further study should address how to foster care beyond an initial community mental health center (CMHC) appointment and clarify key program components using a wider range of outcome measures (authors). 

Order #: 15043

Authors:

Buck, D.S., Rochon, D., Turley, J.P.

Title:

Taking It to the Streets: Recording Medical Outreach Data on Personal Digital Assistants.

Source:

Computers, Informatics, Nursing 23(5): 250-255, 2005. (Journal Article: 6 Pages)

Abstract:

This article talks about how carrying hundreds of patient files in a suitcase makes medical street outreach to the homeless clumsy and difficult.  Healthcare for the Homeless- Houston (HHH) began a case study under the assumption that tracking patient information with a personal digital assistant (PDA) would greatly simplify the process.  Equipping clinicians with custom-designed software loaded onto Palm V Handheld Computers (palmOne, Inc, Milpitas, CA), Healthcare for the Homeless- Houston assessed how this type of technology augmented medical care during street outreach to the homeless in a major metropolitan area.  Preliminary evidence suggests that personal digital assistants free clinicians to focus on building relationships instead of recreating documentation during patient encounters.  However, the limits of the PDA for storing and retrieving data made it impractical long-term.  This outcome precipitated a new study to test the feasibility of tablet personal computers loaded with a custom-designed software application specific to the needs of homeless street patients (authors). 

Order #: 14517

Authors:

Cunningham, C.O., Shapiro, S., Berg, K.M., Sacajiu, G., Paccione, G., Goulet, J.L.

Title:

An Evaluation of a Medical Outreach Program Targeting Unstably Housed HIV-Infected Individuals.

Source:

Journal of Health Care for the Poor and Underserved 16(1): 127-138, 2005. (Journal Article: 12 pages)

Abstract:

This study's objective was to evaluate a medical outreach program that targets unstably housed individuals infected with human immunodeficiency virus (HIV). One hundred sixty-one cross-sectional interviews were conducted prior to and after establishing a medical outreach program in single room occupancy hotels. Participants' mean age was 42 years; 58% were men, 95% minority, and 59% active substance users. The postintervention group was more likely to have a regular health care provider, and take Pneumocystis carinii pneumonia prophylaxis and antiretroviral medication than the pre-intervention group. Quality of care was more positively perceived in the postintervention group. On multivariate analysis the postintervention group remained more likely to have a regular provider, take antiretroviral medication, and have a better perception of quality of care. A medical outreach program targeting unstably housed individuals infected with HIV was associated with increased use of regular medical care and improved perceived quality of care (authors). 

Order #: 14904

Authors:

Friends of the Shattuck Shelter.

Title:

Keeping Safe on the Streets: A Guide for Providers Working with Homeless Women Living on the Streets.

Source:

Jamaica Plain, MA: Friends of the Shattuck Shelter, 2005. (Guide: 40 Pages)

Abstract:

This guidebook, the first of its kind, exists to help those who help homeless women to increase these women’s chances for safety and to reduce their risks for assault on the streets. This guide is full of concrete, realistic suggestions to keep Boston women alive, healthier, safer, and a little less traumatized. The guide is designed to be easy for street outreach workers, police and others to carry in their pockets, and simple for other cities to adapt and adopt. According to Boston's most recent homeless census, the number of homeless women living on the streets is growing faster than that of all other groups. Violence from their partners and others, including sexual trauma, is a common thread that twists their lives from bad to worse. Moreover, physical and sexual assault deceases a homeless woman's likelihood of moving into permanent housing. Enabling homeless women, often substance-dependent and traumatized, to plan for their own best interests sounds like a tall order. Any guidance needs the best wisdom and input from service providers and public agencies from the fields of domestic violence, sexual assault, addiction treatment, law enforcement, healthcare and homeless services. This new guidebook reflects the expertise of these providers and also the insight and voices of homeless women themselves (authors). Available From: Friends of the Shattuck Shelter, 170 Morton Street, Jamaica Plain, MA 02130, (617) 983-0351, info@shattuckshelter.org, www.friendsoftheshattuckshelter.org/documents/FOSS_Keeping_Safe_Final.pdf

Order #: 14887

Authors:

Rosenblum, A., Magura, S., Kayman, D.J., Fong, C.

Title:

Motivationally Enhanced Group Counseling for Substance Users in a Soup Kitchen: A Randomized Clinical Trial.

Source:

Drug and Alcohol Dependency 80(1): 91-103, 2005. (Journal Article: 13 Pages)

Abstract:

This study randomly assigned 289 soup kitchen guests who reported drug or alcohol problems to information and referral (I&R) plus peer advocacy (peers encouraging subjects to participate in other services) or to an experimental 12-session motivational group followed by a 36-session cognitive-behavioral group plus I&R and peer advocacy.  Experimentals were significantly more likely than the controls to have increased their participation in some type of substance abuse intervention during the follow-up period.  In addition, experimentals were significantly more likely than controls to have reduced both drinking and heavy drinking at follow-up (there was no difference between groups in reduction of cocaine use).  Interaction analysis indicated that the experimental intervention was more effective for participants with higher rather than lower substance abuse severity at baseline.  These results support the concept that motivationally enhanced group counseling, provided as a low-threshold outreach intervention, can help to increase participation in formal treatment and 12-step groups and to reduce substance abuse, particularly for those starting with high severity of use (authors). 

Order #: 14506

Authors:

De la Cruz, F., Brehm, C., Harris, J.

Title:

Transformation in Family Nurse Practitioner Students' Attitudes Toward Homeless Individuals After Participation in a Homeless Outreach Clinic.

Source:

Journal of the American Academy of Nurse Practitioners 16(12): 547-554, 2004. (Journal Article: 8 Pages)

Abstract:

This study uses a retrospective pre/post self-assessment survey to determine the attitudes of family nurse practitioner  (FNP) students toward homeless individuals before and after participating in a homeless outreach clinic (HOC) and to elicit, through focus groups, their perspectives on the homeless population after their HOC participation.  A mixed-methods study using focus group tapes and transcripts of 15 FNP students who were divided into two separate focus groups as well as three completed survey measures: Demographic Data Form, Attitudes Toward Homelessness, and HOC Attendance Form.  Overall, the FNP students revealed no stigmatizing attitudes toward homeless people prior to their HOC participation, but a significant positive change in their attitudes occurred after the experience.  There were significant mean differences in 6 out of the 11 scale items and in overall total mean scores after the HOC experience.  The focus groups revealed the transformation of the students' attitudes toward homeless individuals after their HOC participation, supporting and illustrating the survey findings.  The study findings underscore the importance of including the care of homeless patients in FNP educational programs.  Such exposure provides FNP students with an opportunity to develop the social responsibility to care for all segments of society, especially homeless people, in keeping with nursing's social contract as a helping profession (authors). 

Order #: 14094

Authors:

Food Research and Action Center.

Title:

CACFP for Children and Youth in Homeless, Runaway and Domestic Violence Shelters: Outreach Toolkit.

Source:

Washington, DC: Food Research and Action Center, 2004. (Toolkit: 1 Page)

Abstract:

This resource, available online only, includes program information, outreach and training materials, research and background information and links to other important information and organizations. The Child and Adult Care Food Program (CACFP), a federal entitlement, is an important resource for feeding children and youth in homeless and runaway shelters, domestic violence shelters and some transitional housing. Congress extended food program eligibility for children in shelters from up to 13 years of age to 18 and younger. Including teens in the program will allow runaway shelters to use CACFP. The expansion will also allow the program to provide additional much needed support to homeless, domestic violence, and family shelters. Shelters all over the country can use this program to bring much-needed benefits to children and youth. This site provides tools for state agencies, homeless, runaway, and domestic violence advocates, and anti-hunger groups to maximize the use of the homeless shelter option in CACFP (authors). Available From: Geri Henchy, Food Research and Action Center, 1875 Connecticut Avenue, NW, Suite 540, Washington, DC 20009, (202) 986-2200, ghenchy@frac.org, www.frac.org/html/federal_food_programs/programs/homeless/homeless_index.html

Order #: 13594

Authors:

McBride, N.

Title:

Reaching In to Help Out: Relationships Between HCH Projects and Jails.

Source:

Nashville, TN: National Health Care for the Homeless Council, 2004. (Report: 28 pages)

Abstract:

This report examines the issues surrounding individuals transitioning from jail to community health providers. Working from interviews with nine HCH projects around the country, the author outlines ten significant issues of concern including formal and informal partnerships; good communication; cross-training; attention to timing; access to records; service access pre- and post discharge; access to prescribed medications; key resource gaps; boundary spanning; and transition planning (author). Available From: National Health Care for the Homeless Council, P.O. Box 60427, Nashville, TN 37206, (615) 226-2292, www.nhchc.org/Publications/JailsAndHCH.pdf (COST: $10.00).

Order #: 14073

Authors:

Clark, D.L., Melillo, A., Wallace, D., Pierrel, S., Buck, D.S.

Title:

A Multidisciplinary, Learner-Centered, Student-Run Clinic for the Homeless.

Source:

Journal of Family Medicine 35(6): 394-397, 2003. (Journal Article: 4 Pages)

Abstract:

This article discusses Houston Outreach Medicine Education and Social Services, which teaches students, in multidisciplinary teams using the learner-centered model, to provide primary health care to the homeless. The founding and operational aspects of this educational intervention are presented. Student response to this service-learning program is assessed in terms of educational value using a survey and an analysis of student reflections. Clinical service activities are measured to demonstrate program efficacy. Student participants, especially basic science medical students, value the program due to its contributions to their professional and personal education, as well as their increased understanding of biopsychosocial issues. Learners develop empathy, compassion, and heightened social awareness (authors). 

Order #: 12262

Authors:

Desai, M.M., Rosenheck, R.A., Kasprow, W.J.

Title:

Determinants of Receipt of Ambulatory Medical Care in a National Sample of Mentally Ill Homeless Veterans.

Source:

Medical Care 41(2): 275-287, 2003. (Journal Article: 12 pages)

Abstract:

This study used the Behavioral Model for Vulnerable Populations to identify determinants of receipt of outpatient medical care within 6 months of initial contact with a national homeless veterans outreach program.  Data from structured interviews conducted at the time of program intake were merged with Veterans Affairs administrative data to determine subsequent medical service use.  The authors conclude that a majority of homeless veterans contacted through a national outreach program failed to receive medical services within 6 months of program entry.  Greater efforts are needed to ensure that people who are homeless and have mental illnesses are successfully linked with and engaged in medical treatment (authors). 

Order #: 13913

Authors:

HomeBase and the Center for Common Concerns.

Title:

Outreach Procedures and Protocols Manual for Working with Homeless Adults.

Source:

San Francisco, CA: HomeBase and the Center for Common Concerns, 2003. (Manual: 28 pages)

Abstract:

This manual is designed to be a quick and accessible reference for outreach workers, geared towards outreach work with homeless adults 18 and over.  Separated into three chapters and one appendix section, the authors provide general information regarding outreach work, including recommendations and tips, which will be useful to all beginning outreach workers regardless of location.  The appendix section contains information tailored to Contra Costa County, however communities can adapt the appendix section for their own area (authors). Available From: HomeBase and the Center for Common Concerns, Inc., 870 Market Street #1228, San Francisco, CA 94102, (415) 788-7961, www.homebaseccc.org.

Order #: 14053

Authors:

Latkin, C.A., Sherman, S., Knowlton, A.

Title:

HIV Prevention Among Drug Users: Outcome of a Network-Oriented Peer Outreach Intervention.

Source:

Health Psychology 22(4): 332-339, 2003. (Journal Article: 7 Pages)

Abstract:

In this study, a network-oriented HIV prevention intervention based on social identity theory and peer outreach was implemented for HIV positive and negative drug users. A community sample of 250 were randomly assigned to an equal-attention control condition or a multisession, small-group experimental condition, which encouraged peer outreach; 94% of participants were African American, and 66% used cocaine or opiates. At follow-up, 92% of participants returned, and experimental compared with control group participants were three times more likely to report reduction of injection risk behaviors and four times more likely to report increased condom use with casual sex partners. Results suggest that psychosocial intervention emphasizing prosocial roles and social identity, and incorporating peer outreach strategies, can reduce HIV risk in low-income, drug-using communities (authors). 

Order #: 12011

Authors:

McGuire, J., Rosenheck, R.A., Kasprow, W.J.

Title:

Health Status, Service Use, and Costs Among Veterans Receiving Outreach Services in Jail or Community Settings.

Source:

Psychiatric Services 54(2): 201-207, 2003. (Journal Article: 7 pages)

Abstract:

This article describes a study that compared client characteristics, service use, and health care costs of two groups of veterans who were contacted by outreach workers: a group of veterans who were contacted while incarcerated at the Los Angeles jail and a group of homeless veterans who were contacted in community settings.  The findings show that specialized outreach services appear to be modestly effective in linking veterans who become incarcerated with VA health care services. Although it is clinically challenging to link this group with services, the fact that the rate of current substance use is lower during incarceration may provide a window of opportunity for developing linkages between inmates and community rehabilitative services (authors). 

Order #: 12261

Authors:

Nuttbrock, L., Rosenblum, A., Magura, S., McQuistion, H.

Title:

Broadening Perspectives on Mobile Medical Outreach to Homeless People.

Source:

Journal of Health Care for the Poor and Underserved 14(1): 5-16, 2003. (Journal Article: 11 pages)

Abstract:

This paper discusses a tension between an emergency medicine model of outreach and that of primary care.  In the former model, clinicians evaluate clients on the basis of presenting complaints and refer them for treatment.  The latter is a broader model of comprehensive outreach and/or treatment, where clinicians screen clients and assess them for various conditions offering ongoing evaluation and treatment on site.   The authors suggest that while the model of outreach is applicable for some homeless clients,  the prevalence and overlap of physical complaints, infectious diseases, substance abuse, and psychiatric symptoms among homeless people in New York City has resulted in an evolution toward broader approaches to outreach in this population. The article states that improvements in diagnostic testing and increasingly portable medical technology may make the mobile delivery of medical care to homeless persons increasingly feasible (authors). 

Order #: 12786

Authors:

Nwakeze, P.C., Magura, S., Rosenblum, A., Joseph, H.

Title:

Homelessness, Substance Misuse, and Access to Public Entitlements in a Soup Kitchen Population.

Source:

Substance Use and Misuse 38(3-6): 645-668, 2003. (Journal Article: 23 pages)

Abstract:

This study examined the effects of homelessness on access to public entitlements (Medicaid and Food Stamp Programs) in a soup kitchen population. Data were collected between 1997 and 1999 from a sample of 343 adults at two soup kitchen sites in New York City. Five hypotheses, focusing on the effects of housing status (literal homelessness, unstable housing, and domiciled), frequency of drug/heavy alcohol use, drug/alcohol-user treatment history and childcare responsibilities on access to Medicaid and food stamp programs were tested. Multiple logistic regression analysis indicated that both literal homelessness and unstable housing were associated with less access to Medicaid and food stamps. Other significant findings were: current drug/alcohol-user treatment experience was associated with greater access to both Medicaid and food stamps, frequency of drug/heavy alcohol use was associated with less access to Medicaid only, and caring for children was associated with greater access to food stamps only. These findings support the crucial role of housing status in mediating access to entitlements, and the importance of drug/alcohol-user treatment involvement as a cue to seeking entitlements. The need to reduce health disparities through active and sustained outreach programs designed to enhance homeless persons' access to Medicaid and Food Stamp Programs was discussed (authors). 

Order #: 13167

Authors:

Kraybill, K.

Title:

Outreach to People Experiencing Homelessness: A Curriculum for Training Health Care for the Homeless Outreach Workers.

Source:

Nashville, TN: National Health Care for the Homeless Council, 2002. (Curriculum: 330 pages)

Abstract:

This curriculum is designed to be used by any person or program involved in reaching out to people experiencing homelessness. Parts of the curriculum are specifically oriented to those working in federally-funded Health Care for the Homeless (HCH) projects throughout the United States. The intent of this curriculum is to help workers gain a fuller understanding and appreciation for outreach work. There is no set formula, but it is hoped that by exploring the process and content of outreach from a variety of perspectives, workers will become more effective in their efforts to assist people toward greater stability.  At one level, the curriculum attempts to outline the minimum basic training and knowledge requirements that all outreach workers must possess. At another level, its intent is to help workers develop increased self-awareness, empathy and interaction skills in order to use their knowledge effectively. The purpose of this outreach curriculum is to provide a comprehensive overview of the principles, knowledge, and issues relevant to doing outreach in the HCH context. In addition to providing information, it is intended to engage the participant by using various modalities and activities that appeal to different learning styles (author). Available From: National Health Care for the Homeless Council, P.O. Box 60427, Nashville, TN 37206, (615) 226-2292, www.nhchc.org/Curriculum/curriculum.htm

Order #: 11803

Authors:

Park, M.J., Tyrer, P., Elsworth, E., Fox, J., Ukoumunne, O.C., MacDonald, A.

Title:

The Measurement of Engagement in the Homeless Mentally Ill: the Homeless Engagement and Acceptance Scale - HEAS.

Source:

Psychological Medicine 32(5): 855-861, 2002. (Journal Article: 7 pages)

Abstract:

This paper describes the development and psychometric properties of a new scale, the Homeless Engagement and Acceptance Scale (HEAS). This goal of this study was to produce a concise instrument which could be completed by an informant observer, and which could be utilized for all categories of clients who are homeless and mentally ill to measure the individual's degree of engagement with others and their attitude to interventions (authors). 

Order #: 11802

Authors:

Rosenblum, A., Nuttbrock, L., McQuiston, H., Magura, S., Joseph, H.

Title:

Medical Outreach to Homeless Substance Users in New York City: Preliminary Results.

Source:

Substance Use & Misuse 37(8-10): 1269-1273, 2002. (Journal Article: 5 pages)

Abstract:

The purpose of this study was to conduct a medical, drug user treatment and social needs assessment survey of homeless visitors to the medical van.  The authors also conduct a process and outcome evaluation of the mobile medical outreach clinic with the addition of intensive case management (ICM) as an experimental enhancement.  The article suggests that the incorporation of ICM provided an added benefit of engaging highly impaired individuals and helping them to acquire and maintain public assistance benefits.  The authors assert that the mobile medical outreach appears to provide a good opportunity for identifying serious communicable diseases, HIV counseling, and primary care treatment (authors). 

Order #: 12457

Authors:

Santandrea, L.

Title:

On the Road: In New Jersey, an Agency Reaches Out to Those in Need.

Source:

American Journal of Nursing 102(11): 111, 2002. (Journal Article: 1 pages)

Abstract:

This article discusses the Mobile Outreach Clinic Program of the Visiting Nurse Association of Central New Jersey (VNACJ).  The author looks at the participants and staff involved in this program, as well as the outcomes achieved.  The article examines the health care provided to the homeless by the nursing staff of VNACJ, and explains their perspectives on the work they do. 

Order #: 14074

Authors:

Tischler, V., Vostanis, P., Bellerby, T., Cumella, S.

Title:

Evaluation of a Mental Health Outreach Service for Homeless Families.

Source:

Archives of Disease in Childhood 86(3): 158-163, 2002. (Journal Article: 5 Pages)

Abstract:

This article aims to describe the characteristics of homeless children and families seen by the mental health outreach service (MHOS), to evaluate the impact of this service on the short term psychosocial functioning of children and parents, and to establish perceptions of, and satisfaction with, the service. Twenty seven children from 23 families who were in receipt of the MHOS and 27 children from 23 families residing in other hostels where no such service was available were studied. The MHOS was delivered by a clinical nurse specialist with expertise in child mental health, who offered the following interventions: assessment and brief treatment of mental health disorders in children; liaison with agencies; and training of homeless centre staff.  Children in the experimental group had a significantly higher decrease in Strengths and Difficulties Questionnaire (SDQ) total scores. Having received the intervention was the strongest predictor of improvement in SDQ total scores. There was no significant impact on parental mental health (General Health Questionnaire) scores. Homeless families and staff expressed high satisfaction with the MHOS. This MHOS for homeless families is an innovative intervention which meets the complex and multiple needs of a vulnerable population unable to access mainstream mental health services. The primary objective of the service was to improve child mental health problems; however, the service developed in a responsive way by meeting social and practical needs of families in addition to its clinical role (authors). 

Order #: 14837

Authors:

Woods, E.R., Samples, C.L., Melchiono, M.W., Keenan, P.M., Fox, D.J., Harris, S.K.

Title:

Initiation of Services in the Boston HAPPENS Program: Human Immunodeficiency Virus-Positive, Homeless, and At-Risk Youth Can Access Services.

Source:

AIDS Patient Care and STDs 16(10): 497-510, 2002. (Journal Article: 14 Pages)

Abstract:

This study evaluates the factors associated with initiation of services in the Boston HAPPENS Program, which is a collaborative network of care consisting of multiservice outreach agencies, community health centers and hospitals, for human immunodeficiency virus (HIV)-positive and hard to reach youth who are 12-24 years old.  The program served 2116 youth who were 19.8 +/- 2.9 years old; 64% female; 45% youth of color; 16% gay/lesbian, bisexual, or undecided; and 10% homeless or runaway.  At first contact with the program, 56% received outreach services; and 91% received a health intervention.  Among those receiving a health intervention, 55% had HIV counseling and testing services, 49% medical care, 24% case management, and 9% mental health services.  HIV-positive youth needed more contacts before a first medical visit than those who were HIV-negative or untested.  Different kinds of service sites reached different populations of at-risk youth.  Logistic regression modeling showed that for young women, older age, lesbian-bisexual orientation, substance use, high-risk sexual behaviors, and receiving outreach services at first contact were independent predictors of initiation of services at outreach agencies; however, unprotected sex with males, and pregnancy were associated with a greater likelihood of care at hospitals or community health centers.  For young men, older age, Asian/other ethnicity, and substance abuse were associated with care at outreach agencies; however, positive HIV status and unprotected sex with females were associated with care at hospitals or community health centers.  Comprehensive networks of care offering a continuum of services and a variety of entry routes and types of care sites are needed to connect underserved youth to health care (authors). 

Order #: 11146

Authors:

Keenan, P.A., Keenan, J.M.

Title:

Rapid HIV Testing in Urban Outreach: A Strategy for Improving Posttest Counseling Rates.

Source:

AIDS Education and Prevention 13(6): 541-550, 2001. (Journal Article: 10 pages)

Abstract:

In 1998, 48 % of persons who had HIV testing at publicly funded sites in the United States failed to return for test results and posttest counseling.  Opportunities for timely HIV therapy were lost; valuable resources were wasted.  This study tested the hypothesis that rapid HIV testing enables a high percentage of high-risk outreach clients to learn their serostatus.  The authors did on-site counseling and rapid HIV testing at community-based organizations (e.g. chemical dependency programs, homeless shelters) in North Minneapolis.  The project tested 735 persons.  All but one learned their HIV serostatus.  African Americans made up 79% of subjects.  Rapid testing has a role to play in HIV outreach.  It is useful in populations who are at high risk of HIV infection, who currently are not accessing HIV testing, and who have high failure to return rates.  Future developments in rapid testing technology will make this testing option more convenient and cost-effective (authors). 

Order #: 14075

Authors:

Morris, D.W., Warnock, J.K.

Title:

Effectiveness of a Mobile Outreach and Crisis Services Unit in Reducing Psychiatric Symptoms in a Population of Homeless Persons with Severe Mental Illness.

Source:

Journal of the Oklahoma State Medical Association 94(8): 343-346, 2001. (Journal Article: 3 pages)

Abstract:

The purpose of this study was to use a time-lag design to evaluate the effectiveness of a Mobile Outreach and Crisis Services unit in remitting psychiatric symptomatology, improving global functioning, and decreasing homelessness in a population of homeless, severely mentally ill residing in a mid-sized urban center. Using a time-lag study design, two groups of subjects (25 individuals before receiving services making up the control group and 25 individuals after receiving services making up the experimental group) were contrasted across outcome measures. The results indicate that a MOCS unit utilizing a Program for Assertive Community Treatment mode was effective in significantly decreasing psychiatric symptomatology, reducing homelessness, and increasing global functioning. If carefully implemented and interpreted, a time-lag design may be a means of providing valuable feedback and information in a timely manner (authors). 

Order #: 8872

Authors:

Rowe, M., Kloos, B., Chinman, M., Davidson, L., Cross, A.B.

Title:

Homelessness, Mental Illness and Citizenship.

Source:

Social Policy and Administration 35(1): 14-31, 2001. (Journal Article: 18 pages)

Abstract:

Assertive mental health outreach to persons who are homeless, which operates under the premise that mental illness must be understood and treated within the individual's social and economic environment, points towards the goals of community membership and 'citizenship'--a connection to the rights, responsibilities, roles, and resources that society offers through public and social institutions and informal 'associational life'--for homeless persons.  The authors argue that the concept of citizenship is a useful framework for approaching these goals.  The authors review the principles of assertive mental health outreach and relevant aspects of contemporary citizenship theory; present a case example of outreach leading to a 'citizenship project'; and discuss the potential benefits and pitfalls of a citizenship framework, including strategies and recommendations for program administrators, researchers and policy makers (authors). 

Order #: 8633

Authors:

Fisk, M., Rowe, M. Brooks, R., Gildersleeve, D.

Title:

Integrating Consumer Staff Members Into a Homeless Outreach Projects: Critical Issues and Strategies.

Source:

Psychiatric Rehabilitation Journal 23(3): 244-252, 2000. (Journal Article: 9 pages)

Abstract:

In this article, clinical and consumer staff members describe their experiences employing formerly homeless persons with mental disorders and/or substance abuse disorders on a federally funded homeless outreach team.  The authors identify three challenging issues that emerged: disclosure of disability status; client-staff member boundaries; and workplace discrimination.  The authors then propose three strategies to ease the integration of consumer staff members into their work positions in clinical projects: education and training of agency staff members; individual supervision; and distinguishing between when it is necessary to make reasonable accommodations for consumer staff members from when their work responsibilities need to be modified (authors). 

Order #: 5967

Authors:

Mullins, S.D.

Title:

Steps Out: A Peer-Integrated Outreach and Treatment Model for Homeless Persons with Co-Occurring Disorders.

Source:

Rockville, MD: Substance Abuse and Mental Health Services Administration, undated. (Manual: 53 pages)

Abstract:

This manual describes a peer-based treatment initiative designed to assist homeless individuals who suffer from both substance abuse disorders and co-occurring mental illness.  The program's central philosophy is that outreach coordinated by staff who were once homeless is an effective means of linking program participants with prevocational and vocational opportunities.  Topics discussed include: a conceptual framework; history and setting of the intervention; review of the literature; description of participant population; description of the intervention; case studies; and lessons learned. 

Order #: 8458

Authors:

Clatts, M.C., Davis, W.R.

Title:

A Demographic and Behavioral Profile of Homeless Youth in New York City: Implications for AIDS Outreach and Prevention.

Source:

Medical Anthropology Quarterly 13(3): 365-374, 1999. (Journal Article: 10 pages)

Abstract:

In this article, the authors construct a demographic and behavioral profile of the homeless youth population in New York City, particularly as behavioral patterns relate to risk associated with HIV infection.  Structured survey interviews were conducted with 929 street youths between the ages of 12 and 23.  Data show that street youths are involved in multiple high-risk behaviors, including chronic, high-risk drug abuse, as well as high-risk sexual behavior.  The authors conclude that existing resources for prevention services targeted to this population are woefully inadequate relative to the scope of the population and the complexity of these youths' needs.  The authors state that there is a urgent need to expand and integrate street outreach, shelter, drug treatment, and primary health services, and to do so within a unified service-delivery model. 

Order #: 7737

Authors:

Erickson, S., Page, J.

Title:

To Dance with Grace: Outreach and Engagement to Persons on the Street.

Source:

In Fosburg, L.B., Dennis, D.L. (eds.), Practical Lessons: The 1998 National Symposium on Homelessness Research.  Delmar, NY: National Resource Center on Homelessness and Mental Illness, 1999. (Book Chapter: 24 pages)

Abstract:

This paper provides definitions, exemplary practice models, and an extensive bibliography for further inquiry into the topics of outreach and engagement for people who are homeless.  Outreach is defined as the initial and most critical step in connecting or reconnecting a homeless individual to needed services, and engagement is described as the process by which a trusting relationship between worker and client is established.  The authors also discuss the specific needs of homeless populations, values and principles of outreach, and characteristics of outreach workers.  A number of different outreach approaches are described. Available From: HUD USER, P.O. Box 23268, Washington, DC 20026, (800) 245-2691, www.huduser.org/publications/homeless/practical.html.

Order #: 7740

Authors:

Fisk, D., Rakfeldt, J., Heffernan, K., Rowe, M.

Title:

Outreach Workers' Experiences in a Homeless Outreach Project: Issues of Boundaries, Ethics, and Staff Safety.

Source:

Psychiatric Quarterly 70(3): 231-246, 1999. (Journal Article: 16 pages)

Abstract:

Mental health professionals and researchers have emphasized the importance of conducting outreach to locate homeless persons with mental illness, and of creatively engaging these persons into a therapeutic relationship.  These outreach and engagement activities raise challenging issues in the areas of client-staff boundaries, professional ethics, and staff safety.  While several issues in each of these three key areas have received attention in the growing literature on homelessness, certain issues within each area remain unexplored.  The authors draw from the street experiences of outreach staff in the ACCESS demonstration program, a federally funded homeless outreach project, to further explore each of these areas, and suggest that experiences of outreach workers are essential in shaping and redefining work activities in these, and other important areas (authors). 

Order #: 7733

Authors:

Lam, J.A., Rosenheck, R.

Title:

Street Outreach for Homeless Persons with Serious Mental Illness: Is it Effective?

Source:

Medical Care 37(9): 894-907, 1999. (Journal Article: 14 pages)

Abstract:

This study examined data on case management clients who are homeless and have a severe mental illness to determine how those contacted through street outreach differ in their socio-demographic characteristics, service needs, and outcomes from those clients contacted in shelters and other health and social service agencies.  As part of the Center for Mental Health Services' Access to Community Care and Effective Services and Supports (ACCESS) program, data were obtained from potential clients over the first three years of the program at the time of the first outreach contact, at the time of enrollment in the case management program, and three months after enrollment.  Clients contacted at outreach on the street were more likely to be male, older, spent more night literally homeless, were more likely to have psychotic disorders, and took longer to engage in case management.  Three month outcome data showed that enrolled clients contacted through street outreach showed improvement equivalent to those enrolled clients contacted in shelters and other service agencies.  The authors conclude that street outreach appears to be effective as the clients reached in this way showed improvement equal to that of other clients in most outcome domains (authors). 

Order #: 8208

Authors:

Rowe, M.

Title:

Crossing the Border: Encounters Between Homeless People and Outreach Workers.

Source:

Berkeley, CA: University of California Press, 1999. (Book: 208 pages)

Abstract:

The relationship between the homeless and the social service community marks a border where the disenfranchised meet the mainstream of society.  This book uses ethnographic tools to examine encounters at this border.  The author's personal encounters with the homeless as Director of the New Haven ACCESS outreach project, his interviews with fifty homeless persons for this study, and his numerous interviews with outreach staff, provide an invaluable personal perspective.  In this study, the author draws a collective portrait of the homeless whom he interviewed and observed, discusses the outreach workers in depth, examines transactions from the perspective of each party, and finally, places these encounters within the social and institutional contexts that shape them. Available From: California-Princeton Fulfillment Services, 1445 Lower Ferry Road, Ewing, NJ 08618, (800) UC-BOOKS,   (COST: $17.95)

Order #: 8284

Authors:

Tsemberis, S., Elfenbein, C.

Title:

A Perspective on Voluntary and Involuntary Outreach Services for the Homeless Mentally Ill.

Source:

New Directions for Mental Health Service 82: 9-19, 1999. (Journal Article: 11 pages)

Abstract:

Outreach teams use a range of strategies to engage people who are homeless and mentally ill and living on the streets.  This article describes and evaluates the effectiveness of various voluntary and involuntary approaches and presents a model program for serving this population. 

Order #: 7293

Authors:

Curtis, J.L., Millman, E.J., Struening, E.L., D'Ercole, A.

Title:

Does Outreach Case Management Improve Patients' Quality of Life?

Source:

Psychiatric Services 49(3): 351-354, 1998. (Journal Article: 4 pages)

Abstract:

This article examined whether enhancing standard aftercare with an outreach case management intervention would improve patients' quality of life.  A sample of 292 patients discharged from an inpatient psychiatry service were assigned to either an intervention group that received the case management or a control group that received standard aftercare services.  Interviews were conducted during the follow-up period, which lasted 15 to 52 months, to determine quality of life in 39 different categories.  No difference was found between the groups on any of the quality of life variables.  The authors conclude that outreach case management was not associated with improved quality of life (authors). 

Order #: 7530

Authors:

Dixon, L., Stewart, B., Krauss, N., Robbins, J., Hackman, A., Lehman, A.

Title:

The Participation of Families of Homeless Persons with Severe Mental Illness in an Outreach Intervention.

Source:

Community Mental Health Journal 34(3): 251-259, 1998. (Journal Article: 9 pages)

Abstract:

This article describes how an assertive community treatment (ACT) team that employs a family outreach worker interacts with homeless persons with severe mental illness and their families.  The team's ratings of the frequency and the importance of clients' and treatment team's family contact are summarized and compared with independent research reports on patients' satisfaction with family relations, housing, and hospitalization outcomes.  Seventy-three percent of clients had contact with their families, and ACT worked with 61% of these families.  Findings showed that client days in stable housing were associated with increased ACT family contact.  The authors contend that the role of the family outreach worker should be explored further (authors). 

Order #: 9843

Authors:

Gerber, J.C., Stewart, D.L.

Title:

Prevention and Control of Hypertension and Diabetes in an Underserved Population Through Community Outreach and Disease Management: A Plan of Action.

Source:

Journal Association of Academic Minority Physicians 9(3): 48-52, 1998. (Journal Article: 5 pages)

Abstract:

Hypertension and diabetes are overrepresented in the African-American population and can be particularly devastating in this population. These diseases share genetic predisposition, medical risk factors, and environmental influences as etiologic factors, and they may be interrelated, at least in part, by obesity and accompanying hyperinsulinemia. Noncompliance with treatment plans is a significant barrier to health improvement in both diseases, but increased attention to patient involvement in care is a potential solution to this long-standing problem. The Baltimore Alliance for the Prevention and Control of Hypertension and Diabetes was established in January 1998 to promote care to the underserved community of West Baltimore, Maryland, and to improve outcomes of hypertension and diabetes. Based at the University of Maryland School of Medicine, the Baltimore Alliance comprises a community health worker program, a church-based education and screening effort, managed care and pharmaceutical company (Hoechst Marion Roussel) partners, a health policy and services research group, and inpatient/outpatient clinical care sites in the health system. Mobilization, cultural relevance, and partnership are employed to ensure that the Alliance's goals of increased patient enrollment and retention in treatment programs will be achieved. Thereby, improved outcomes--clinical, humanistic, and economic--will result. Novel as well as classic approaches to patient education, compliance, and goal achievement are being pursued. Complete expert systems for hypertension and diabetes disease management are being created and will be implemented in the near future. Baseline practices and current outcomes are being identified to act as historical controls. The organization and administration of the Alliance will serve as a prototype that others may follow. 

Order #: 8005

Authors:

Levy, J.S.

Title:

Homeless Outreach: A Developmental Model.

Source:

Psychiatric Rehabilitation Journal 22(2): 123-131, 1998. (Journal Article: 9 pages)

Abstract:

In this article, the author introduces an outreach model based on universal principles of ecology and development in order to better serve disaffiliated, homeless adults with psychiatric disabilities. The outreach process is viewed as transactional in nature and consisting of manageable stages.  This presents a transactional and phasic context for a psychosocial developmental assessment which identifies client-worker issues relevant to each phase of the management process.  This model provides outreach counselors with guidance toward establishing the critical helping relationship needed for homeless persons with psychiatric disabilities to transition to a home in the community (author). 

Order #: 9848

Authors:

McCarley, T.D., Yates, W.R.

Title:

Mobile Outreach Crisis Services: An Innovative Model for Taking Psychiatric Care into the Community.

Source:

Journal of Oklahoma State Medical Association 91(8): 452-456, 1998. (Journal Article: 5 pages)

Abstract:

Mobile outreach psychiatric services have become a popular model of providing care to the mentally ill. A mobile program has been instituted in Tulsa, Oklahoma, to provide care to homeless mentally ill in Tulsa County and to assist with emergency crisis intervention. The SPMI (Severely and Persistently Mentally III) have been a challenge for both medical and psychiatric providers, and MOCS (Mobile Outreach Crisis Services) was developed to address these problems. This article describes MOCS, briefly reviews recent literature, and discusses ways this program can benefit primary care physicians. 

Order #: 7910

Authors:

National Network for Youth.

Title:

Toolkit for Youth Workers: Street Outreach.

Source:

Washington, DC: National Network for Youth, 1998. (Resource Guide: 11 pages)

Abstract:

This resource guide lists resources covering street outreach to homeless youth and other street populations. 

Order #: 7735

Authors:

Wasmer, D.

Title:

Engagement of Persons Who Are Homeless and Have Serious Mental Illness: An Overview of the Literature and Review of Practices by Eight Successful Programs.

Source:

Chicago, IL: De Paul University, 1998. (Dissertation/Thesis: 68 pages)

Abstract:

This paper examines the literature on outreach to persons who are homeless and have serious mental illness and the results of a survey of eight programs that offer outreach services.  Programs were found to share a highly mobile "find and serve" approach to the target population.  The largest portion of new clients are engaged at homeless shelters, followed by mobile outreach to other homeless service sites.  Outreach to streets and public places is maintained by most programs and special drop-in centers for the target group are operated by others.  Offering help with basic needs, especially emergent health problems, was found to be a critical ingredient to linkage and committed staff make things happen despite myriad challenges.  Continued investigation into the features of successful outreach, especially the amount and duration of linkage efforts and details about the timing of basic needs and supports, would help advance the principles of what is a distinct component of today's mental health service system (author). 

Order #: 7720

Authors:

Woods, E.R., Samples, C.L., Melchiono, M.W., Keenan, P.M., Fox, D.J., Chase, L.H., Tierney, S., Price, V.A., Paradise, J.E., O'Brien, R.F., Mansfield, C.J., Brooke, R.A., Allen, D., Goodman, E.

Title:

The Boston HAPPENS Program: A Model of Health Care for HIV-Positive, Homeless, and At-Risk Youth.

Source:

Journal of Adolescent Health 23(2S): 37-48, 1998. (Journal Article: 12 pages)

Abstract:

This article describes the Boston HAPPENS (HIV Adolescent Provider and Peer Education Network for Services) Program.  Boston HAPPENS provides a citywide network of culturally and developmentally appropriate adolescent-specific care, including: outreach and risk-education counseling through professional and adult-supervised peer staff; access to appropriate HIV counseling and testing support services;  life management counseling;  health status screening and services needs assessment; client-focused, comprehensive, multidisciplinary care and support; follow-up and outreach to ensure continuing care; and integrated care and communication among providers in the metropolitan Boston area.  This innovative network of care offers a continuum from street outreach to referral and HIV specialty care that crosses institutional barriers (authors). 

Order #: 6724

Authors:

Cousineau, M.

Title:

Health Status of and Access to Health Services by Residents of Urban Encampments in Los Angeles.

Source:

Journal Health Care for the Poor and Underserved 8(1): 70-83, 1997. (Journal Article: 13 pages)

Abstract:

Results from a survey of 134 homeless people living in 42 urban encampments in central Los Angeles found many in poor health status.  Over 30% had chronic illnesses, and 40% had a substance abuse problem. Although outreach efforts have had success in bringing HIV and tuberculosis screening services to encampments, residents report significant barriers to using primary health care and drug and alcohol treatment services. Public hospitals and clinics remain the major source of primary medical care for the homeless people living in encampments. Outreach and case management continue to be critical components of improved access to health care for homeless people. 

Order #: 6978

Authors:

Goering, P., Wasylenki, D., Lindsay, S., Lemire, D., Rhodes, A.

Title:

Process and Outcome in a Hostel Outreach Program for Homeless Clients with Severe Mental Illness.

Source:

American Journal of Orthopsychiatry 67(4): 607-617, 1997. (Journal Article: 11 pages)

Abstract:

This article reports on findings of an 18-month follow-up of 55 homeless and severely mentally ill clients of a hostel outreach program.  Results indicated that despite chronic histories of transiency and shelter use, housing stability had been achieved.  Initial gains in social functioning and symptom reduction also increased.  The authors contend that development of a strong working alliance between clients and their case managers proved to be a key element in the results (authors).  

Order #: 9845

Authors:

Jones, A., Scannell, T.

Title:

Outreach Interventions for the Homeless Mentally Ill.

Source:

British Journal of Nursing 6(21): 1236-1238, 1240-1243, 1997. (Journal Article: 7 pages)

Abstract:

There has been a steady rise in the number of homeless mentally ill in Britain. This article reviews the scale of the problem and identifies the need for change within mental health services in order to address this challenge. It is argued that mainstream psychiatric services need to become more diverse and open in their approach to this potentially isolated group of users. The authors suggest that this could be achieved by embracing assertive outreach interventions. Innovative projects using a range of care providers, including voluntary workers, past users of the service and professional mental health workers, are discussed as an alternative framework to traditional services. In conclusion, the article highlights some of the professional and social implications for psychiatric nurses and mental health practice. 

Order #: 7039

Authors:

Knight, E.L.

Title:

A Model of the Dissemination of Self-Help in Public Mental Health Systems.

Source:

New Directions for Mental Health Services 74: 43-51, 1997. (Journal Article: 9 pages)

Abstract:

This article discusses the origins of self-help and begins by providing an understanding of four forms of self-help:  mutual support, advocacy, consumer/survivor run services, and coping.  The author then looks at examples of the five different strategies by which self-help in public mental health systems has been disseminated.  These strategies include: intensive strategies that show the efficacy of the model, extensive strategies of outreach to as many people as possible, and the process of legitimation through research and development, symbolic dissemination, and flanking strategies. 

Order #: 7281

Authors:

Martin, E., McDaniels, C., Crespo, J., Lanier, D.

Title:

Delivering Health Information Services and Technologies to Urban Community Health Centers: The Chicago AIDS Outreach Project.

Source:

Bulletin of the Medical Library Association 85(4): 356-361, 1997. (Journal Article: 6 pages)

Abstract:

Health professionals cannot address public health issues effectively unless they have immediate access to current biomedical information. This paper reports on one mode of access, the Chicago AIDS Outreach Project, which was supported by the National Library of Medicine through outreach awards in 1995 and 1996. The three-year project is an effort to link the programs and services of the University of Illinois at Chicago Library of the Health Sciences and the Midwest AIDS Training and Education Center with the clinic services of community-based organizations in Chicago. The project was designed to provide electronic access to AIDS-related information for AIDS patients, the affected community, and their care givers. The project also provided Internet access and training and continued access to library resources. The successful initiative suggests a working model for outreach to health professionals in an urban setting (authors). 

Order #: 9849

Authors:

McElmurry, B.J., Wansley, R., Gugenheim, A.M., Gombe, S., Dublin, P.

Title:

The Chicago Health Corps: Strengthening Communities Through Structured Volunteer Service.

Source:

Advanced Practice Nursing Quarterly 2(4): 59-66, 1997. (Journal Article: 8 pages)

Abstract:

The Chicago Health Corps is an AmeriCorps USA program, established in 1994 by the Corporation for National Service in partnership with the Health Resources and Services Administration (HRSA) of the U.S. Public Health Service. The Chicago Health Corps deploys 20 full-time equivalent corps members in selected community sites that offer primary health care services to Chicago's underserved families. Chicago Health Corps members provide a combination of outreach, home visit, and case management services to address unmet health needs identified by community members, including both laypersons and professionals. Providing meaningful opportunities for participants to assist their communities with health care helps corps members develop an awareness of their fellow community members and an ethic of service. 

Order #: 6879

Authors:

Plescia, M., Watts, R., Neibacher, S., Strelnick, H.

Title:

A Multidisciplinary Health Care Outreach Team to the Homeless: The 10-Year Experience of the Montefiore Care for the Homeless Team.

Source:

Family and Community Health 20(2): 58-69, 1997. (Journal Article: 12 pages)

Abstract:

This article describes the Montefiore Care for the Homeless Team, a multidisciplinary health care outreach team that has provided health care to a diverse homeless population in the Bronx, NY, for 10 years.  Yearly descriptions of patient demographics, continuity measures, diagnoses, interventions, and referral patterns are presented for a four-year period.  These reveal that an increasing number and diversity of services have been provided by nurse practitioners who address social problems and preventive care in addition to providing direct clinical care for a range of acute and chronic health problems.  Findings also indicate that providing services at on-site premises led to the building of relationships with shelter and soup kitchen staff, and improved patient participation and social support.  The authors suggest that a multidisciplinary team approach reduces barriers to health care services for the homeless populations and contributes to improved provider retention (authors). 

Order #: 6610

Authors:

Porter, B.

Title:

To Reach the Homeless.

Source:

New York, NY: Times Square Business Improvement District, 1997. (Report: 28 pages)

Abstract:

This report describes the first year of a major effort to address homelessness in the Times Square district in New York City.  The stories demonstrate the difficulty of the work and challenge the reader to continue to grapple with the complexities involved in working with homeless clients.  Components of the project described include: concept; challenges; outreach; stories about specific people who are homeless; and results of the program after one year.  The author concludes that outreach teams will reduce the number of homeless people in Times Square as first year results indicate that some people who are homeless do accept offers of help and come inside. 

Order #: 9854

Authors:

Shalala, D.

Title:

Recognizing Community Outreach Nurses.

Source:

Nursing Management 28(8): 64, 1997. (Journal Article: 1 pages)

Abstract:

In an address to the nurses at Pine Street Inn Nurses' Clinics in Boston, Massachusetts, U.S. Secretary of Health and Human Services Donna Shalala recognizes their commitment to outreach and preventive care for homeless men and women. For the past 25 years, the clinic-the first in the country to be licensed by a state-has been caring for citizens who too often fall through the cracks of the health care system. 

Order #: 6072

Authors:

Alemagno, S.A., Cochran, D., Feucht, T.E., Stephens, R.C., Butts, J.M., Wolfe, S.A.

Title:

Assessing Substance Abuse Treatment Needs Among the Homeless: A Telephone-Based Interactive Voice Response System.

Source:

American Journal of Public Health 86(11): 1626-1628, 1996. (Journal Article: 3 pages)

Abstract:

The authors report on a pilot project that used a telephone-based interactive voice response system, accessed by cellular phones at diverse sites, to interview homeless persons on their need for alcohol and other drug treatment.  Using this technique, 207 homeless adults at eight shelters in Cleveland, Ohio were interviewed.  The cellular approach was comparable to human-administered interviews in reliability and validity.  It yielded higher self-reported levels of drug use.  The authors conclude that cellular telephones and interactive voice response interviewing systems can be useful tools in assessing the health-service needs of difficult-to-reach populations. 

Order #: 6471

Authors:

Alexy, B.,  Elnitsky, C.

Title:

Community Outreach: Rural Mobile Health Units.

Source:

Journal of Nursing Administration 26(12): 38-42, 1996. (Journal Article: 5 pages)

Abstract:

With the increased emphasis on cost containment, hospital administrators are investigating community outreach projects to remain economically viable.  The authors describe the planning and implementation of a mobile health unit for rural elderly residents.  This project represents an alternative model of healthcare delivery in a rural area with limited resources and healthcare providers (authors). 

Order #: 5616

Authors:

Buhrich, N., Teesson, M.

Title:

Impact of a Psychiatric Outreach Service for Homeless Persons With Schizophrenia.

Source:

Psychiatric Services 47(6): 644-646, 1996. (Journal Article: 3 pages)

Abstract:

Since 1988, a 24-hour psychiatric outreach service has been in operation in the inner city of Sydney, Australia, to provide services to homeless individuals.  A total of 506 homeless persons with schizophrenia were referred to the outreach service between April 1988 and mid-1992.  Ninety-one of these individuals failed to attend.  Hospitalization data were collected for the four years before and the four years after each individual's referral to the service.  After the introduction of the service, the rate and duration of psychiatric hospital admissions for residents with schizophrenia who were treated by the outreach service decreased significantly, whereas those who failed to attend showed no such decrease (authors). 

Order #: 6532

Authors:

Fuhr, M.E.

Title:

No Place to Stay: A Handbook for Homeless Outreach.

Source:

Oakland, CA: M. Elizabeth Fuhr, 1996. (Book: 152 pages)

Abstract:

This guide to outreach and engagement is based on the author's six years experience of providing outreach to elderly homeless persons in Oakland, CA.  Topics covered include: an overview of case management; skill building exercises; personal stories, poetry, and art by homeless persons; specific needs of the homeless person with alcohol and drug addiction and/or  mental disorders; and concerns of the older homeless person. Available From: M. Elizabeth Fuhr, 2851 West 52nd, Denver, CO 80221, (303) 458-6270 ext 134, meafuhr@aol.com, www.eoncity.com/homeless/fuhrord.html (COST: $10.00)

Order #: 3067

Authors:

Lopez, M.

Title:

The Perils of Outreach Work: Overreaching the Limits of Persuasive Tactics.

Source:

In Dennis, D., and Monahan, J. (eds.), Coercion and Aggressive Community Treatment:  A New Frontier in Mental Health Law.  New York, NY: Plenum Press, 1996. (Book Chapter: 8 pages)

Abstract:

This chapter discusses some of the engagement strategies used by outreach workers that could be considered coercive.  According to the author, the outreach worker, whose primary mission is to canvass the streets looking for persons with mental illnesses in need of medication, treatment or homes, must invent strategies that engage the prospective client into treatment, even though that client has fled from mental health workers in the past.  To identify whether the tactics of the outreach worker are coercive, one must acknowledge that the outreach worker is in a position of power when she or he relates to a client (author). Available From: Plenum Press, 233 Spring Street, New York, NY 10013, (212) 620-8000, www.wkap.nl.

Order #: 6067

Authors:

McQuiston, H.L., D'Ercole, A., Kopelson, E.

Title:

Urban Street Outreach: Using Clinical Principles to Steer the System.

Source:

New Directions for Mental Health Services (52): 17-27, 1996. (Journal Article: 11 pages)

Abstract:

The authors explain that a decade ago, urban street outreach was part of a rapid response to the epidemic of homelessness, but today it is struggling to find its own niche in the system of services to homeless people who have mental illnesses.  A study of the engagement and referral activity of a well-established outreach service was conducted to begin to understand the process and the outcome of urban street outreach.  The authors contend that program planning needs to establish a structure in which sound clinical principles can flourish. 

Order #: 5950

Authors:

Morse, G.A., Calsyn, R.J., Miller, J., Rosenberg, P., West, L., Gilliland, J.

Title:

Outreach to Homeless Mentally Ill People: Conceptual and Clinical Considerations.

Source:

Community Mental Health Journal 32(3): 261-274, 1996. (Journal Article: 14 pages)

Abstract:

This article describes a model of outreach predicated on developing a trusting, meaningful relationship between the outreach worker and the homeless person with mental illness.  The authors describe five common tasks inherent in this model of outreach (establishing contact and credibility, identifying people with mental illness, engaging clients, conducting assessments and treatment planning, and providing ongoing service).  Other issues discussed include: responding to dependency needs and promoting autonomy; setting limits while maintaining flexibility; and dealing with resistance to mental health treatment and follow-up service options (authors). 

Order #: 9855

Authors:

Testani-Dufour, L., Green, L., Green, R., Carter, K.F.

Title:

Establishing Outreach Health Services for Homeless Persons: An Emerging Role for Nurse Managers.

Source:

Journal of Community Health Nursing 13(4): 221-235, 1996. (Journal Article: 15 pages)

Abstract:

Nurse-managed clinics can be an effective strategy for addressing the health care needs of homeless and indigent populations. The role of the nurse manager in the establishment of a clinic involves community leadership; specifically, it involves addressing strategic planning, financial and manpower issues. The collaborative relationship of nurse managers, educators, and the community laid the groundwork for accessible and affordable health care for the homeless and indigent of one northwest Georgia community. Specific tools and strategies are presented.