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MFT / LCSW

Ending Chronic Homelessness for Those with Co-Occurring Disorders

6.75 - CE credit hours training

$40.50 - Cost of course

This page contains important information about the course, including training details, a comprehensive course description, learning objectives, and source references. We encourage you to review each section to gain a clear understanding of the course content, educational goals, and supporting materials before beginning your training and taking the POST TEST below.

Target audience and instructional level of this course: foundational
There is no known conflict of interest or commercial support related to this CE program.

Ending Chronic Homelessness for Those with Co-Occurring Disorders

Follow the link below, read the material and then take the 40 question post test

Read the Course Material:
Ending Chronic Homelessness for Those with Co-Occurring Disorders

40 Questions

1. Homelessness has become an enduring presence in American society. Despite two decades of Federal support, statewide planning, and local initiatives, an estimated 637,000 adults in the United States are homeless in a given week, with 2.1 million adults experiencing homelessness over the course of a year.
2. The estimated 200,000 people who experience chronic homelessness tend to have disabling health and behavioral health problems. Recent estimates suggest that at least 40 percent have substance use disorders, 25 percent have some form of physical disability or disabling health condition, and 20 percent have serious mental illnesses.
3. People, who experience shorter homelessness tend to be slightly older than those who experience longer homeless episodes, are non-white, and male.
4. Outreach programs have been effective in reaching people with serious mental illnesses who are homeless, especially those who are unable or unwilling to accept help from more traditional office-based providers. In many cases, these efforts are literally saving people's lives.
5. Many individuals who are homeless have both substance use disorders and serious mental illnesses. A growing body of research supports the concept of integrated treatment for these individuals; that is, treatment for both disorders provided concurrently by the same clinician or team of clinicians in a single setting. Such treatment is particularly beneficial in helping individuals recover from substance use.
6. Between 1991 and 1993, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in consultation with the National Institute on Mental Health (NIMH) funded two rounds of demonstration projects.
7. The ACCESS program was designed specifically to test the hypothesis that integrated service systems will improve individual functioning, quality of life, and housing outcomes for people with serious mental illnesses who are homeless.
8. The PATH program was a two-phase, multisite study designed to examine and compare the effectiveness of various housing approaches for people with serious mental illnesses, many of whom were or had been homeless.
9. Through outreach, case management, screening and assessment, staff training, alcohol and drug treatment for people with co-occurring disorders, and support services in housing, PATH-funded providers nationwide have set a standard for the delivery of services to people with serious mental illnesses who are homeless.
10. Among veterans who are homeless, one-third to nearly one half have co-occurring mental illnesses and substance use disorders.
11. Homeless sexual minorities, especially youth, also are at increased risk for negative outcomes. Forty-two percent of homeless youth identify as lesbian, gay, or bisexual. Transgender individuals are especially stigmatized. They may become homeless as a direct result of job or housing discrimination.
12. Homeless people are rarely arrested for minor offenses such as trespassing, petty theft, shoplifting, and prostitution.
13. Categorical funding also is likely to cause gaps in coverage as an individual prepares to exit homelessness and is required to deal with multiple service agencies, each with its own case management staff.
14. People with co-occurring disorders who are homeless frequently are excluded from mental health treatment programs because of their substance use disorder from substance abuse treatment programs because of their mental illness, and from homeless service programs because of their mental illnesses and substance use disorders.
15. A study of different assessment methods in Boston's Long Island Shelter found that case managers could identify substance use problems by using a set of close-ended questions.
16. Self-reported substance use is a common assessment method, but the validity of self-reports has been called into question by several studies indicating that people vastly underreport the use of substances, especially illicit drugs.
17. Housing is especially problematic for people with substance use disorders, particularly for those with co-occurring mental illnesses. Their behaviors place them at high risk for eviction, arrest, and incarceration.
18. The term "recovery" has been used extensively in the field of substance use, where it refers to a return to sobriety. For many individuals, spirituality and peer support are critical to their recovery from addictions.
19. Before a community can develop a plan to integrate care for people who are homeless, it must be clear about the services it currently offers and the existing gaps or unmet needs. Data that indicate where people are not being served or are underserved in the system, along with anecdotal examples that point to barriers or gaps in the system, should be discussed openly to help the group produce a shared definition of the problem.
20. Mental health and substance abuse services providers must participate in Continuum of Care planning to ensure that the needs of the individuals they serve are represented in requests for homeless assistance funds.
21. People who have few episodes of homelessness but each for long periods of time are known as:
22. The Stewart B. McKinney Homeless Assistance Act of 1987 is now known as the:
23. McKinney Research Demonstration Programs began in:
24. The McKinney Research Demonstration Programs was designed to test hypotheses from earlier research studies by developing effective service models for people with :
25. Results of which program revealed that that systems integration has a positive impact on housing outcomes for people with serious mental illnesses who are homeless.
26. Individual risk factors include:
27. Between 51 and 97 percent of women with serious mental illnesses report some form of:
28. People with mental illnesses who become homeless have less contact with their families and are more likely to have poor family relationships than those who are
29. Some of the Service System challenges include:
30. An instance of eligibility gaps is:
31. Social risk factors include:
32. Federal Housing Choice Vouchers require that people pay only
33. Many people for whom SSI or SSDI are their only source of income are forced to live in overcrowded or substandard living environments that place them at:
34. Individuals who have engaged in drug-related criminal activity must be denied admission to:
35. A recent nationwide survey of homeless assistance providers and clients found that 44 percent of homeless people were working, but most were employed in
36. Person Centered Values include:
37. System level values include:
38. Some specific system-level barriers to effective integration include:
39. The steps in the strategic planning process include:
40. Implementing strategies include:

Course Description

About half of all adults who are homeless have substance use disorders, and many have co occurring mental illnesses, as well. Yet, the outlook is far from bleak. Federal demonstration programs and the experience of hundreds of community-based providers offer a rich reservoir of evidence-based and promising practices. For example, recent studies reveal that the cost of providing permanent, supportive housing for people with serious mental illnesses is more than offset by savings incurred by the public hospital, prison, and shelter systems (Culhane et al., 2001). When nothing is done, people with serious mental illnesses and/or co occurring substance use disorders who are homeless often cycle between the streets, jails, and high-cost care, including emergency rooms and psychiatric hospitals. This is inhumane, ineffective, and costly.

Further, research reveals that people with serious mental illnesses and/or co occurring substance use disorders who are homeless, once believed to be unreachable and difficult-to-serve, can be engaged into services, can accept and benefit from mental health services and substance abuse treatment, and can remain in stable housing with appropriate supports (Lam and Rosenheck, 1999; Morse, 1999; Lipton et al., 2000; Rosenheck et al., 1998).

Ending Chronic Homelessness for Persons with Serious Mental Illnesses and Co-Occurring Substance Use Disorders: Blueprint for Change

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Training Material

http://store.samhsa.gov/shin/content//SMA04-3870/SMA04-3870.pdf

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Learning Objectives

After completing this training the healthcare professional will be able to:

  • Describe how treatment for serious mental illnesses and substance use disorders has evolved
  • Recognize individual risk factors
  • Develop the infrastructure for change
  • Create a system that supports recovery
  • Engage in strategic planning
  • Outline societal risks
  • Utilize mainstream resources to prevent homelessness
  • Describe the concept and practice of recovery
  • Support values that put people first
  • Create a system that supports recovery
  • Use mainstream resources to prevent homelessness
  • Improve access to mainstream programs
  • Expand the capacity of mainstream programs
  • Promote coordination and collaboration
  • Apply knowledge from this course to practice and/or other professional contexts.
Francine Williams, M.A. and Deborah Dennis, M.A.
Policy Research Associates
Susan Wells
Advocates for Human Potential
Published by Substance Abuse and Mental Health Services Administration (SAMHSA)