ENGAGING HOMELESS PEOPLE WITH MENTAL ILLNESS IN NEEDED CARE: NEXT STEPS
Using Costly Services Efficiently
Rosenheck (2000) has observed that while specialized interventions for the mentally ill homeless have improved outcomes, they are also associated with the increased use of many types of health and support services, resulting in increased costs. Whether or not the body politic will support the increased cost of providing effective and more humane care to people with mental disabilities, there are steps that can be taken to ensure that the available service options are used most efficiently. Toward that end, Clark and Rich (2003) suggest that the effectiveness and cost of services for homeless people could be improved by matching the intensity of services to the individual’s severity of psychiatric impairment and substance use, rather than by “treating mentally ill homeless people as a homogeneous group” (Clark & Rich, 2003, p. 78). Tsai and Rosenheck (2012) carried out a pilot project for a group-based peer support intervention for homeless veterans as an adjunct to supported housing that would lower the direct service costs compared to the cost of multidisciplinary teams. Further study of this approach could reveal whether group-based peer support is as effective as individual peer support for homeless people with severe mental illness.