Cited by 147Homelessness and Social IssuesPsychiatric care and mental health servicesSchizophrenia research and treatment

An experimental comparison of three types of case management for homeless mentally ill persons

Gary A. Morse, Robert J. Calsyn, William Dean Klinkenberg, Michael L. Trusty, F Gerber, R Smith, Betty Tempelhoff, L Ahmad·1997·Psychiatric Services

Abstract

OBJECTIVE: Three types of case management were compared to determine their relative effectiveness in helping people with severe mental illness who were homeless or at risk of homelessness. METHODS: Subjects recruited from a psychiatric emergency room and inpatient units were randomly assigned to one of the three treatment conditions: broker case management, in which the client's needs were assessed, services were purchased from multiple providers, and the client was monitored; assertive community treatment only, in which comprehensive services were provided for an unlimited period; and assertive community treatment augmented by support from community workers, who assisted with activities of daily living and were available for leisure activities. Of 165 subjects recruited, 135 were followed for 18 months. RESULTS: Compared with clients assigned to broker case management, clients assigned to assertive community treatment only and assertive community treatment with community workers had superior outcomes on several variables. They were number of contacts with the assigned treatment program, resource utilization (for example, use of entitlements), severity of thought disorder, activity level, and client satisfaction. Clients in the assertive community treatment only condition achieved more days in stable housing than those in the other two treatment conditions. No significant treatment group effects were found on income, self-esteem, or substance abuse. CONCLUSIONS: Assertive community treatment is superior to broker case management in assisting individuals with serious mental illness who are at risk of homelessness.

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Crossref · 10.1176/ps.48.4.497

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  • In that 2009 review, only one mental health study was included: an RCT of ACT, ACT plus CHWs, and brokered case management for homeless or at-risk people with serious psychiatric diagnoses.

    “Only one study within this 2009 review addressed mental health: a randomized controlled trial comparing assertive community treatment (ACT), ACT + CHWs, and brokered case management for those with a serious psychiatric diagnosis who are homeless or at risk for being homeless.21,22”

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Authors
Morse, G. A., Calsyn, R. J., Klinkenberg, W. D., Trusty, M. L., Gerber, F., Smith, R., Tempelhoff, B., & Ahmad, L.
Affiliations
University of Missouri–St. Louis (US)
Venue
Psychiatric Services
Published
1997-04-01
Volume
48
Issue
4
Pages
497-503
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
OpenAlex
W1769249323
Cited by
147
References
7
Citations by year
2026: 2 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 11 · 2021: 1 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 2 · 2014: 1 · 2013: 4 · 2012: 5
FWCI
30.69
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r18mh046160-03)
  • National Institute of Mental Health (MH 46160)
Topics
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
case management, homelessness, severe mental illness, assertive community treatment, community workers, housing stability, thought disorder, resource utilization (health care), client satisfaction, psychiatric emergency care
MeSH terms
Activities of Daily Living, Adult, Mental Disorders, Community Mental Health Services, Female, Ill-Housed Persons, Humans, Male, Managed Care Programs, Middle Aged, Missouri, Patient Care Team, Psychotic Disorders, Comorbidity, Treatment Outcome, Case Management

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