Homeless Families in Westchester County, NY
Westchester Families First

Principal Investigator: Judith Samuels, Ph.D.; Co-Principal Investigator: Nancy Travers (Deputy Commissioner, Westchester County Dept. of Social Services); Co-Investigators: Kim Hopper, Ph.D., Dan Herman, Ph.D.,  Alan Felix, MD (NYS Psychiatric Institute, Columbia University)  

PROJECT GOALS

The overall aim of this study is to: 

• test the hypothesis that homeless mothers with mental health or substance abuse problems who are together with their children can achieve better mental health and housing outcomes when rapid placement into community housing is augmented by intensive short term case management (Critical Time Intervention - CTI), in contrast to extended stays in congregate shelter living. .

This project is one of 14 nationwide study sites participating in a multi-site study of services for homeless families with mental illness and/or substance abuse disorders. The project's aim is to increase the knowledge base on successful interventions that work for this population.

Phase 1 project goals were to:

• develop an understanding of the flow and step-wise progression of families through the shelter and housing system, and document the specific problems they encounter;
• develop a database of individual and family characteristics that describes this population; 
• enhance and evaluate the fidelity of intensive intervention through provision for rapid placement in transitional housing and adaptation of  the Critical Time Intervention (CTI) case management model to fit the needs and issues of families.
• determine the feasibility of returning these homeless families to the community shortly after their homeless episode begins. 

In Phase 2 of this study, goals are to: 

• provide targeted, intensive, short-term assistance that would enable these families to succeed in community re-entry.

Funding:

This project has been funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). 

RESEARCH ACTIVITIES AND RESULTS

This Center's study targets single-parent homeless families in the Westchester County shelter system, where the mothers in these family groups have been assessed as having a mental health and/or substance abuse problem. The Westchester County NY homeless families shelter system assists a constant flow of families, almost all of whom have single female heads of household. Most of these mothers have been assessed as having mental health and/ or substance abuse problems. The shelter system is a "service-intensive shelter program" and all family members receive comprehensive assessments to determine service and treatment needs in health, mental health, substance abuse, education, job training and child-related problems. However, the system has been slow to assist families to move out of shelters and into permanent or transitional housing in the community. 

Methods: The proposed intervention has three components: availability of conventional or transitional housing; intensive, short-term case management; and the brokering and monitoring of appropriate surrogate support arrangements when the study period ends. Families will be followed over a 15-month period.  The Family CTI is an adaptation of the Critical Time Intervention model that was tested in NYC to prevent recurrent homelessness among single men with mental disorders.

Phase 1 of this project was completed in October 2001. Data was collected by conducting focus groups with residents in the Westchester homeless shelter system and with program/shelter staff. Additional information was collected through a series of interviews with program/shelter management and administrators. Epidemiological data on all homeless families who entered the shelter system between Jan. 1 and June 30, 2000  was extracted from information collected at the family assessment center, the primary entry point into the shelter system.  On- and off-site service providers were also studied including health care providers, mental health and substance abuse services, job training, parenting programs, education, housing programs, and county departments of social services, mental health and health. A systems analysis was conducted on the progression of all families through the shelter and housing system, a database of individual and family characteristics developed, the intervention was adapted to the setting and a fuller understanding of the systems processes in Westchester County was obtained.

In Phase 2 of this study which began in Oct. 2001, 172 families that met eligibility criteria were randomly assigned to one of two conditions: families in the experimental group were placed in transitional, scatter-site apartments and will receive a modified version of CTI, a form of intensive, short-term case management; families in a comparison control group are undergoing usual treatment in the shelter system, attending programs and waiting placement.  Caseworkers in the county's Emergency Housing Apartment Program have been trained in the CTI model adapted to the needs and circumstances of homeless families, and were given reduced size caseloads. 

The project has recently been expanded to include young families - those with infants under 18 months - who were previously excluded from the multi-site study. The PI worked with HOPE, Inc., a collaborating agency, to obtain a grant from the NYS Office of Temporary and Disability Assistance, to fund this aspect of the study. Additional funding was also secured from HUD to serve families who complete the Family Critical Time Intervention program, but need longer term intensive services to maintain permanent housing.

Findings: Data indicate that mothers in this study group tend to be poorly educated, have meager work histories, and face multiple medical, mental health, and substance abuse problems. Their children's lives have lacked stability in terms of housing, education, and periods of separation from their mothers. Racial and ethnic minorities were found to be over-represented among this group, at proportions greater than the national average for homeless populations. 

SIGNIFICANCE OF FINDINGS/ POLICY IMPLICATIONS

The study, by providing intensive case management services and housing,  tests the widely held assumption that homeless mothers with children, especially those beset with multiple problems, require extended stays of congregate shelter living in order to progress to a stage of sufficient housing readiness to manage a household on their own.   

PLANS

The project is ongoing. Data collection will continue through July 2004. This will be followed by a comprehensive analysis.

While the current study concentrates on outcomes for the mothers of these families,  additional funding has been awarded by NIMH for a study of outcomes for the children affected (see related project).  

INCLUSION  OF GENDER AND MINORITY SUBJECTS

 Targeted /Planned Enrollment

Entered: July 2000 

Updated: 7/8/03

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