“住房第一”、消费者选择以及对患有双重诊断的无家可归者的伤害减少。
Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis.
作者信息
Tsemberis Sam, Gulcur Leyla, Nakae Maria
机构信息
Pathways to Housing, Inc, New York, NY 10027, USA.
出版信息
Am J Public Health. 2004 Apr;94(4):651-6. doi: 10.2105/ajph.94.4.651.
Abstract
OBJECTIVES
We examined the longitudinal effects of a Housing First program for homeless, mentally ill individuals' on those individuals' consumer choice, housing stability, substance use, treatment utilization, and psychiatric symptoms.
METHODS
Two hundred twenty-five participants were randomly assigned to receive housing contingent on treatment and sobriety (control) or to receive immediate housing without treatment prerequisites (experimental). Interviews were conducted every 6 months for 24 months.
RESULTS
The experimental group obtained housing earlier, remained stably housed, and reported higher perceived choice. Utilization of substance abuse treatment was significantly higher for the control group, but no differences were found in substance use or psychiatric symptoms.
CONCLUSIONS
Participants in the Housing First program were able to obtain and maintain independent housing without compromising psychiatric or substance abuse symptoms.
摘要
目的
我们研究了“先提供住房”项目对无家可归的精神病患者在消费者选择、住房稳定性、物质使用、治疗利用和精神症状方面的纵向影响。
方法
225名参与者被随机分配，一组接受基于治疗和戒酒的住房安排（对照组），另一组接受无需治疗前提条件的即时住房安排（实验组）。在24个月内每6个月进行一次访谈。
结果
实验组更早获得住房，住房保持稳定，且报告的感知选择更高。对照组对药物滥用治疗的利用率显著更高，但在物质使用或精神症状方面未发现差异。
结论
“先提供住房”项目的参与者能够获得并维持独立住房，而不会加重精神症状或物质滥用症状。
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2
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3
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7
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8
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9
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10
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