VA New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut 06516, USA.
Womens Health Issues. 2011 Sep-Oct;21(5):383-9. doi: 10.1016/j.whi.2011.03.004. Epub 2011 Jun 23.
The U.S. federal government recently committed itself to ending chronic homelessness within 5 years. Women constitute one out of four chronically homeless adults and represent a particularly vulnerable group, but have been little studied. To identify potentially unique needs in this group, we report characteristics and 2-year outcomes in a large sample of male and female chronically homeless adults participating in a multisite, supportive housing program.
Men and women participating in the outcome evaluation of the 11-site Collaborative Initiative on Chronic Homelessness (n = 714) supportive housing program and who received at least one follow-up assessment were compared on baseline characteristics and up to 2-year follow-up outcomes. Mixed model multivariate regression adjusted outcome findings for baseline group differences.
Few significant baseline differences existed between males and females, with both sexes self-reporting very high rates of lifetime mental health (83% women, 74% men) and substance use (68% women, 73% men) problems. Throughout the 2-year follow-up, both men and women dramatically increased the number of days housed, showed minimal changes in substance use patterns, and had modest improvements in mental health outcomes, without significant differences between genders.
Unlike other U.S. populations, chronically homeless adults do not demonstrate substantial gender differences on mental health or addiction problems. Policy and service delivery must address these remarkably high rates of substance use and mental illness.
美国联邦政府最近承诺在 5 年内结束慢性无家可归者问题。女性占慢性无家可归成年人的四分之一，是一个特别脆弱的群体，但对她们的研究甚少。为了确定这一群体可能存在的独特需求，我们报告了参与多地点支持性住房计划的大量男性和女性慢性无家可归成年人的特征和 2 年结果。
参与 11 个地点的慢性无家可归问题合作倡议（Collaborative Initiative on Chronic Homelessness）的支持性住房项目的结果评估的男性和女性参与者（n=714），并且至少接受了一次随访评估，他们在基线特征和长达 2 年的随访结果方面进行了比较。混合模型多变量回归调整了基线组差异对结果的影响。
男性和女性之间几乎没有显著的基线差异，两者都自我报告了非常高的终生心理健康（83%的女性，74%的男性）和物质使用（68%的女性，73%的男性）问题。在整个 2 年的随访期间，男性和女性都大大增加了居住的天数，物质使用模式几乎没有变化，心理健康结果也有适度改善，性别之间没有显著差异。
与其他美国人群不同，慢性无家可归的成年人在心理健康或成瘾问题上没有表现出显著的性别差异。政策和服务提供必须解决这些高得惊人的物质使用和精神疾病问题。
