Department of Psychiatry, Department of Veterans Affairs Connecticut Healthcare System, 950 Campbell Ave., 151D, West Haven, CT 06516, USA.
Psychiatr Serv. 2012 Dec;63(12):1186-94. doi: 10.1176/appi.ps.201200100.
Community-based intensive case management may be more intense than necessary and may be socially isolating for persons living in supported housing. This study evaluated a group intensive peer-support (GIPS) model of case management that was implemented in a supported housing program for homeless veterans with a broad range of psychiatric,substance use, and general medical problems. Group meetings led by case managers are the default mode of case management support, and individual intensive case management is provided only when clinically necessary.
GIPS was implemented by the U.S. Department of Housing and Urban Development–Veterans Affairs Supportive Housing(HUD-VASH) program at one demonstration site in April 2010. The study used administrative data to compare outcomes, service delivery, and timing of housing acquisition among clients of the demonstration site one year before (N=102) and after (N=167) GIPS implementation and among clients of other HUD-VASH sites across the country before (N=9,659) and after (N=21,318) implementation of GIPS at the demonstration site.
After adjustment for differences in baseline characteristics, the analyses found that GIPS implementation was associated with a greater increase in social integration ratings, a greater number of case manager services, and faster acquisition of Section 8 housing vouchers after program admission compared with outcomes at the same site before GIPS implementation and at the other sites before and after implementation.
GIPS may be a viable service model of supported housing that represents a recovery-oriented approach that can be scaled up to address homelessness.
基于社区的强化病例管理可能比必要的强度更大,并且可能对居住在支持性住房中的人造成社交孤立。本研究评估了一种在为有广泛精神科、物质使用和一般医疗问题的无家可归退伍军人提供的支持性住房计划中实施的集体强化同伴支持(GIPS)病例管理模式。由病例经理领导的小组会议是病例管理支持的默认模式,只有在临床需要时才提供个人强化病例管理。
GIPS 由美国住房和城市发展部-退伍军人事务支持性住房(HUD-VASH)计划于 2010 年 4 月在一个示范地点实施。该研究使用行政数据比较了示范地点实施 GIPS 之前(N=102)和之后(N=167)一年期间客户的结果、服务提供情况和住房获得时间,以及全国其他 HUD-VASH 地点实施 GIPS 之前(N=9659)和之后(N=21318)客户的结果。
在调整基线特征差异后,分析发现,与实施 GIPS 之前和实施 GIPS 之后的同一地点和其他地点的结果相比,实施 GIPS 与社会融合评分的更大增加、更多的病例经理服务以及在项目入院后更快获得第 8 节住房券相关联。
GIPS 可能是一种可行的支持性住房服务模式,代表了一种以康复为导向的方法,可以扩大规模以解决无家可归问题。