Shelter-based treatment of the homeless alcoholic.

We describe a model for integrating municipal shelter and hospital-based alcoholism outpatient treatment services for the homeless alcoholic, and report on its outcome at 12 months. The experimental program was designed to increase homeless patient's length of stay in treatment and was based on integrating clinic services for homeless men at Bellevue Hospital in New York with an abstinence oriented dormitory, the "Clean and Sober" Unit in a municipal shelter. The study sample consists of 189 consecutive male admissions to an intensive outpatient alcoholism treatment program in the Bellevue hospital. The patients' outcome was assessed in relation to their place of residence divided in three groups: the experimental group counts 100 men housed in the Clean and Sober Unit. The two contrast groups counted 34 residents of various unaffiliated shelters and 55 domiciled men with independent living arrangements. The three subject groups did not differ significantly on demographic or clinical characteristics. After 12 months, residents in unaffiliated shelters were significantly less likely to be retained than the domiciled patients and showed a trend towards less retention than the experimental group.