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Community Centered Work Stabilization Programs Help Homeless with Substance Abuse Problems

PITTSBURGH, May 5, 2001 — A community supported work stabilization program promotes sustained decreases in substance use, criminal behavior and health care utilization in Pittsburgh homeless, according to a presentation at today’s Society of General Internal Medicine Meeting by University of Pittsburgh physician, Adam Gordon, M.D., M.P.H.

The project evaluated a community-based work stabilization program that integrated health care providers, managed care providers, social service agencies, members of the private sector and charitable organizations to provide treatment to homeless individuals with substance abuse problems.

“The people we studied were a very vulnerable population, what we were looking for, and may have found, is the best method to help them” said Dr. Gordon, who is from the department of Internal Medicine at the University of Pittsburgh School of Medicine and a member of the Center for Research on Health Care and VA Pittsburgh Center for Health Services Research.

Past studies in Pittsburgh indicate that 63 percent of homeless have received health care in the previous six months, indicating that they are utilizing health care services. Yet the age-mortality rate nationwide for the homeless is 3.7 times that of the general population. This indicated that there was something missing from the care they were receiving, according to Dr. Gordon. “This population may need a comprehensive approach to health and social care, encompassing not only detoxification and other health services but long term rehabilitation and continued support from their communities,” he said.

One hundred twenty participants of the Salvation Army’s Public Inebriate Program were enrolled in the work stabilization program. Participants received temporary, skill-building employment at Goodwill for three months as well as monitoring of their abuse problem. The program also provided them with a checking account, housing assistance, free medical care and vocational training.

Almost half of the participants completed the program. Of those who completed the program, 95 percent found employment. While participating in the work component, 84 percent were arrest free, 87 percent attended medical appointments, 69 percent reported career skill improvement, 47 percent improved their housing status and 40 percent remained abstinent from drugs and alcohol.

Six months after completing the program 33 percent maintained full-time employment, 39 percent further improved their housing situation and 36 percent remained abstinent of substance abuse. Over 90 percent reported that their medical and psychiatric needs were met.

“This study proves that community collaboration can effectively reduce the harm associated with homelessness and substance abuse. By reaching out, the South Side community dramatically improved these people’s lives by giving them the skills as well as the support to succeed,” said Paul J. Freyder, M.S.W, of the Salvation Army Public Inebriate Program.

The study was funded through a grant from the Birmingham Foundation and sponsored by the University of Pittsburgh Program for Health Care to Underserved Populations and Center for Research on Health Care, the Salvation Army Public Inebriate Program and the Johns Hopkins University. Community participants included the Salvation Army, Goodwill Industries, Mellon Bank, the University of Pittsburgh, the Birmingham Foundation and the South Side community of Pittsburgh.

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