November 17, 2005

Homeless Prevention Research Project

Columbia University's Mailman School of Public Health receives grant for homelessness prevention studies

November 16, 2005 -- Researchers at Columbia University's Mailman School of Public Health have been awarded a $5 million grant from the National Institute of Mental Health to establish the Columbia Center for Homelessness Prevention Studies. A key objective of the Center is to develop interventions to prevent chronic homelessness among people with severe mental illness.

To achieve the Center's broad prevention agenda, faculty from an array of disciplines, including public health, psychiatry, social work, economics, and urban planning, will be brought together with service providers, consumers, and city and state policy makers to collaborate on the development of new and more effective approaches to enable people at risk of chronic homelessness to retain safe, adequate, and affordable housing.

"Homelessness is a social problem of enormous public health significance, " says Carol Caton, PhD, professor of clinical Sociomedical Sciences at the Mailman School, center director, principal investigator, and a research scientist at the New York State Psychiatric Institute. "It has been estimated that 25 percent of homeless adults aged 18 years and older suffer from severe mental illness." Successful efforts to create supportive housing for people with severe and persistent mental illness have enabled many to move from shelters and streets, according to Dr. Caton. However, a high rate of recidivism has been identified raising concern that people with mental illness may be vulnerable to chronic homelessness despite best efforts to date. Moreover, these initiatives have not forestalled the steady increase in the numbers of new people with mental illness falling into homelessness with each passing year. "As research on homelessness moves into its third decade, what we know about it and the causes of its widespread prevalence among different groups of America's most impoverished is overshadowed by our inability to prevent it," she observes.

About 12 million people of the U.S. adult population have experienced literal homelessness at some time in their lives. In 1996, the most recent year for which such data are available, 3.5 million Americans were homeless at least once during the year, an increase of 1.2 million over that estimated 10 years earlier. The condition of homelessness has been associated with mental illness, substance abuse, and health problems, sometimes alone, but often in combination. "There is a need to advance the knowledge base on the factors underlying chronic homelessness, accelerate the development of evidence-based preventive interventions, and disseminate effective interventions, treatments, and service models to benefit the mentally ill at greatest risk of long-term housing instability," observes Ezra Susser, MD, DrPH, Anna Cheskis Gelman and Murray Charles Gelman Professor of Epidemiology, professor of Psychiatry, chair of the Department of Epidemiology, and center co-director.

To date, most of the empirical work on homelessness has been cross-sectional or of limited duration of follow-up. Therefore, there is little understanding of the impact of homelessness over the life course or its association with access to services or participation in social and community activities. "What is now needed is an assertive, coordinated effort to thrust the science of homelessness prevention forward," says Dr. Susser.

Preliminary evidence as well as field experience suggests that homelessness experiences can exacerbate existing illnesses, impede recovery, and provoke new illnesses. "For all these reasons, we believe that our prevention program must focus on both high risk and population-level prevention," notes Dr. Caton. The strategy of the Columbia Center for Homelessness Prevention Studies is to develop an agenda for homelessness prevention studies ranging from pre-intervention research to Phase I, II, and III clinical trials and effectiveness studies.

Richard Parker, PhD, professor and chair, Department of Sociomedical Sciences, serves as associate director of the Center. Dr. Susan Barrow, research scientist at the New York State Psychiatric Institute, also serves as an associate director of the new Center.

Other partner institutions affiliated with the new center are the New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, Graduate School of Arts and Science, School of Social Work, and other academic centers in the region in collaboration with providers and stakeholders.

About the Mailman School of Public Health

The only accredited school of public health in New York City, and among the first in the nation, Columbia University 's Mailman School of Public Health provides instruction and research opportunities to more than 850 graduate students in pursuit of masters and doctoral degrees.


In Northern California, transitional housing for the homeless is being addressed in a half-baked manner, doomed to failure.

A combination of well-meaning-though-naive social service bureacrats, clever land speculators and programmmatic quick buck artists, and faith-based do-gooders comprise odd coalitions. With the blessings of local (city or county) planners, these coalitions set up and run transitional housing/social service programs wherever they can get hold of some downtrodden property.
Homeless adults and children are herded in and incarcerated for 3 to 18 months. If one is to believe the advance hype, the homeless will have their lives turned around by the time they are released. Trouble is, these operations:
1) are not subject to any apparent federal, state, or local standards re location, housing (structure, density, population mix, on-site or nearby facilities and amenities), operations.
2) are not licensed
3) may be staffed by uncredentialled people who find themselves "in over their heads" in dealing with the homeless (both individually and in quasi-institutional settings).

As these transitional housing "experiments" proliferate, I predict the aforementioned inadequacies will, often as not, combine with local citizen/community paranoia (not entirely unfounded) to create volatile situations. In turn, efforts to aid the homeless will suffer a severe backlash.

Any experiences, advice, thoughts, or references you might share along these lines would be most appreciated.

I find myself in the role of community representative, not as an advocate of programs for the homeless. To bridge the potential chasm between advocates and local residents, I believe that programs must be well-conceived and administered. The onus is clearly on advocates to demonstrate responsibility, prior to and during program operations. The days of misty-eyed social engineering are long gone.

Posted by: D Wiltsee at November 18, 2005 12:07 PM

My brother is schizophrenic he
is impossible to live with and refuses to take medication.
He is developing aggressive
and explosive tendencies. He
attends a clinic but really gets
no help there. Even though he
is delusional we are told he can't
get help from a hospital unless
he admits himself or breaks the
law. My parents can't have him
in their house anymore but don't
want him to live on the streets.
What can we do?

Posted by: Linda at November 28, 2005 06:30 PM

I'm the mother of a 22 year old schizophreic son. He is my only child. He has the worst case of schizophrenia there is, with multiple disorders combined. You can do something. I'm in the legal profession, so it was easier for me. But, not knowing which state you live in, I can only give you some general routes to take. In most states, you need 2 to 3 adults, some related, some not, to go to the courts for help. Go to your county courthouse. Find out which court has jurisdiction over judging an adult a danger to himself/herself. Find out the requirements to have your brother picked up on an "OTA", "an Order To Apprehend". Have your brother committed to a hospital that way, for stabilization. If he's not already declared "disabled", go through that process in your state, so that you can get an income for him, as well as medicaid for prescriptions. Then, make sure that check goes into someone else's name (since a mentally disabled adult is not supposed to have free access to that money, for good reason), then, find him an efficiency apartment, or something comparable, pay his bills, buy his groceries, check up on him once or twice a day, and you and your family commit yourself to managing his life, which will include hospitalizing him everytime he goes off his meds. That's the best you can do. That's Love! Stay committed. It's next to impossible to live with a schizophrenic; and it's difficult enough managing our own lives, let alone managing the life of a mentally ill adult, but remember, your brother never chose to have this disease. Would you? You love them for better or for worse. Worse case scenerio: if you and your family just don't want to bother with him anymore (since you can't cure him or change the dynamic of his disease) you have another option. Most states have a "guardian ad litem" program for people who have been declared mentally incompetent. Go to the courts and find out about it. This would remove any and all resposibility from you and your family, to an impartial person.
Good luck and God bless you and your family.

Posted by: Catherine at December 3, 2005 05:21 PM

I now live with my schizophrenic mother in law. My husband works full time, I am raising our newborn son, and she doesn't speak great English. Sometimes, I get so frustrated. I know she means well, but she has destroyed, wasted, overcompensated, been depressed... it has been very hard. I do want her to be healthy but it seems like a lot to deal with.

Posted by: ami at August 11, 2007 08:27 PM

Thanks for a beautiful site! I have added you in elected!
Necessarily I shall advise your site to the friends!
Best wishes for you!

Posted by: Sarah at June 19, 2008 01:28 AM

Post a comment

Please enter this code to enable your comment -
Remember Me?
(you may use HTML tags for style)
* indicates required