Jeffrey Draine, School of Social Work, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104-6214, 215.573.9298, jdraine@ssw.upenn.edu, David Dunbeck, Homeless Services, Horizon House, 1201 Chestnut Street, Philadelphia, PA 19107, and Marcella A Maguire, Philadelphia Office of Behavioral Health, 1101 Market Street, Suite 800, Philadelphia, PA 19107.

Following the work of outreach and engagement for long term street dwellers with mental illness is the often complex work of moving the individual into housing. This involves a high degree of coordination among bureaucracies while also maintaining motivation and comfort to an individual accustomed to the activity of life on the street. Case studies which include first person consumer accounts as well as accounts from service providers, housing providers and service system representatives, will illuminate these complexities. These case studies are derived from an evaluation of a Housing First/Assertive Community Treatment initiative implemented in Philadelphia modeled after Pathways to Housing in New York. Cases are selected to represent particular issues encountered in the implementation of this service model. Data for the cases were collected using a phenomenological interviewing and analysis technique which privileged the perspective of the principal informants in understanding the experience of providing and receiving housing. Among these case studies, there are individuals who refuse to use established apartments, opting to remain on the street. Others who repeatedly attempt sabotage of the assistance offered. There are also cases illustrating the physical and emotional health risks of increased isolation resulting from new housing. Analysis using constant comparison of case study material reveal several areas for further service development, policy refinement and research. These include the need for further concentration on social rehabilitation and integration in interventions to support new housing situations.

Learning Objectives:

• Delve into the complexities of moving a person into housing who is accustomed to a long period of street living.
• Understand the impact of mental health, housing, and other service system coordination issues on the housing process.
• Understand how to address the perils related to physical safety, social isolation, or criminal justice involvement in this housing process.
• Prioritize further research and service development for housing this population.

Keywords: Homelessness, Mental Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.