Integrated Services for Persons Who Are Homeless and Have Co-Occurring Disorders: Lessons Learned from Project Home Base in Santa Cruz, California

This presentation will discuss evaluation results, lessons learned, and recommendations for successful implementation of Project Home Base (PHB), a 5-year SAMHSA-funded intervention for persons with co-occurring disorders (mental illness and substance use) who have been homeless in Santa Cruz County, California. PHB uses the Integrated Dual Disorders Treatment (IDDT) evidence-based practice, and Housing First and Harm Reduction approaches, to provide person-centered services to adults who have been chronically homeless and wish to move from the streets to permanent housing.

Evaluations of PHB for the past 3 years have been designed to determine how well the IDDT model has been implemented (process/fidelity evaluations), and the effects of the IDDT intervention on clients (outcome evaluations).  Specific lessons learned and recommendations will be discussed, as well as potential generalizability for similar programs.

Process evaluation results will include discussion of the General Organizational Index (GOI), and SAMHSA IDDT scales; interviews with PHB staff and clients; chart reviews; observations of staff meetings, and client groups. Implementation status, challenges and recommendations associated with fully or partially meeting scale components will be presented.

Outcome evaluation results will include discussion of Government Performance Results Act (GPRA) and Mental Health Statistical Improvement Program (MHSIP) data associated with PHB’s 10 goals: Decrease in number of days using alcohol/illegal drugs, needle use, number of unprotected sexual contacts, number of days living on the street/outdoors, and number of arrests; improvement in overall health status, physical and mental health functioning, and social connectedness; satisfaction with services received; and participation in employment, school or job training.