Effectiveness of Assertive Community Treatment and Integrated Dual Disorder Treatment in a Rural Homeless Population

Background: In the United States, approximately 50-70% of homeless individuals suffer from co-occurring mental health and substance abuse problems. The effectiveness of Assertive Community Treatment (ACT) and Integrated Dual Disorder Treatment (IDDT), when used in combination, among the rural homeless has not been well established. The primary goal of this paper is to evaluate effectiveness of ACT and IDDT among a rural homeless population in middle Tennessee. Methods: Intake and six-month follow-up data were collected for demographics, substance abuse patterns, mental health problems, and other performance indicators such as living situation, criminal behavior, and employment. Results: During the project period, 328 clients were served with the majority being white (76.9%) females (56.2%). At the six-month follow-up, 84.4% of participants reported maintaining recovery from alcohol abuse and 83.6% reported maintaining recovery from illegal drugs. The number of clients receiving inpatient treatment for emotional difficulties in the 30 days prior to assessment decreased by 87.7% from intake to follow-up. At the time of intake, all clients reported a lack of permanent housing; whereas, 81.3% of clients lived in regular housing at the six-month follow-up. Other improvements included: a decrease in number of clients arrested in the last 30 days, a decrease in the number of clients committing crime, an increase in the number of clients employed—both full and part-time. Conclusions: The results clearly show that the ACT and IDDT when used in combination for dually diagnosed rural homeless population are effective in addressing co-occurring disorder while substantially improving residential stability and other outcomes. This is one of first studies of this nature focusing primarily on the rural homeless population.