An emergency housing program as an alternative to inpatient treatment for persons with severe mental illness

Objective: This study evaluated the feasibility and effectiveness of an emergency housing program as a step-down program after inpatient care, as a step-up program from community-based living, and as an alternative to inpatient care for individuals with serious mental illness who sought treatment at an urban medical center. Methods: One hundred sixty-one persons admitted consecutively to an emergency housing program were assessed retrospectively with the Severity of Psychiatric Illness scale and the Acuity of Psychiatric Illness scale at admission and again at discharge. Analyses of covariance were used to evaluate the change in residents' clinical acuity and psychosocial status between admission and discharge. Results: Residents who had been admitted to the emergency housing program from inpatient psychiatric treatment showed a significant decline in acuteness of psychiatric symptoms. Psychiatric symptoms also improved for residents who were admitted to the program from community-based service programs and for residents admitted as an alternative to inpatient treatment, although the differences for these two groups were less prominent. Conclusions: The findings suggest that an emergency housing program is a feasible mode of extended community-based care for many persons with serious and persistent mental illness.