The Role of Organizational Characteristics in Determining Patterns of Utilization of Services for Substance Abuse, Mental Health, and Shelter by Homeless People

Author:

North Carol S.1,Pollio David E.2,Perron Brian3,Eyrich Karin M.4,Spitznagel Edward L.5

Affiliation:

1. Professor of psychiatry in the Washington University School of Medicine in St. Louis, Missouri

2. Associate professor and associate director of the Comorbidity and Addictions Center in the George Warren Brown School of Social Work, Washington University and associate professor of psychiatry in the School of Medicine

3. Doctoral candidate and NIMH predoctoral trainee in the George Warren Brown School of Social Work

4. Joint appointment at the Treatment Research Institute and the Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia

5. A professor in the Department of Mathematics with a joint appointment in the Division of Biostatistics, Washington University

Abstract

This study aims to advance understanding of service provision to the homeless population through investigation of the effects of organizational characteristics. A longitudinal study of homelessness obtained structured psychiatric interview data from 400 participants and these individuals' service use and organizational data from 23 organizations over the next 12 months. Substance abuse service use was associated with organizational funding diversity, professionalism, and focus of services on substance abuse service provision. Other mental health service use was associated with small organizational size, professionalism, and simplicity of organizational funding diversity. Shelter service use was associated with complexity of services and small organizational size and inversely related to professionalism of staff. Results suggest relevance of organizational characteristics to understanding service access and use, controlling for individual need factors. Only by examining interactions among individual and organizational characteristics across sectors of care can the complexity of service provision to this multifaceted population be approached.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health,Public Health, Environmental and Occupational Health,Health (social science),Medicine (miscellaneous)

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