Chronically Homeless Women Report High Rates of Substance Use Problems Equivalent to Chronically Homeless Men

  • Ellen Lockard Edens
    Correspondence to: Ellen Lockard Edens, MD, MPE, MA, 950 Campbell Ave, West Haven, CT 06516. Phone: 203-932-5711, ext. 4123; fax: 203.937-3472.
    VA New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut

    Department of Psychiatry, Yale University, New Haven, Connecticut

    National Center on Homelessness Among Veterans, West Haven, Connecticut
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  • Alvin S. Mares
    College of Social Work, The Ohio State University, Columbus, Ohio
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  • Robert A. Rosenheck
    VA New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut

    Department of Psychiatry, Yale University, New Haven, Connecticut

    National Center on Homelessness Among Veterans, West Haven, Connecticut

    School of Epidemiology and Public Health, Yale University, New Haven, Connecticut
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      The U.S. federal government recently committed itself to ending chronic homelessness within 5 years. Women constitute one out of four chronically homeless adults and represent a particularly vulnerable group, but have been little studied. To identify potentially unique needs in this group, we report characteristics and 2-year outcomes in a large sample of male and female chronically homeless adults participating in a multisite, supportive housing program.


      Men and women participating in the outcome evaluation of the 11-site Collaborative Initiative on Chronic Homelessness ( n = 714) supportive housing program and who received at least one follow-up assessment were compared on baseline characteristics and up to 2-year follow-up outcomes. Mixed model multivariate regression adjusted outcome findings for baseline group differences.


      Few significant baseline differences existed between males and females, with both sexes self-reporting very high rates of lifetime mental health (83% women, 74% men) and substance use (68% women, 73% men) problems. Throughout the 2-year follow-up, both men and women dramatically increased the number of days housed, showed minimal changes in substance use patterns, and had modest improvements in mental health outcomes, without significant differences between genders.


      Unlike other U.S. populations, chronically homeless adults do not demonstrate substantial gender differences on mental health or addiction problems. Policy and service delivery must address these remarkably high rates of substance use and mental illness.
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      Ellen Lockard Edens, MD, MPE, MA, is an addiction psychiatrist with the VA Connecticut Healthcare System in West Haven, Connecticut. Her research expertise is in addiction epidemiology and health services research.


      Alvin S. Mares, PhD, is an Assistant Professor in the College of Social Work at The Ohio State University. His research interests include housing and supportive services for the homeless and transition-aged youth, and solution-focused brief therapy-informed interventions for low-income young adults.


      Robert A. Rosenheck, MD, is a Professor of Psychiatry, Public Health, and the Child Study Center at the Yale School of Medicine. He is a member of the VA New England Mental Illness Research, Education, and Clinical Center.