Absence of conflict of interest.
Citation
Harpaz-Rotem, I., Rosenheck, R. A., & Desai, R. (2011). Residential treatment for homeless female veterans with psychiatric and substance use disorders: Effect on 1-year clinical outcomes. Journal of Rehabilitation Research & Development, 48(8), 891-899.
Highlights
- The study examined the impact of community residential treatment on female veterans’ employment and health outcomes.
- The study team used statistical tests to examine the differences between two groups: (1) people who were offered at least 30 or more days of residential treatment (RT) services at Veterans Affairs (VA) medical centers and (2) people who were not offered these services or were offered these services for less than 30 days. The data for this study came from case managers, discharge summaries, interviews, and standardized self-reported measures.
- The study showed that receiving RT services was associated with a greater number of days worked but with mixed results on health outcomes.
- The quality of causal evidence presented in this report is moderate because it is based on a well-implemented nonexperimental design. This means we are somewhat confident that the estimated effects are attributable to the RT program, but other factors might also have contributed to the effects.
Intervention Examined
Residential Treatment
Features of the Intervention
Generally, RT involves housing people in a central location for at least 30 or more days and provides clinical and rehabilitation services. VA or non-VA community organizations can provide RT. RT programs in the study included VA- and non-VA-funded programs that served homeless female veterans treated in 11 VA medical centers. Most services were delivered by professional staff, but some veterans took part in peer counseling.
Features of the Study
The study was a nonexperimental analysis that used statistical tests to examine differences between groups of homeless, female veterans who received at least 30 days of RT versus those who received no RT or less than 30 days of RT.
Study data came from case managers, discharge summaries from RT programs, interviews, and standardized self-report measures (reported by members of both the treatment and comparison groups). There were 451 homeless, female veterans in the study; 217 received at least 30 or more days of care in an RT program, and 234 received no RT or less than 30 days of RT. The study team examined whether 30 or more days of care in an RT program (within three months of program entry) affected the number of days worked and the health and wellness of homeless, female veterans during the first year after study entry.
Findings
Employment
- The study showed that, at 12 months after study entry, veterans who were offered RT for 30 days or more worked about one and a half more days in the past month than veterans who were offered no RT or RT for fewer than 30 days.
Considerations for Interpreting the Findings
The authors did not account for preexisting differences between the veterans who were offered RT for 30 days or more and those who were not offered these services for as long. Such differences—and not the RT—could explain the observed differences in outcomes related to the drug and alcohol addiction severity scores.
Causal Evidence Rating
The quality of causal evidence presented in this report is moderate because it is based on a well-implemented nonexperimental design. This means we are somewhat confident that the estimated effects are attributable to the RT program, but other factors might also have contributed to the effects.