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Explaining Service Use and Residential Stability in Supported Housing: Problems, Preferences, Peers
Russell K Schutt1,2,3, Mark Schultz3, Chantele Mitchell-Miland4
1Department of Sociology, University of Massachusetts Boston.
Medical Care
|March 12, 2021
Summary
Peer specialists improve access to mental health and substance abuse services for Veterans. Their support, alongside service preferences and needs, predicts service use and stable housing.
Area of Science:
- Behavioral Health Services Research
- Health Services Utilization
- Substance Abuse and Mental Health Services
Background:
- The behavioral model of health service use highlights needs, preferences, and availability as key predictors.
- Consistent conceptualization and effect estimation of these factors on substance abuse and mental health service use remain challenging.
- Understanding these influences is crucial for predicting service outcomes and improving care for dually diagnosed individuals.
Purpose of the Study:
- To test hypotheses predicting the use of substance abuse and mental health services.
- To evaluate the impact of peer specialists on residential stability and service utilization.
- To examine the interplay of health needs, service preferences, and enabling factors in service access.
Main Methods:
- A randomized trial was conducted, adding peer support to standard case management within the Housing and Urban Development-VA Supportive Housing program.
- The study included 166 dually diagnosed Veterans across two urban sites.
- Measures included VA service episodes, residential instability, service preferences, problem severity, and peer specialist availability.
Main Results:
- Self-assessed health needs, mediated by service preferences, predicted use of VA behavioral health services and residential stability.
- Assignment to a peer specialist was a significant predictor of service use and residential stability.
- Chronic medical problems, sex, and race also influenced service utilization and stability.
Conclusions:
- The behavioral model effectively predicts health service use and residential stability, emphasizing the mediating role of service preferences.
- Peer specialists can proactively enhance service availability and residential stability, even in systems without financial barriers.
- Clinical judgment in needs assessment and consideration of social background factors are vital for optimizing care.
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