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Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
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Outreach Models for Substance Use Disorder in Homeless Populations: A Systematic Review and Network Meta-Analysis.

Mohammad Ghafouri1, Terence Meyerhoefer1, Dina N Ali1

  • 1Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.

Psychiatric Services (Washington, D.C.)
|January 1, 2026
PubMed
Summary
This summary is machine-generated.

The Community Reinforcement Approach (CRA) is most effective for treating substance use disorder in homeless individuals. Integrated, multifaceted interventions are recommended for long-term recovery and support.

Keywords:
AddictionAssertive Community TreatmentCommunity Reinforcement ApproachEvidence-Based InterventionsHomelessnessIntensive Case Management

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Area of Science:

  • Public Health
  • Addiction Medicine
  • Mental Health Services Research

Background:

  • Effectiveness of outreach models for substance use disorder (SUD) among homeless populations is unclear.
  • Homelessness and SUD are significant public health challenges requiring effective interventions.

Purpose of the Study:

  • To systematically review and network meta-analyze the efficacy of various outreach interventions for SUD in homeless populations.
  • To compare substance use frequency and severity outcomes at 1- and 2-year follow-ups.

Main Methods:

  • Systematic search of PubMed, Embase, PsycInfo, and Cochrane Library (Jan 1990-Jan 2024).
  • Network meta-analysis comparing substance use frequency and severity.
  • Interventions ranked using P scores; effects standardized by mean differences.

Main Results:

  • Community Reinforcement Approach (CRA) showed highest effectiveness (P scores=0.81-0.83).
  • Combined assertive community treatment and intensive case management improved outcomes at 2 years (P score=0.79).
  • Substantial heterogeneity observed (I²=76.3%-84.7%).

Conclusions:

  • Comprehensive, integrated approaches like CRA are most effective for SUD in homeless populations.
  • Multifaceted interventions addressing immediate and long-term needs are supported.
  • Findings highlight the need for robust support systems in recovery.