Study Details | Pathways to Work

28647.01-Outpatient Treatment Compared with Drop-In Center

Study quality: Low

Low

Reason for the rating: This study received a low study quality rating because it is a high-attrition randomized controlled trial that does not adjust estimated impacts for potentially important differences between the intervention and comparison groups.

Intervention: Outpatient Treatment (as compared with Drop-in Center)

Population and employment barriers:

Specific employment barriers (Homelessness, Mental illness)

Services provided:

Health services (Substance use disorder treatment and mental health services)

Setting: Urban only

Study design

Design:

Randomized controlled trial

Study group formation:

From 1988 to 1989, researchers screened 238 individuals experiencing homelessness for participation in the project, and 178 met the following selection criteria: a severe psychiatric disorder, no history of violent behavior, and an intention to stay in the St. Louis area for the duration of the study. Researchers initially assigned 50 participants to each of three conditions, with equal probabilities of assignment. We review two of these conditions here. However, because several participants refused or dropped out between study enrollment and the beginning of the intervention, researchers identified additional eligible participants and randomly assigned them to one of the conditions. Because more clients dropped out in certain conditions than others, the final participant sample varied in size across conditions. Sixty-four participants were ultimately assigned to the intervention condition, and 62 were assigned to the comparison condition reviewed here. Fifty-two participants were assigned to a third condition that we do not review.

Time period of study:

The intervention was studied over 12 months spanning 1988 to 1989.

Pathways only reports results from studies with a study quality rating of high or moderate.

Sample characteristics

Age

Mean age

34 years

Sex

Female	42%
Male	58%

Specific employment barriers

Had a mental illness	100%
Were experiencing homelessness	100%

Intervention implementation

Implementing organization:

Missouri Department of Mental Health and public daytime drop-in centers in St. Louis

Intervention services:

The intervention condition was traditional outpatient treatment provided by a state mental health clinic. The outpatient clinic provided psychotherapy, psychiatric medication, and assistance in obtaining social services from clinicians and other administrative staff.

Mandatory services:

None

Comparison services:

The comparison condition was one of two drop-in centers (one exclusive to women, one for both genders) for people with a mental illness who were also experiencing homelessness. Drop-in centers provided daytime shelter, food, clothing, showers, recreational activities, and referrals to social services via on-site social workers.

Study publications

Morse, Gary A., Robert J. Calsyn, Gary Allen, Betty Tempethoff, and Ruth Smith (1992). Experimental comparison of the effects of three treatment programs for homeless and mentally ill people, Hospital and Community Psychiatry 43(10): 1005-1010. Available at https://pubmed.ncbi.nlm.nih.gov/1398563/.

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The Pathways Clearinghouse refers to interventions by the names used in study reports or manuscripts. Some intervention names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.

Study of Outpatient Treatment versus Drop-In Center