Integrated Behavioral Health Services, Recovery Support and Housing for Individuals with Serious Mental Illness or Co-occurring Disorders who are Experiencing Homelessness - Bailey House, Inc.’s (BH) proposed project will enhance the community infrastructure to provide integrated substance use and mental health treatment, housing, and access to critical recovery support services to individuals experiencing homelessness. The program’s model will be enhanced by peer services, housing transition support, care coordination, and an on-going assessment of client barriers to maintaining stable housing and linkage to needed services. The project will target adults (over age 18) in the overwhelmingly African American and Hispanic neighborhoods of East and Central Harlem in Manhattan; Hunts Point-Mott Haven/Highbridge-Morrisania in the South Bronx; and Bedford-Stuyvesant/Crown Heights in Central Brooklyn. The economic conditions in these neighborhoods are among the poorest in New York City (NYC) and residents have high rates of mental illness and substance use: drug-related and mental health hospitalizations are roughly 1.5–3 times higher compared to NYC overall. These areas also disproportionately harbor the city’s 64,000 homeless individuals, a population that has higher mortality, worse access to care, and higher rates of almost all chronic conditions, including behavioral health disorders, compared to the general population. The homeless face complex, multidimensional barriers to accessing services and remaining engaged in care, and the racial disparities of the homeless population (close to 90% of NYC’s shelter residents are African American or Hispanic) further drive disparities in behavioral health outcomes. In addition to linking clients to mental health and substance use services at BH’s licensed Behavioral Health Center, the project will implement four evidence-based practices—Screening, Brief Intervention, and Referral to Treatment (SBIRT), Wellness Self Management Plus (WSM+), Critical Time Intervention (CTI), and a Tobacco Cessation Program based on SAMHA’s Smoking Cessation for Persons with Mental Illness. These interventions will be part of BH’s existing trauma-informed and recovery-oriented behavioral health and supportive services, which include benefits enrollment assistance and medical care provided in collaboration with community partners, case management, and peer support. By increasing capacity and providing integrated mental health, substance use and supportive services and linkages to permanent housing, the program aims to improve the health of homeless individuals with SMI or COD and reduce homelessness through the following objectives: 1) Reduce clients’ substance use; 2) Improve clients’ mental health; 3) Improve access to and retention in behavioral health services; 4) Increase linkage to permanent housing; and 5) Improve housing stability through increased provision of or linkage to recovery support services. The project will serve 336 clients over the five-year funding period (56 in year 1; 70 in years 2-5). BH will measure project implementation and outcomes via data collected through GPRA Intake, Follow-up and Discharge Assessments; progress on individual Care Plans; screening/assessment tools to continually assess clients’ barriers to sustainable housing; and independent evaluations of SBIRT, WSM+, and CTI.
