Evaluating SAMHSA’s Four Homelessness Programs and Resources

Opportunity

With our project partners (RTI International, Advocates for Human Potential, Technical Assistance Collaborative and Center for Mental Health Policy and Services Research of the University of Pennsylvania), we worked to evaluate the effectiveness of and models of service delivery of four SAMHSA-funded programs that provide services to people who are experiencing homelessness and living with mental health and/or substance use disorders.

Approach

Expanding access to treatment, support services and permanent housing

SAMHSA awards grants to fund programs and initiatives focused on meeting the treatment, housing, and support service needs of people who are homeless and have substance use disorders, serious mental illness, serious emotional disturbance, or co-occurring mental and substance use disorders. Between 2009 and 2012, SAMHSA funded nearly 200 grantees through four grant programs (three discretionary grants and one formula grant) to address housing instability among people with mental health and/or substance use disorders. Those programs are:

• Cooperative Agreements to Benefit Homeless Individuals (CABHI)
• Grants for the Benefit of Homeless Individuals (GBHI)
• Programs for Assistance in Transition from Homelessness (PATH)
• Services in Supportive Housing (SSH)

Funds for GBHI programs come from SAMHSA’s Center for Substance Abuse Treatment, whereas SAMHSA’s Center for Mental Health Services funds the SSH and PATH programs; together, the two Centers jointly fund the CABHI programs.  

While the four grant programs share the same overarching goal, each has its own unique subset of goals or area of focus that sets it apart.

Data collection and reporting

To produce a comprehensive picture of the four homelessness grant programs and their effectiveness, the evaluation included structure/process, outcomes and cost evaluation components and collected data at the client, grantee, and systems level through:

• Project Director Web Surveys
• Informant Web Surveys
• Evidence-Based Practice (EBP) Self-Assessment Surveys
• Permanent Supportive Housing (PSH) Self-Assessment Surveys
• Supplemental Client Interviews (SCI)
• Site visits to grantees
• Consumer focus groups
• Cost study

The evaluation also made use of existing client-level data collected via the CSAT Government Performance and Results Act (GPRA) and the CMHS National Outcome Measures (NOMs) interviews for the three discretionary programs and annual data submitted by PATH grantees and providers.

HSRI was particularly involved in programming and fielding the Project Director and Stakeholder Web Surveys, conducting site visits to grantees, and conducting consumer focus groups.  We were also involved in data analysis and reporting.  We led the evaluation of the PATH program, which required a separate evaluation report.

Changes in Unmet Service Needs

Using data from the supplemental client interviews, we examined changes in unmet service need. Program participants were asked in the baseline interview and 6-month follow-up interview whether they needed and received any of 14 services in the last 6 months. Using their responses, we calculated across the three discretionary programs (CABHI, GBHI and SSH program) and separately for each program the percentage of services that were needed but not received. We found large decreases in unmet need for many types of services. For key services (substance abuse treatment, mental health services, and “core” services that included housing, transportation support, and case management or coordination), unmet need was reduced by more than half. 

Impact

Our evaluation found that project participants in the three discretionary grant programs reported improvements in key outcomes and that grant projects were successful in meeting people’s needs for services. Grantees across the four programs successfully implemented services in accordance with grant requirements.