Community Connections
Services for Homeless Individuals with Co-Occurring Mental Health and Substance Use Disorders

In the late 1980's, the complex and interacting mental health and substance use problems of many homeless individuals were increasingly evident. With funding from the National Institutes on Alcohol Abuse and Alcoholism, Community Connections and the New Hampshire-Dartmouth Psychiatric Research Center conducted a study to examine the effects of integrated mental health, substance abuse, and housing interventions for homeless, dually diagnosed adults.
Using a quasi-experimental design, we compared integrated treatment to standard community services for 217 individuals over an 18-month period. At CC (the integrated condition), participants received nearly all outpatient services, including housing, mental health, and substance abuse treatment. All services were closely coordinated by two case management teams. The "standard treatment" group received services through multiple agencies in the D.C. community. These services were based on a parallel treatment approach with separate systems addressing different problems. The key difference between conditions, then, was the level of integration of services.
Results demonstrated several advantages of integrated services. Participants in the integrated services condition had fewer institutional days and more days in stable housing, made more progress toward recovery from substance abuse, and showed greater improvement of alcohol use disorders than did participants in the standard treatment group.
For information about related training opportunities, please see our Training & Consultation page, Events Calendar, or contact Lori Beyer, MSW, Director of Trauma Training, at 202-608-4788 or at
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