Hadley, Trevor
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Publication Public Service Reductions Associated with Placement of Homeless Persons with Severe Mental Illness in Supportive Housing(2002-01-01) Culhane, Dennis P.; Hadley, Trevor; Metraux, StephenThis article assesses the impact of public investment in supportive housing for homeless persons with severe mental disabilities. Data on 4,679 people placed in such housing in New York City between 1989 and 1997 were merged with data on the utilization of public shelters, public and private hospitals, and correctional facilities. A series of matched controls who were homeless but not placed in housing were similarly tracked. Regression results reveal that persons placed in supportive housing experience marked reductions in shelter use, hospitalizations, length of stay per hospitalization, and time incarcerated. Before placement, homeless people with severe mental illness used about $40,451 per person per year in services (1999 dollars). Placement was associated with a reduction in services use of $16,281 per housing unit per year. Annual unit costs are estimated at $17,277, for a net cost of $995 per unit per year over the first two years.Publication Policy to Implementation: Evidence-Based Practice in Community Mental Health — Study Protocol(2013-01-01) Beidas, Rinad S; Barg, Frances K; Evans, Arthur C; Hadley, Trevor; Marcus, Steven C; Aarons, Gregory; Mandell, David S; Hoagwood, Kimberly; Schoenwald, Sonia; Walsh, LuciaBackground: Evidence-based treatments (EBTs) are not widely available in community mental health settings. In response to the call for implementation of evidence-based treatments in the United States, states and counties have mandated behavioral health reform through policies and other initiatives. Evaluations of the impact of these policies on implementation are rare. A systems transformation about to occur in Philadelphia, Pennsylvania, offers an important opportunity to prospectively study implementation in response to a policy mandate. Methods/design: Using a prospective sequential mixed-methods design, with observations at multiple points in time, we will investigate the responses of staff from 30 community mental health clinics to a policy from the Department of Behavioral Health encouraging and incentivizing providers to implement evidence-based treatments to treat youth with mental health problems. Study participants will be 30 executive directors, 30 clinical directors, and 240 therapists. Data will be collected prior to the policy implementation, and then at two and four years following policy implementation. Quantitative data will include measures of intervention implementation and potential moderators of implementation (i.e., organizational- and leader-level variables) and will be collected from executive directors, clinical directors, and therapists. Measures include self-reported therapist fidelity to evidence-based treatment techniques as measured by the Organizational Social Context Measurement System and the Implementation Climate Assessment, leader variables as measured by the Multifactor Leadership Questionnaire, attitudes towards EDTs as measured by the Evidence-Based Practice Attitude Scale, and knowledge of EBTs as measured by the knowledge of Evidence-Based Services Questionnaire. Qualitative data will include semi-structured interviews with a subset of the sample to assess the implementation experience of high-, average-, and low-performing agencies. Mixed methods will be integrated through comparing and contrasting results from the two methods for each of the primary hypotheses in this study. Discussion: Findings from the proposed research will inform both future policy mandates around implementation and the support required for the success of these policies, with the ultimate goal of improving the quality of treatment provided to youth in the public sector.Publication Supportive Housing for Homeless People with Severe Mental Illness(2002-02-20) Culhane, Dennis P; Hadley, Trevor; Metreaux, StephenResearch suggests that as many as 110,000 single adults with severe mental illness (SMI) are homeless on any given day in the United States. The combination of mental illness and homelessness make this population especially hard to reach through either housing or mental health programs alone. Supportive housing programs, which provide independent housing along with health and social services, hold great promise for this population, but are costly to launch and maintain. This Issue Brief highlights a landmark study that examines the extent to which supportive housing costs are offset by reductions in the use of public services for health, corrections, and shelter.