Longitudinal assessment of family support among homeless mentally ill participants in a supported housing program

Although strengthening the family relations of individuals with severe mental illness has been identified as an important objective for community-based case management programs, little is known about the impact of such programs on patterns of family relations over time. This study assesses longitudinally the family support of a large sample of homeless mentally ill individuals participating in a supported housing program. The program randomly assigned participants to one of four experimental conditions created by varying the level of access to independent housing and the intensity of case management services provided. Substantial improvements were found during the 3-year follow-up period for frequency of family interaction, perceived availability, and satisfaction with family. Regression analyses were used to model factors correlated with change. Improvement in support was not associated with housing or case management conditions. Increased levels of family support were associated with housing status and mental health status. Clients in stable independent and community housing showed greater improvement than a group of clients living in an unstable housing environment. Substantial gains in family relations also occurred among a subgroup who did not achieve housing stability, but received family housing assistance during follow-up. The lack of relationship between the experimental intervention and change in support is discussed. © 1998 John Wiley & Sons, Inc.