Mission Neighborhood Resource Center (MNRC) partners with the Psychiatric Foundation of Northern California (PFNC) and the Harm Reduction Therapy Center (HRTC) to provide on-site harm reduction and bilingual individual and group-level psychotherapy and psychiatric services to homeless immigrants living with episodic and ongoing mental illnesses. A particular focus is chronic drug and alcohol users among this population, who have been traditionally excluded from mental health and drug treatment services.
The collaborative evaluation project had as its intention to provide crucial outcome data that accurately measure life stability, psychiatric symptoms, drug use and related negative effects within this diverse and difficult to serve population.
By utilizing a collaborative and participatory approach to the design and implementation of the comprehensive evaluation of the mental health services offered at MNRC, we aimed to increase the capacity at this agency and their partnership with Psychiatric Foundation of Northern California and the Harm Reduction Therapy Center.
The collaborative approach and subsequent findings will also be of great use to other service providers and scholars working on issues of homelessness, mental health services, substance abuse and HIV transmission among marginalized immigrant populations in the United States.
MNRC clients in this study perceive that their participation in the MNRC harm reduction program benefits them along a number of dimensions including general health, mental health, substance use, personal relations, and life stability. In particular, the program is helpful in reducing substance use related problems and accessing services to help with their problems in general.
Clients reported improved health outcomes and less concern over health-related and other life problems after participation in the program. Of note were statistically significant improvements (95% confidence level) between initial and follow measures for:
* how much family problems worried or bothered them
* how much the way they spent free time worried or bothered them
* how much psychological or emotional problems worried or bothered them
* the importance of receiving treatment for psychological or emotional problems
* how much problems with alcohol worried or bothered them
After participation in the program, clients reported:
* Better psychological and emotional states. Overall, those who did experience negatives states were less worried or bothered by them. This overall improvement was the most significant statistically of all the before and after measures (p=.002; 95% confidence). Clients also felt that the need for treatment for psychological and emotional problems was lower after their participation, perhaps signaling the effectiveness of the treatment they received.
* Decrease in being worried or bothered by problems with alcohol. Most of those who reported problems with substance use (more than 8 out of 10) agreed that they had fewer substance use related problems after participating in the program.
* Less harm (in general and to others) due to their alcohol use╩ (i.e. they need less help and are less likely to feel their alcohol use is a problem).
An analysis of the impact of different amounts and types of treatment received by the individuals participating in this study indicates that there may be subgroups within this population that require different amounts and types of treatment depending on their current condition and effect of treatment available. Some clients may require more intensive treatment beyond harm reduction therapy.
Significantly, it appears that even minimal contact (e.g., two therapy sessions) with the program has beneficial outcomes. It could be that initiating contact with a supportive agency such as MNRC has a stabilizing effect regardless of the type and amount of treatment that follows. Larger samples and more rigorous data collection standards and tracking procedures are required to further examine the impact of different amounts and types of treatment.