Stephen Metraux

Bio: Stephen Metraux is an academic researcher from University of Delaware. The author has contributed to research in topics: Population & Mental illness. The author has an hindex of 28, co-authored 90 publications receiving 3294 citations. Previous affiliations of Stephen Metraux include University of Pennsylvania & United States Department of Veterans Affairs.

Public Service Reductions Associated with Placement of Homeless Persons with Severe Mental Illness in Supportive Housing

Abstract: This 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.

Testing a typology of family homelessness based on patterns of public shelter utilization in four U.S. jurisdictions: Implications for policy and program planning

Abstract: This study tests a typology of family homelessness based on patterns of public shelter utilization and examines whether family characteristics are associated with those patterns. The results indicate that a substantial majority of homeless families stay in public shelters for relatively brief periods, exit, and do not return. Approximately 20 percent stay for long periods. A small but noteworthy proportion cycles in and out of shelters repeatedly. In general, families with long stays are no more likely than families with short stays to have intensive behavioral health treatment histories, to be disabled, or to be unemployed. Families with repeat stays have the highest rates of intensive behavioral health treatment, placement of children in foster care, disability, and unemployment. The results suggest that policy and program factors, rather than family characteristics, are responsible for long shelter stays. An alternative conceptual framework for providing emergency assistance to homeless families is discussed.

Homeless shelter use and reincarceration following prison release

Abstract: Research Summary: This paper examines the incidence of and interrelationships between shelter use and reincarceration among a cohort of 48,424 persons who were released from New York State prisons to New York City in 1995-1998. RESULTS show that, within two years of release, 11.4% of the study group entered a New York City homeless shelter and 32.8% of this group was again imprisoned. Using survival analysis methods, time since prison release and history of residential instability were the most salient risk factors related to shelter use, and shelter use increased the risk of subsequent reincarceration. Policy Implications: These findings show both homelessness and reincarceration to be substantial problems among a population of released prisoners, problems that fall into the more general framework of community reintegration. They also suggest that enhanced housing and related services, when targeted to a relatively small at-risk group among this population, have the potential to substantially reduce the overall risk for homelessness in the group. Language: en

The Age Structure of Contemporary Homelessness: Evidence and Implications For Public Policy

Abstract: Amidst concern about the implications of an aging U.S. population, recent evidence suggests that there is a unique aging trend among the homeless population. Building on this, we use data from New York City and from the last three decennial Census enumerations to assess how the age composition of the homeless population—both single adults and adults in families—has changed over time. Findings show diverging trends in aging patterns for single adults and adults in families over the past 20 years. Among single adults, the bulk of the sheltered population is comprised of persons born during the latter part of the baby boom era whose high risk for homelessness has continued as they have aged. Specifically, the age group in this population facing the highest risk for homelessness was 34–36 (born 1954–1956) in 1990; 37–42 (born 1958–1963) in 2000; and 49–51 (born 1959–1961) in 2010. In contrast, among adults in sheltered families, there is no indication of any progressive aging of the family household heads. The modal age across the study period remains at 21–23 years of age. We consider implications for the health care and social welfare systems, and policy responses to homelessness.

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Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

Abstract: www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.

What is resilience? A review and concept analysis.

Abstract: The complexities of defining what appears to be the relatively simple concept of resilience are widely recognized. This paper analyses the concept of resilience from a range of disciplinary perspectives and clarifies a definition in order to inform research, policy and practice. The work takes a life course approach to resilience, examining evidence derived from research across the lifespan. It incorporates the methods of systematic review, concept analysis and consultation through face-to-face meetings. The synthesis of methodological approaches enables a clear identification of the antecedents, defining attributes and consequences of resilience, validated with stakeholder partners. Through this process, resilience is defined as the process of effectively negotiating, adapting to, or managing significant sources of stress or trauma. Assets and resources within the individual, their life and environment facilitate this capacity for adaptation and ‘bouncing back’ in the face of adversity. Across the life course, the experience of resilience will vary. A large proportion of resilience research is routed within the discipline of developmental psychology, and has mainly been developed with children and adolescents. A major contribution to resilience research could be made through more multi-disciplinary studies that examine the dynamics of resilience across the lifespan, its role in healthy ageing and in managing loss, such as changes in cognitive functioning.

A Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems

Abstract: We test whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system. In T. L. Scheid T. N. Brown (Eds.), A handbook for the study of mental health: Social contexts, theories. Find 9780521567633 A Handbook for the Study of Mental Health : Social Contexts, Theories, and Systems by Horwitz et al at over 30 bookstores. Buy, rent. A review of mental health problems in fathers following the birth of a child. for the study of mental health:Social contexts, theories, and systems (2nd ed., pp.