Homelessness Prevention in the Treatment of Substance Abuse and Mental Illness: Logic Models and Implementation of Eight American Projects

This book describes eight programs designed to prevent homelessness in high-risk populations with problems of alcoholism, drug abuse, and mental illness. The programs were funded by the Substance Abuse and Mental Health Services Administration. Each is described by key persons in the program. (The material was also published as numbers 1 and 2 of volume 17 of the Alcoholism Treatment Quarterly.)

The book places much emphasis on "logic models" developed for each program. A logic model provides a schematic representation, a detailed figure with multiple boxes, showing the target population and environmental contexts, the interventions provided by the program and the theory and assumptions underlying the interventions, the structure of the program and its distinctive features, and the intended outcomes, including short-term, intermediate, and long-term goals.

The program descriptions and their rationales are interesting and generally well presented. I am of two minds about the logic models. On the one hand, they no doubt help those operating these programs to conceptualize what they are doing and why. In addition, after one reads the program descriptions, the logic models provide a summary, often somewhat complex, of the various aspects of these programs. On the other hand, it is not clear how much the models actually add to the program descriptions.

All of these programs were designed with built-in program evaluations. However, there has not been time for these evaluations to be completed and analyzed. This would have been a far better book if the editors had waited another two years so that the reader would know how successful these programs had been, in whole or in part, and why.

Among the more valuable aspects of this book are the sections on lessons learned, especially in the chapters by Richard Bebout, by Sam Tsemberis and Sara Asmussen, by Michael Kirby and associates, and by Kendon Conrad and associates. These sections report hard-won, practical knowledge that is useful and well worth reading.

This book, then, has the potential for being a valuable addition to the literature on treating and preventing homelessness among mentally ill persons in its next edition, when the objective evaluations are available and, one hopes, more of the authors' considerable amount of practical experience is presented.

Dr. Lamb is professor of psychiatry at the University of Southern California School of Medicine in Los Angeles.