Neighborhood locations of Section 8 housing certificate users with and without mental illness

OBJECTIVE

The study examined whether participants with mental illness in the federal Section 8 housing subsidy program settle in neighborhoods different from those of Section 8 participants without mental illness. The nature of these differences and the reasons they occur were also examined.

METHODS

Data sources included the Section 8 survey for Baltimore and Cincinnati of the national evaluation of the Robert Wood Johnson Foundation Program on Chronic Mental Illness, police records, and 1990 census tract files, supplemented with the addresses of all Section 8 users and mental health services in both cities. Analyses consisted of calculations of dissimilarity indexes, comparisons of means, and multiple regressions.

RESULTS

Dissimilarity index scores were .54 for Baltimore and .48 for Cincinnati, indicating that roughly half of all Section 8 users with mental illness would have to move to eliminate neighborhood disparities between them and Section 8 users without mental illness. Section 8 users with mental illness settled in somewhat better neighborhoods than those without mental illness. This finding was largely attributable to the sizable disparities in the racial composition of the two groups of Section 8 users: a greater proportion of users with mental illness were white.

CONCLUSIONS

The neighborhood quality of Section 8 users with mental illness was found to be at least as high as that for users without mental illness. It is not clear whether the Section 8 program of the Program on Chronic Mental Illness disproportionately served whites, although the racial composition of the Section 8 program in both cities is disproportionately black.

The provision of high levels of personal assistance services in the U.S

State programs which provide personal assistance services (PAS) were surveyed to determine how many offer 24-hours of PAS per day if necessary. A total of 103 programs in 44 states were contacted and of these 23 (22.3%) in 7 states said that they offered 24-hour PAS in at least some circumstances. Persons with significant levels of disability who do not have extensive informal supports and live in states which do not offer 24-hour PAS may be placed in nursing homes or other institutions. The research highlights problems in defining 24-hour PAS and determining who needs this level of service. The economic and policy implications of 24-hour PAS are discussed and specific research is recommended on the cost of different models of service provision.

Showdown time

There may not be a train wreck this fall, but that doesn't mean that there won't be some close calls as the White House and Congress come to grips on such issues as spending and taxes, health care, welfare and the environment.

The compulsory removal of elderly people in England and Wales under Section 47 of the National Assistance Act and its 1951 Amendment: a survey of its implementation in England and Wales in 1988 and 1989

Section 47 of the National Assistance Act 1948 and its 1951 Amendment allow for the compulsory removal from their homes of predominantly elderly people to a place of safety. The Amendment has been in use for over 40 years. Little information is available on the workings of the Acts in England and Wales. For the period 1988 to 1989 inclusive, 771 requests for compulsory removal were received by 148 'proper officers'. We examined referrals and removals under the Acts. During this time 165 people were removed. The majority of referrals were from family practitioners (46%), but social workers also played a role (18%). Of the 165 people who were actually removed from their homes, 41 were removed under Section 47 of the National Assistance Act and 124 under its 1951 Amendment. The outcome of compulsory removal was only known in 126 instances. In 34% of cases the person was transferred to residential care and 24% returned home; 18% of the detainees died during their compulsory admission. The outcome varied significantly between health regions (chi 2 = 72; p < 0.001), with for example apparently high death rates in the North West, Trent and South West regions. For a disturbing 24% of people nothing is known of their fate. A mandatory reporting system to examine the use of this legislation is required.

Can we make a new deal? Entitlement reform sounds alluring, but the reality is stark

After simmering for more than a decade, the Great Entitlement Debate promises to dominate the 1995 congressional agenda. But lost amid a tangle of conflicting parochial interests, voter confusion and searing partisan rhetoric are some harsh truths about our options.

Chipping away at general assistance: a matter of economics or an attack on poor people?

Over the past few years, a number of states and localities have restricted or discontinued their general assistance programs. This article describes the political climate that contributed to these general assistance changes and recommends efforts social workers should be making toward reversing this trend.

Unleashing the health care border guards

A fervent anti-immigrant sentiment is picking up momentum, and it is reflected in state and federal legislative proposals, including those addressing health reform. If these bills become law, including a California initiative, doctors and nurses could be turned into border patrol guards, and as many as one million legal immigrants could be denied non-emergency medical care.

Social services to assist nutrition

Social services to assist in improving nutritional status in older adults are reviewed. The social service interventions are placed in three broad categories of risk for older people to include poverty, social isolation, and dependency/disability. Each social service is identified and described to include eligibility and local resources. A social services intervention contact guide is provided as well as a state-by-stage aging services and resources directory.