Introduction

This chapter is in two sections. The first section will be a survey of the types of evaluative studies that have been conducted on services for homeless people with mental disorders. The survey will pay particular attention to the problems that have arisen in carrying out these studies. This section will be illustrated throughout by examples of evaluative studies from the UK literature; where UK studies are lacking, examples will be taken from the world literature.

The second section will consider how far evaluative studies have provided evidence for the effectiveness of hostels for the homeless. As indicated in Chapter 9 the role of hostels in this area is increasingly controversial.

A Survey of Evaluative Studies

Evaluative studies of services for homeless people with mental disorders can be classified according to design. Such a classification produces the following broad groupings:

1. Retrospective evaluations.

2. Evaluations based on the impressions of a trained observer.

3. Surveys.

4. Follow-up evaluations.

5. Before and after evaluations.

6. Single case and ‘action research’ evaluations.

7. Quasi-experimental evaluations.

8. Randomized controlled trials.

Examples of evaluations from each of these groupings will be discussed below. The discussion will pay particular attention to the reasons for adopting particular designs and the problems that arise in implementing these designs with homeless subjects.

Retrospective evaluations

Description

Retrospective evaluations are based on the analysis of routine data collected during clinical work.

Uses of retrospective evaluations

Retrospective evaluations may usefully describe the structure of a new service and the activities of that service.