Qualitative Research for and in Practice: Findings from Studies with Homeless Adults Who Have Serious Mental Illness and Co-Occurring Substance Abuse

This article draws upon findings from the New York Services Study, a Federally-funded qualitative study conducted in practice
settings representing two fundamentally different approaches to serving homeless adults with serious mental illness and co-occurring
substance abuse. The findings yielded four themes—cumulative adversity, individual acts of kindness in a system designed to
control, discordant case managers’ perspectives, and the benefits of permanent housing. Recommendations for practice include
respecting individuality, being sensitive to previous traumas, and working to achieve housing security sooner rather than
later. Future research is needed to study the micro-level contexts of service delivery and how they inhibit or encourage engagement
in care.