Evaluating SAMHSA’s PATH program

Housing & Homelessness

PATH: Improving access to permanent housing to assist recovery

Under subcontract to RTI, we’ve been working with SAMHSA to evaluate the effectiveness of federal programs that help people with serious mental illness or substance use disorders (or both) access permanent housing.

Impact

Our most recent evaluation of SAMHSA’s PATH program—examining 2010-2012 data—showed that the program achieved its intended outcomes and expanded its reach, providing services to approximately 200,000 people each year, and was highly regarded by the people it served. 

Services
  • Evaluation

Housing as a crucial piece of recovery

Safe and stable housing is a critical component of recovery from mental health or substance use disorders, and SAMHSA seeks to increase access to permanent housing through its homelessness programs. These programs provide funds to states and territories to support a variety of behavioral health treatments and recovery-oriented services.

SAMHSA’s Projects for Assistance in Transition from Homelessness (PATH) program is one such program and was authorized under the Stewart B. McKinney Homeless Assistance Amendments Act of 1990. This Act mandates that the PATH program be evaluated every three years. PATH provides grant funds to fifty states, the District of Columbia, Puerto Rico and four US territories.  States (but not territories) are required to match PATH funds with at least $1 in cash or in-kind services for every $3 in federal funds.

Most grantees award these funds to local public or nonprofit organizations to provide: 

  • Outreach
  • Screening and diagnostic treatment
  • Habilitation and rehabilitation
  • Community mental health
  • Substance use treatment
  • Case management services
  • Referrals for primary healthcare, job training, educational services, and housing
  • Housing services as specified in Section 522(b)(10) of the Public Health Service Act

The priority population for PATH is people who are literally homeless: people living outdoors or in a short-term shelter when providers first contact them. SAMHSA also asks its PATH grantees to prioritize funding to providers who serve veterans.

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PATH providers served a growing number of consumers between 2010 and 2012.

Examining effectiveness of PATH funding and services

Analyzing data from grantees’ annual reports, along with data we collected through web surveys of state coordinators and service providers and through site visits with grantees and consumers, we were able to answer questions of interest to SAMHSA:

  • Whether the services funded with PATH dollars were appropriate
  • Whether the grantee programs were well administered
  • Whether outcomes and process goals were achieved

The results

We found that PATH grantees were clearly targeting the intended population: 90.1% of enrolled consumers had a mental illness diagnosis; approximately 50% had co-occurring mental health and substance use disorders; and over 50% met the definition of literal homelessness.

We also found that PATH grantees had heeded SAMHSA’s encouragement to provide priority services, including outreach (provided to ~80% of enrolled consumers), case management (~70%), and community mental health services (~65%).

State coordinators were using multiple strategies to make sure the grantee programs were well administered: using available data to monitor performance, offering a range of training and technical assistance to staff, and transitioning to a standardized reporting system.

And the program exceeded its outcomes targets in 2011 and 2012, with providers making contact with more people, enrolling more in services, and providing community mental health services to a greater number than targeted.

Client(s):

Substance Abuse and Mental Health Services Administration

Project Partner(s):

RTI International

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