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While epidemiological research has offered much valuable information about substance use among homeless persons in general and homeless mentally ill persons in particular it has lacked information about the context in which substance use occurs, patterns of use, how use influences subsistence adaptation, and factors that mediate its effects. The Adaptation of the Homeless Mentally Ill (AHMI) research was able to address these gaps in our knowledge through long-term ethnographic field work with 50 homeless mentally ill individuals in the Skid Row area of Los Angeles. Most importantly, we found variation in the extent to which alcohol and drug use dominated the lives of sample members. Where some individuals organized their lives completely around the pursuit and use of drugs and alcohol, others were able to precariously balance their substance use with the tasks of meeting their basic needs. We then examine several of the possible factors that shape the relationship between substance use and subsistence adaptation, looking specifically at: (1) Skid Row; (2) psychopathology; (3) institutional affiliations; (4) values and beliefs, and; (5) the role of eventfulness. We conclude by summarizing our findings and their implications for social policy.

This paper examines the economic resources of homeless adults using a unique data set from Los Angeles. The homeless rely on a variety of sources for income; the two most common sources are the government and the family. Over 58% received government transfers in the 30 days prior to the interview, while one‐third had received cash assistance from a family member or friend. Familial transfers in the form of shared housing and meals also are important. While familial transfers buffer declines in income among the homeless, private support networks are not pervasive enough to overcome the severe difficulties the homeless face. Moreover, it is unclear why such a high share of the homeless do not participate in government assistance programs, although the evidence suggests that transaction costs are likely to be an important factor.

Recent efforts on the part of survey researchers to understand the characteristics and needs of homeless individuals have been hampered by factors which make it extra ordinarily difficult to draw representative samples of this population. To date, only one study (Rossi et al., 1987) has drawn a probability sample of homeless persons that includes unsheltered individuals. Because the design of the Rossi study can only accommodate a short interview and is best carried out in one night, additional designs that allow more lengthy interview protocols and data collection periods are needed. An effort to draw a probability sample of homeless adults in the inner-city area of Los Angeles resulted in a sampling design that meets these criteria. This article describes this design in detail.

Decisions about how inclusive one should be in attempting to sample and/or enumerate homeless populattons are best guided by information regarding what is sacrificed when different sampling choices are made. This article draws upon data from the Course of Homelessness Study to explore how three progressively less inclusive sampling frames affect understandings of the size and characteristics of homeless populations in two Los Angeles sites. Findings suggest that less inclusive sampling frames substantially affect populatton estimates, but do not consistently produce biased estimates of population characteristics. Whether, and the extent to which, such bias is introduced varies by site, by gender, and by the population characteristic in question.

Objective: To compare community engage­ment and planning (CEP) for coalition support to implement depression quality improvement (QI) to resources for services (RS) effects on service-use costs over a 12-month period.Design: Matched health and community programs (N=93) were cluster-randomized within communities to CEP or RS.Setting: Two Los Angeles communities.Participants: Adults (N=1,013) with depressive symptoms (Patient Health Questionnaire (PHQ-8) ≥10); 85% African American and Latino.Interventions: CEP and RS to support pro­grams in depression QI.Main outcome measures: Intervention training and service-use costs over 12 months.Results: CEP planning and training costs were almost 3 times higher than RS, largely due to greater CEP provider training partici­pation vs RS, with no significant differences in 12-month service-use costs.Conclusions: Compared with RS, CEP had higher planning and training costs with simi­lar service-use costs.Ethn Dis. 2018;28(Sup­pl 2):349-356; doi:10.18865/ed.28.S2.349.