Russell K. Schutt, Ph.D.


University of Massachusetts at Boston



First I must thank my interviewers, all graduate students at UMass/Boston, for their exemplary assistance:  Dianne Fitzpatrick, John Flaherty, Stephanie Howard, Doug Klayman, Tatjana Meschede and Joan Struzziery.  The interviewing was financed by the Long Island Shelter and by the University of Massachusetts at Boston's Office of Graduate Studies and Research, and by one federal work-study grant.  I am grateful in particular to Barbara Blakeney, Richard Weintraub and William Dillon of the Long Island Shelter and to Dean Fuad Safwat, UMass/Boston, for their support and encouragement.  Many staff assisted in the study in many ways, and I am grateful to each one of them.  Finally, and most importantly, I thank the many guests of the Long Island and Woods-Mullen shelters for participating in the study.



EXECUTIVE SUMMARY                                        i

INTRODUCTION                                             1

METHODOLOGY                                              1

BACKGROUND                                               3

THE SHELTER EXPERIENCE                                   5

SERVICES                                                 8


SOCIAL SUPPORT                                          11

PHYSICAL HEALTH ASSESSMENT                              13

MENTAL HEALTH ASSESSMENT                                15

TRAUMA AND ABUSE                                        19

SUBSTANCE ABUSE                                         20

AIDS                                                    22

LEGAL HISTORY                                           25

WORK AND BENEFITS                                       26

SERVICE NEEDS                                           28

CONCLUSIONS                                             29

RECOMMENDATIONS                                         30


****Shelter users were most likely to be young black men, but there were many who were older, white and female. 

****Woods-Mullen guests were more likely to be black and female than were those at the Long Island Shelter.

****About equal proportions had not finished high school, graduated from high school, and had some education beyond high school.  Literacy was a problem for about one in five.

****Women tended to have more social supports than men.

****Lower levels of education were associated with a higher likelihood of having been incarcerated.

****Lower levels of education were associated with more satisfaction with the shelter.

****Reading problems were associated with less likelihood of looking for work.

****Veterans were much more likely to have been assaulted or robbed in the past year.

****Members of minority groups were much less likely than whites to be participating in a contract bed program.

****Members of minority groups were more interested in AIDS education.

****Younger age was associated with higher levels of drug use, more legal problems, more interest in AIDS education, fewer health problems, less health insurance and fewer reports of victimization.

****Almost half of the respondents had had a contract bed; participation in the contract bed program was higher at Woods-Mullen than at Long Island.

****Guests were satisfied with the shelter; one-quarter found it preferable to their last regular housing.

****Shelter staff, the shelter's conditions and the shelter's health services were rated most highly; dissatisfaction was common with the shelter's location, with the other guests and with help about getting a job; the lack of privacy was the most common complaint.

****Long Island guests were more satisfied about the level of privacy; Woods-Mullen guests were more satisfied with their shelter's physical condition and its convenience to stores and shopping.

****The Department of Public Welfare and the Social Security Administration were the most often used service agencies.  Woods-Mullen guests had somewhat higher rates of contact with service agencies.  Services were received as needed from most agencies.

****About one in five guests stayed at times with friends, family and in other shelters.

****The median length of time homeless was about one year; more than one-third had been homeless two years or more.

****Guests were most likely to have last lived in Dorchester, Roxbury or the South End.

****The overwhelming majority of respondents wanted to move out of the shelter and get their own apartment.

****About two-thirds of the guests received at least a fair amount of personal support from family or friends--the family was the greatest source of support.  Shelter staff were also a key source of personal support for many.  Few were married.

****Almost half reported a current physical health problem; over one-third had no health insurance.

****Those who had health problems were less likely to be working or looking for work, but were more likely to have financial benefits.

****About one in five had been hospitalized for a psychiatric problem.

****Symptoms of depression, thoughts of suicide and worry about getting AIDS were all higher among those who had been hospitalized for psychiatric problems; those previously hospitalized were also more likely to be receiving financial benefits.

****Traumatic events were common--being assaulted or robbed, having had at least one life-threatening experience, or being abused as a child.

****Childhood abuse was the single strongest correlate of other characteristics.  Those who reported physical assault as a child reported, at the time of the interview, more false beliefs and perceptions, more psychiatric hospitalization, more substance abuse and more physical health problems, more legal problems and greater experience of victimization within the preceding year.

****Drinking was a problem for one-third to half of the respondents.  Drinking was somewhat more common for those using the Long Island Shelter than Woods-Mullen.

****Drinkers were more depressed and suicidal, less able to afford things and less likely to be receiving financial benefits.  They were more likely to have been in the custody of youth services as an adolescent.

****About half had used some street drugs in the previous year; half of these had been treated at some time for a drug problem.

****Drug use was associated with more legal problems, more difficulty affording things and more legal problems.

****Half worried a lot about getting AIDS and half knew someone with AIDS.  About two-thirds wanted to learn more about AIDS.  One-third had been tested for HIV infection and another third wanted to be tested.

****Basic facts about HIV transmission were widely understood, but many were worried unnecessarily about transmission through blood transfusions, insects, toilet seats, kissing and food preparation.

****About one third mistakenly believed that AIDS can be cured, that drug users cannot avoid AIDS and that infected people cannot still feel healthy.

****About half had noticed AIDS prevention activity at the shelter.  About one-third were not comfortable with the idea of participating in AIDS prevention activities, such as picking up a condom.  About one in five believed that AIDS education had affected their own behavior.

****One quarter had current legal problems; two-thirds had been in jail or prison at some time.

****Almost all the respondents had worked in the past but three-quarters were not working at the time of the survey.  Two in five of the unemployed were looking for work.

****Two in five were receiving some type of financial benefits.

****Respondents rated the importance of receiving help in thirteen service areas.  Finding a place was rated most important by a large margin, but help with financial benefits and AIDS education were also viewed as critical service needs.  Help in most other service areas was viewed as important; help with legal problems and alcohol problems were viewed as important by the smallest portion of guests.

****A higher proportion of guests at Woods-Mullen were employed, had contact with service agencies and had social supports available than was true at Long Island; substance abuse also was more common at Woods-Mullen.


     Since Boston's Long Island Shelter first opened its doors in 1982, it has expanded both its bed capacity and its service approach.  Begun with 100 beds at one location, it now provides almost 700 beds in two locations; initially meeting only the emergency needs of guests for food, shelter and medical care, it now offers a physical health clinic, a psychiatric nurse, substance abuse counseling and job and training programs.  The shelter also has opened a home that provides transitional living for eight former guests.

     Service delivery for most of Long Island's guests begins with an intake interview administered by a case manager.  The intake interview identifies general service needs and particular concerns for each guest--a profile that can then inform subsequent decision-making by nurses, counselors and other shelter staff.  For years, statistical analysis of these intake interview data has helped to describe the diverse population of shelter guests and identify their unmet needs. 

     By 1990, the shelter's growth had begun severely to tax the capacity of the existing system for collecting, processing and analyzing intake interview data.  At the same time, shelter management began to detect changes in the service needs of shelter guests that suggested a need for a more systematic assessment.  As a result, the shelter decided to sponsor a comprehensive survey of its guests at both locations:  the Long Island Shelter itself and the newer Woods-Mullen Shelter that is administered by Long Island.  This report presents the basic survey findings and draws some comparisons with the earlier studies.


     Guests at the Long Island and Woods-Mullen shelters were asked to participate in the interview study between July and November, 1990.  Guests were identified for interviews using a stratified random sampling technique.  Nightly bed lists provided the sampling frame for the study.  On selected days and nights each week, guests whose bed numbers matched a randomly generated list of numbers were approached by a staff member or a research assistant and asked if they would consider participating in an interview.  Each prospective respondent was offered a pair of socks or a pack of cigarettes in exchange for participating, and each signed a detailed consent form before the interview began.  The acceptance rate was 80 percent.

     Shelter staff helped to recruit guests for the interviews, which were conducted by specially trained research assistants from the university's graduate programs in clinical psychology and applied sociology; interviews were conducted in special rooms at both locations and required from 45 to 90 minutes. 

     Many guests at both shelter locations participated in a "contract bed program."  Both special programs within the shelter and arrangements to facilitate activities outside of the shelter are operated as contract bed programs:  a shelter-based stabilization program for alcoholics, a work experience program within the shelter, enrollment in courses at a local college or training institute, or simply regular employment outside of the shelter.  Some contract beds also are allotted to individuals with physical or mental health problems who need special care.  Contract bed participants are able to keep their bed assignment each night and to leave some belongings at the shelter during the day; participants in in-shelter programs are also able to remain in the shelter during the day.

     Contract bed participants and other guests were sampled separately, in part to take advantage of the availability of many program participants for daytime interviews at the shelter, and to ensure proportional representation of both types of shelter users.  The final sample was then weighted to represent exactly the proportions of guests at the two shelters and in each program at both shelters.

     The interviews consisted of approximately 150 questions concerning respondents' residential history, satisfaction with the shelter, physical and mental health, substance abuse, employment and benefits, social supports and social background.  Questions were drawn from two sources:  the shelter's intake interview schedule and, in some areas, standard scales.  The following scales were included in the interview schedule:  the CES-D (a measure of depression); the PERI Scale of False Beliefs and Perceptions (psychotic thinking); the ISEL (a measure of social support); the xx program satisfaction scale; and selected questions from the ASI (the Addiction Severity Index).  An extensive series of AIDS awareness questions was also included in the interview schedule.  The Life Lines AIDS Prevention Project for the Homeless collaborated in developing these questions.

     In addition to describing the distributions of most variables, this report identifies differences between guests staying at Long Island and Woods-Mullen.  The relationship between numerous sets of variables also was investigated, and selected relationships are included in the report.  All reported differences were statistically significant at the .05 level or better; in other words, there is less than one chance in twenty that any association between two variables that is mentioned in the report was due to chance, rather than to an actual association in the total population of shelter guests.


More than half of the shelter users were younger than 40; one-quarter were in their twenties.  Nine percent of the shelter users were at least 60 years old.  The median age was 35.




           20s             26%*

           30s             33

           40s             16

           50s             17

           60s              9




*One respondent was 19 years old; she is included in the "20s" category in this table.


     Four in five shelter users were men.  More than half were black, while one-quarter were white and about one in ten were Hispanic. 



        Male               79%

        Female             21







       White                26%

       Black                57

       Hispanic             11

       Asian,Pacific         1

       Am. Indian,Alaskan    1

       Other                 4



     Prior schooling varied widely among the shelter users.  About one-third had gone no further than grade school, another third had completed high school, and one third had had some college (although very few had completed college).  About one in five reported some difficulty reading.





     No school, less than 8     5%

     Grade school              28

     High school               34

     GED                        8

     Some college              16

     Vocational school          3

     College                    1

     Graduate work              5








       Read well           81%                

       OK                  15

       Not at all           4






    Any trouble reading....


    Road signs              15%

    Newspaper               21

     Each of the demographic characteristics reported was associated with some health problems and other characteristics.  Men reported less social support than women--two-thirds of the women had at least a moderate level of social support available, compared to just under half of the men.  Those who had not graduated from high school were more likely to have been incarcerated--three-quarters compared to just over half.  The two education groups also differed in satisfaction with the shelter:  two-thirds of those who had not completed high school were satisfied with the shelter, compared to just under half of the high school graduates.  Self-reported problems with reading had one significant correlate:  those who reported problems with reading were less likely to be looking for work (50%) than those who did not report problems with reading (28%).  Veterans were much more likely than other men to report having been assaulted or robbed in the past year--two-thirds compared to about one-third.


Variable           Min. White

Contract Bed       39%  72%      

Interested--AIDS ed.53% 30%



Variable           <=30 31+

Use Drugs          46%  17%

Health problem     30%  52%

Health insrnce     44%  63%

Victimized         24%  50%

Legal problem      39%  18%

AIDS interest      63%  40%

Good health        75%  55%





     Most respondents used the shelter intensively:  more than half reported staying at the shelter "most of the time" since their first night at the shelter and two-thirds had stayed there every night during the previous week. 




Since first stay, you've stayed at this shelter...



         Most of the time     52%

         Some of the time     38

         Only rarely          10








                  0-1        10%

                  2-3         6

                  4-5        13

                  6-7        72



     Almost half of the respondents had participated in a contract bed program, in which they received a regular bed and some other privileges in exchange for participating in a program.  The specific program in which respondents had participated was not identified in many cases, but the most often mentioned programs were employment in or outside the shelter (13 percent) and health care (8 percent).  About four percent had participated in an in-shelter program for alcoholics.




Program Enrolled in or Finished


Program       Frequency  Percent 


Work Exp              7      4.7   

Lit Prog              1       .5   

Formal Sch            1       .5   

Stablz/Holding (Alc)  5      3.8   

Work outside          6      4.0   

Emp Serv              6      4.1   

Heal C               12      7.6   

Other Prog           23     14.5   

Program not known    28     18.1 

Not in Program       65     42.1   

                  -------  ------- 

        Total       155    100.0   

     More guests at the Woods-Mullen Shelter were participating in a contract bed program than at the Long Island Shelter--about two-thirds compared to one-third.

     A series of questions were asked to identify respondents' level of satisfaction with the shelter.  The responses indicated general satisfaction, with complaints about some particular shelter features.

Four in five shelter users were satisfied overall with the shelter in which they were interviewed; almost one-quarter were very satisfied and just under one in ten were very dissatisfied.  When compared to other shelters, two-thirds thought their shelter was better and only one in ten found it to be worse.  Nonetheless, when compared to their last regular housing, almost two-thirds said the shelter was worse--what is perhaps most striking is that more than one-quarter of the shelter users found the shelter to be at least somewhat better than their last regular housing.






          Very satisfied         23%

          Satisfied              50

          Dissatisfied           19

          Very dissatisfied       9







                   Other Shelters    Last R. Housing  

Much Better            34%                13%

Somewhat Better        31                 16

About the Same         24                 11

Somewhat Worse          6                 25

Much Worse              5                 36

                      100%               101%

                     (122)              (143)                   

     Satisfaction varied with specific shelter features.  Services at the shelter were rated as excellent by one in five and as at least good by more almost three in five.  About one-third thought the shelter's services were just fair, but only six percent rated services as poor.

     Satisfaction was highest with shelter staff, with the shelter's physical conditions and safety and with health services at the shelter.  At least seventy percent were satisfied in these areas.  Just over half the shelter users were satisfied with the shelter's convenience to stores and shopping, with the help the shelter provided with getting a job, and with the other residents of the shelter.  Satisfaction was lowest with respect to the amount of privacy at the shelter--just over four in ten were satisfied in this area and one-quarter were very dissatisfied.





              Excellent             22%

              Good                  37

              Fair                  35

              Poor                   6






                               V.         Dis-   V.       

                              Sat.  Sat.  Sat.  D.Sat. Tot.

Condition/state of repair     17%    63    14     6    100%

Amount of room/space          11%    65    18     6    100%

Furnishings                   11%    56    25     9    101%

Staff                         19%    61    12     8    100%

Amount of privacy              6%    37    32    25    100%

Security/safety               18%    53    18    12    101%

Other residents                8%    49    25    18    100%

Convenient for shopping       16%    43    25    17    101%

Health services               20%    49    21    10    100%

Help with getting a job        8%    49    27    16    100%



     Levels of satisfaction differed between Long Island and Woods-Mullen with respect to several satisfaction dimensions:  Long Island guests were more satisfied with the level of privacy at the shelter; Woods-Mullen guests were more satisfied with the shelter's condition and location.


     Shelter users relied on a wide array of service agencies for meeting their needs.  Four in ten had had contact with the Department of Public Welfare.  Both Social Security and other shelters had been contacted by about one-quarter of the respondents in the preceding year.  Between 10 and 15 percent of the respondents had had contact in the last year with the Boston Housing Authority, the St. Francis House day program and the Department of Social Services.  Other agencies and organizations had been used less often.

     Most respondents who had used another service agency or organization in the preceding year reported that they received the services they needed.  Over 90 percent had received the services they needed from other shelters and the St. Francis House, while between 80 and 90 percent had received the services they needed from DPW.  Among the agencies contacted by at least 10 percent of the respondents, satisfaction was lowest for two:  the Boston Housing Authority and the Department of Social Services.  Nonetheless, about two-thirds reported that they had received the services they needed from these agencies.

     Long Island Shelter guests reported somewhat less contact with service agencies than did Woods-Mullen guests.




                            Contact    Rcvd. Serv. Needed

Dept. Pub. Welfare           41%             85%(62)

Social Sec. Admin.           25%             82%(38)

Other homeless shelters      23%             93%(36)

Boston Housing Authority     14%             68%(21)

St. Francis                  13%             95%(18)

Dept. Soc. Services          11%             63%(16)

Vocational rehab              7%             66%(11)

Mass. Rehab. Comm.            7%             71%(10)

BCH Soc. Serv.                7%             85%(10)

Veteran's Admin.              6%             56%(9)

Dept. of Mental Health        5%             90%(8)

Other                         5%             75%(8)

Salvation Army                3%            100%(4)

Bridge                        3%            100%(7)

Agency for Elderly Af.        1%            100%(1)

Dept. of Immig.               1%            100%(1)

Traveler's Aid                1%            100%(2)

Comm. for Blind               0%             



     About one in five shelter guests had stayed with friends and another one in five with family members since they had used the shelter.  A comparable proportion had stayed in other shelters or halfway houses during this same period; just one in ten had stayed on the streets since first using the shelter.





        Friends                     18%

        Family                      20

        Own Place                   11

        Streets                     11

        Oth Shel or Hlfway Hse      23

        Institution                  3

        Other                        5

        Have only Stayed Here        9



     One-quarter of the respondents had been homeless for no more than four months; the median length of time homeless and the median length of time since first staying at the shelter was one year.  More than one-third had been homeless for at least two years.  Dorchester, Roxbury and the South End were the neighborhoods where most shelter users had most recently had a regular place.  Just seventeen percent came from outside the Boston metropolitan area; two-thirds had most recently lived in the city of Boston itself.





            Under a Month            7%

            1-4 Months              20

            5-11 Months             17

            1 Year-19 Months        18

            2-3 Years              21

            4 Years or More         16



                 LAST REGULAR PLACE



            South End                10%

            Back Bay                  4

            South Boston              1

            East Boston               3

            Boston Proper             5

            Roxbury                  16

            Dorchester               21

            Jamaica Plain             2

            Cambridge                 1

            Chelsea                   1 

            Brookline                 3

            Beacon Hill               2

            Roslindale                1

            Mattapan                  3

            Malden                    1

            Revere                    1

            South Sub. Bost.          5

            North Sub. Bost.          4

            West Sub. Bost.           1 

            Western Mass.             3

            Other N.E. States         1

            Outside N.E.             12

            Outside the U.S.          1



*Error due to rounding


     In spite of their overall satisfaction with the shelter, the respondents were eager to move on.  Almost two-thirds said they wanted to move out "right now," and all but five percent wanted to move out within at least one year.  The overwhelming favorite residential preference was for an independent apartment, rather than a group living arrangement.  Almost nine in ten respondents "definitely" wanted to get their own apartment rather than live with other folks from the shelter.

     Two-thirds felt "distressed" about not having a place to stay, although fifteen percent said they felt "OK" about not having a place to stay.





           Rest of my life          5%

           Several more years       0

           6 months-a year         15

           Several wks.-a month    19

           Like to move out now    61




   If given the choice, would you rather share a house w

  other folks from the shelter, or get your own apartment?..



    Definitely share house           2%

    Probably share house             2

    Don't really care, not sure      4

    Probably get own apartment       7

    Definitely get own apartment    86







          Distressed        65%

          So-So             20

          O.K.              15





     Although few respondents were married, most had some family connections.  The majority of respondents had never been married and about one in five were divorced; only one in ten were married or living together.  Nonetheless, almost two-thirds had relatives in the Boston area and two-thirds reported that they received a great deal or a fair amount of support from family members.  Two in five reported children in the Boston area and a similar proportion had children elsewhere.  Most of these children were in the care of a relative and about one in ten were in foster care.

     Friends were an important source of social support for the shelter users.  Most of the respondents, four in every five, had good friends in the Boston area and 62 percent received a great deal or a fair amount of personal support from friends. 

     Shelter staff also provided social support to many shelter users.  Almost half of the respondents reported a supportive relationship with someone on the shelter's staff and two-thirds received a great deal or a fair amount of personal support from shelter staff.  Overall, more than two-thirds reported having a special person they could count on in times of need.


              MARITAL STATUS



          Married            7%

          Living Together    3

          Separated          6

          Divorced          23

          Widowed            4

          Single            58






                          Boston Area     Elsewhere                               

      Have Children          42%             38                

      Any Relatives          64%             73

      Have Good Friends      79%             57




                  CARE OF CHILDREN



               Foster             12%

               Relative           52

               Adopted             2

               On Own              9

               Else               25






                              Yes   Not   No  Tot.


One Spec. Person              71%    5    23   99%

Someone on Shel Staff         47%   23    30  100%








Amount of Personal Support Received From......


                    Great    Fair     Not Too   None   Tot.

                    Deal     Amount    Much

Shelter Staff        23%       45       15       18    101%

Friends              28%       34       18       20    100%

Family               40%       17       16       27    100%



     Social support was also measured with responses to a series of statements that comprise the widely used "ISEL" index of social support.  Respondents could answer "definitely true," "probably true," "probably false," or "definitely false" in response to such statements as: "When I feel lonely, there are several people I can talk to." 

     The median response to the ISEL statements was 2.9, indicating that the respondents were most likely to feel that it was "probably true" that they had social supports.  The ISEL distribution was somewhat clumped toward the low support end of the scale, but only one respondent received the lowest possible average score.


ISEL Social Support


Count   Value    One symbol = approx. 4.00 occurrences


  1    1.00

 35    2.00  *********

102    3.00  **************************

 16    4.00  ****


            0        40        80       120         

                    Histogram frequency


     Overall, guests staying at Woods-Mullen reported somewhat higher levels of available support than did those staying at Long Island.




     Physical health problems were common, although by no means universal.  Almost half reported at least one current physical health problem and one-third had a medical prescription; more than half had seen a doctor in the preceding year and more than one-third had been hospitalized; almost one-third were at least somewhat dissatisfied with their physical ability to get things done; almost one-fifth rated their own physical health as worse than most.  Of course, this suggests that a majority of shelter users had no physical health problems and were satisfied with their physical health.  In any case, about one-third reported they had no health insurance.





     Better than most         43%

     About the same           42

     Worse than most          16







     Completely satisfied      29%

     Very satisfied            21

     Somewhat satisfied        20

     Somewhat dissatisfied     15

     Very dissatisfied          9

     Completely Dissatisfied    6






     HAVE ANY HEALTH INSURANCE?            36%

     N = 154-155





         Hospital only          17%

         Hospital and doctor    22

         Doctor only            14

         No                     48



     The specific health problems ranged from heart and circulation problems (approximately five percent mentioned them) to bone problems and injuries (seven percent) and eye/ear/nose/throat problems (four percent).

HEALPROB  Types of health problems                  

                            Freq Percent

PSYCHIATRIC              2   1.2                PANCREAS KIDNEY BLAD     1    .5

HEAD INJURIES            2   1.5                SEIZURE DISORDER         2   1.5

DIABETES ALLERGIES B     2   1.4                CHEMICAL DEPENDENCY      1    .4

OTHER INJURIES           2   1.2                EYE EAR THROAT           3   2.2

CIRCULATION              8   5.0                EYE EAR THROAT RECEN     3   1.7

HEART CIRCULATION        0    .3                AIDS                     1    .5

HEART STOMACH            2   1.4                MUSCLE                   3   1.7

HEART MUSCLE             1    .5                BACK                     2   1.0

HEART RECENT OPERATI     1    .5                DIABETES                 1    .5

STOMACH                  1    .7                RECENT SURGERY           2   1.0

KIDNEY OR BLADDER        1    .5                OBESITY                  1    .7

BONE                     7   4.4                OBESITY PICKWICK SYN     1    .5

GAUT ARTHRITIS           1    .5                THYROID                  2   1.5

ASTHMA                   1    .5                DENTAL                   3   2.0

ASTHMA EPILEPSY          3   1.7                STROKE                   1    .5

ASTHMA BACK EYE EAR      1    .5                SLEEP DISORDER           1    .5

HIGH BLOOD PRESSURE      1    .5                NO HEALTH PROBLEM       86  55.2

HEALTH PROBLEM NOT ID'D    5   5.0          TOTAL                  155 100.0



     Prescribed medications were for the same range of problems, with seven percent also mentioning medication for psychiatric problems.


What is medication for?


  Value Label             Frequency  Percent

SEIZURES                         3      1.9

SEIZURES THYROID                 1       .5

HEART                            1       .5

NERVOUS CONDITION                4      2.3

NERVOUS CONDITION HE             2      1.4

DEPRESSION                       5      3.0

SCHIZOPHRENIA                    1       .5

BACK                             7      4.5

HEART                            1       .8

PREGNANCY                        2      1.0

BLOOD PRESSURE                   7      4.7

BLOOD PRESSURE KIDNE             1       .5

BLOOD PRESSURE GLUCO             1       .5

HYPERTENSION LIVER D             1       .5

MOLE                             3      1.7

ASTHMA                           2      1.2

KIDNEY TUMOR                     2      1.4

BACK                             1       .5

DIABETES                         1       .5

PNEUMONIA                        1       .5

SLEEP CONDITION                  1       .5

LIMBS                            2      1.6

NO MEDICATION                98     63.0

MEDICATION NOT ID'D          10      6.2

                               -----  -------

                   Total       155    100.0

     Poorer physical health was associated with several other variables.  Those who reported physical health problems were more likely to be receiving financial benefits, but less likely to be employed and less likely to be looking for work.  Those who were ill also knew less about AIDS.

              Health Problem

Variable           Yes  No

Financial benefits 58%  23%

Looking for work   30%  58%

Employed           13%  39%

Know AIDS facts    39%  56%




     About one in five respondents had been hospitalized for a mental or nervous problem and one in ten were patients at a community mental health center; about one quarter had been either in a psychiatric hospital or a CMHC.  The median number of times hospitalized for those who had been hospitalized was 2.0. 





Been Hospitalized for Mental or Nervous Problem?   21% (153)

Assigned to Community Mental Health Ctr in Boston?  9% (151)






                          1              21%

                          2              31

                          3              19

                          5              10

                          6               8

                         20              12



     Respondents were asked numerous questions about their feelings.  Three quesitons came from the lengthy "Mental Health Index"; they indicate the proportion of guests who felt unhappy and who had had suicidal thoughts.

     Between 20 and 30 percent of the respondents had felt unhappy or depressed in the previous month, and 14 percent had thought of taking their own life at some time in the previous month.  Between one-quarter and one-third had been generally happy in the previous month.

How happy/satisfied over past month



EXTREMELY HAPPY             11.5  

VERY HAPPY/MOST TIME        12.3  

GENRLLY SATISFIED           21.9  

TIMES HAPPY/UNHAPPY         30.2  

GENRLLY UNHAPPY             13.2  

VERY DISSATISFIED           10.9  






So down nothing could cheer you up in past month


ALL THE TIME                   6.2  

MOST OF TIME                  12.7  

GOOD BIT OF TIME              10.9  

SOME OF TIME                  30.0  

A LITTLE OF TIME              25.3  

NONE OF TIME                  14.9  


                             100.0 (149)


Think of taking your life in the past month?


YES, CONSTANTLY                2.0  

YES, VERY OFTEN                3.3  

YES, FAIRLY OFTEN               .5  

YES, A COUPLE OF TIM           5.0  

YES, ONCE                      2.5  

NO, NEVER                     86.6  


                             100.0  (149)

     An index of depressed feelings was constructed from six questions selected form the widely used CES-D index.  Response choices varied from 1 to 3, with 3 indicating depressed feelings "all of the time," 2 indicating depressed feelings "some of the time," and 1 indicating depressed feelings "never."  The median depression score was 1.7, and the cases tended to clump just under the middle section.


Count   Midpoint    One symbol = approx. .50 occurrences

16    1.0  ********************************

 0    1.1

10    1.2  ********************

14    1.3  ***************************

 0    1.4

17    1.5  **********************************

 1    1.6  **

25    1.7  *************************************************

21    1.8  ******************************************

 0    1.9

17    2.0  **********************************

 0    2.1

10    2.2  *********************

 5    2.3  **********

 0    2.4

 6    2.5  ************

 0    2.6

 6    2.7  ***********

 5    2.8  ***********


          0         5        10        15        20  


     Guests at the Long Island Shelter reported more symptoms of depression than did guests at Woods-Mullen.

     The PERI scale of False Beliefs and Perceptions (with yes/no response choices) indicated that relatively few guests harbored false beliefs or perceptions that might indicate psychosis or hallucinations for other reasons.  The median number of false beliefs and perceptions was two of a possible thirteen.



Count      Value    One symbol = approx. 1.00 occurrence

43        .00  *******************************************

20       1.00  ********************

23       2.00  ***********************

23       3.00  ***********************

10       4.00  **********

 9       5.00  *********

 8       6.00  ********

 4       7.00  ****

 1       8.00  *

 4       9.00  ****

 0      10.00

 0      11.00

 1      12.00  *

 3      13.00  ***


              0        10        20        30        40  

     Prior hospitalization for psychiatric problems was associated with more symptoms of depression, but a greater chance of having received financial benefits in the past month.  Such individuals were also more worried about getting AIDS but knew less about prevention methods. 

Prior Psych. Hospitalization

Variable           Yes  No

More depressed     64%  39%

Thought of suicide 25%  10%

Financial benefits 54%  34%

Worry about AIDS   86%  64%

Know AIDS facts    30%  53%

     Those who reported more false beliefs and perceptions were also more likely to have had difficulty affording things--58% compared to 38% of those with few false beliefs and perceptions.



     Traumatic events were remarkably common.  Two in every five respondents had been assaulted or robbed in the past year and two-thirds had experienced a life-threatening experience at some time in their lives.  Three in every five of these persons experienced nightmares about losing their life at least rarely (half had such nightmares at least sometimes).





          Assaulted                         11%

          Robbed                            15

          Both Assaulted and Robbed         17

          No                                58






Freq. of Nightmares Related to Trauma in Past Yr...



         Frequently              13%

         Sometimes               23

         Rarely                  22

         Never                   42



     *Question asked of the 67% who reported a life-threatening experience.


     Many respondents had first been traumatized as children.  One-third had been physically assaulted by an intimate as a child and two in five had run away from home or been in foster care.


             CARE AS A CHILD



      Foster Care            12%

      Instit. Care            6

      DSS                     2

      No Such Care           80




             CHILDHOOD EXPERIENCE             


Phys. Assaulted by Pers. Close to you?   31% (153)

Ran Away from Home/Foster Care?          41% (153)


              Any Childhood Trauma

Variable           Yes       No

False beliefs      69%       43%

Psych. hospitlztn  32%       13%

Drinking problem   32%       15%

Drug problem       35%       14%

Health problem     53%       34%

Legal problems     32%       15%

Victimized         50%       32%

     Childhood trauma was related to a number of more recent problems:  more false beliefs and perceptions, a much higher rate of pscyhiatric hospitalization, more evidence of drinking and drug problems, more physical health problems, more legal problems and more victimization while homeless.




     Three-quarters of the sample drank at least occasionally, half had been told at some time that they had a drinking problem, and two in five had been treated for a drinking problem.  One-third admitted to drinking at least several times a week at the time of the interview.





         Daily                    20%

         Several Times a Week     17

         Once a Week              11

         2 or 3 Times a Month     13

         Less Than Once a Month   13

         Never                    26

                                 100% (152)


               PROBLEM DRINKING



Anyone Ever Said You Drink Too Much?   50%

Ever Been Treated for Drinking Prob?   39%


     Indicators of drinking problems were associated with a variety of other characteristics and orientations.  Drinkers were more likely to have had suicidal thoughts and to be depressed.  Drinkers reported more difficulty affording things and were less likely to be receiving financial benefits.  In addition, drinkers were more likely to have been in the custody of youth services as an adolescent.

             Drinking Problem

Variable           Yes*      No**

More depressed     60%       40%

DYS involved       31%       12%

Difficult to afford 72%       45%

Financial benefits 18%       46%




     Street drug use was less common.  Half said they did not use any street drugs in the previous year; of those who admitted to some street drug use, half had been treated at some time for a drug problem.






          Daily                       14%

          Several Times a Week         7

          Once a Week                  7

          2 or 3 Times a Month        11  

          Less Than Once a Month      11

          Never                       51




               DRUG TREATMENT


    Ever Been Treated for Drug Problem?  46%(88)


     The correlates of drug abuse were more limited than were those for alcohol abuse.  Those with a drug problem had more legal problems and greater difficulty affording things.  Drinking problems were much more common among drug users than among others.

                    Drug Problem

Variable           Yes*      No**

Legal problems     46%       17%

Difficult to afford 67%       47%

Drinking problem   45%       17%




     Overall, substance abuse appeared to be more common at the Woods-Mullen Shelter than at Long Island.



     AIDS awareness was an area of particular concern in the survey.  Shelter users were asked about their worry about getting AIDS, their beliefs about HIV infection, and about their exposure to and reactions to various shelter-based prevention activities.  Their responses indicated the importance of this topic to many.

     Almost half of the respondents worried "a lot" about getting AIDS, although over one-third worried not at all.  One-third of the respondents believed that other shelter residents worry a lot about AIDS.  Almost half said they knew someone with AIDS.  In response to other questions (not in the table presented here), 43 percent of the respondents reported that they were afraid around people infected with HIV, but only ten percent thought that they'd probably get AIDS.  Sixty-four percent wanted to learn more about AIDS.

     Responses to another question also revealed the widespread concern about AIDS among shelter users:  more than one-third had been tested for HIV infection and another third wanted to be tested.




                                   A lot  Some-  None  Tot.

How much do you worry about AIDS?   46%    17     37   100%

Other residents worry about AIDS..  35%    39     26   100%





                KNOW ANYONE WITH AIDS?


                  Yes        43%           

                  Not Sure    9

                  No         49





                  AIDS TESTING


        Have Been Tested           38%              

        Like to Get Tested         36

        Not Sure                    8

        Would Not Like Testing     17




     About nine in ten of the respondents knew the most basic facts about HIV transmission:  it can be transmitted through sex and sharing needles and it can't be transmitted just through proximity or casual contact.  However, half believed that giving blood could transmit HIV and between 15 and 25 percent mistakenly identified insects, toilet seats, kissing and food preparation as risk behaviors.

     Responses to another series of statements concerning AIDS beliefs and knowledge also reflected almost universal awareness of the most basic facts but much confusion beyond these.  At least nine in ten knew that preventive action can reduce the risk of infection, that using a condom helps, that risk increases with the number of sex partners and that AIDS does not only affect gay men.  Slightly fewer respondents knew that only a blood test tells if you're infection, that a man can get AIDS from sex with a woman, that people don't die soon after infection and that a condom can still help even after infection. 

     There was more disagreement about a range of other AIDS beliefs.  About two-thirds believed, correctly, that there's no cure for AIDS, that drug users can avoid AIDS and that infected people can still feel healthy.      


                   AIDS KNOWLEDGE


Percent Who Believe the Following Can Give You AIDS....

Being Near Infected People             9%

Hugging an Infected Person             8   

Being Bitten by an Insect             25        

Having Sex w Infected                 90

Sharing Needles w Drug Users          90

Giving Blood                          50

Toilet Seat Used by Infected          16

Kissing an Infected Person on Mouth   29

Eating Food Prepared by Infected      20


                  BELIEFS ABOUT AIDS


Percent Agreeing with the Following Statements About AIDS...

There's No Cure for AIDS                   65

Infected People Can Still Feel Healthy     66

AIDS Only Affects Gay Men                   7

The More Sex Partners, More Risk of AIDS   92

No Way Drug Users Can Avoid AIDS           29

It Helps a Lot to Use a Condom             90

Only a Blood Test Tells if Infected        84

People Can Do a lot to Avoid Infection     96

Men Can't Get AIDS from Sex w Woman        15

People Die Soon After Infected             29

A Condom Doesn't Help After Infection      78


     Overall, the median percent correct on the AIDS knowledge questions was 75.  The responses were clumped toward the high end of the distribution, indicating many correct answers to the AID knowledge questions.




Count Value    One symbol = approx. .80 occurrences


 1   30.00  **

 7   40.00  ********

10   50.00  *************

13   60.00  ****************

28   70.00  ***********************************

32   80.00  ****************************************

36   90.00  *********************************************

17  100.00  *********************


           0         8        16        24        32       

                        Histogram frequency


Valid cases     143      Missing cases    12

     There had been a substantial amount of AIDS prevention activity at the two shelters, but awareness of these activities was by no means universal.  About half had read prevention information at the shelter and an equal proportion had noticed condoms available at the shelter.  Just one in five had noticed bleach bottles available for drug users and only five percent had received a greeting card with a condom (and a prevention message)--a prevention activity sponsored by an AIDS prevention project that had occurred once at the shelter.  Few had attended an AIDS awareness meeting at the shelter, but then few had heard of such meetings being held.




Have Read Info. at Shelter        50%

Noticed Condoms Available         52

Received Card w Condom             5

Noticed Bleach Bottles            18




        Attended AIDS Education meeting?


        Attended                   18%

        Haven't Heard About One    69

        Heard, Didn't Go           13




     About two-thirds of the respondents were comfortable with participating in the most straightforward prevention activities:  picking up or requesting prevention supplies; speaking to a shelter staff member about AIDS; and attending a meeting about AIDS. 




Feel Comfortable......


Taking Condom from Basket           62%

Asking Male Staff for Condom        66

Asking Female Staff for Condom      65

Taking Bleach from Basket           46

Asking Staff Member for Bleach      63

Speak to Staff About AIDS           72

Would Attend AIDS Meeting           79


     How effective were these activities?  One in five respondents reported that the shelter's AIDS education efforts had affected their behavior or the behavior of other shelter users.  Almost three-quarters believed that shelter staff should do more to educate shelter users about AIDS.  And more than two-thirds felt that people with AIDS were treated more poorly by other shelter users.



                                      % Agree

People w AIDS are Treated Poorly by Others  69%     

Staff Should Do More Educ. Guests re AIDS   73

AIDS Education Affected Own Behavior        21

AIDS Education Affected Others              23





     One-quarter of the respondents were currently on probation, parole, pending arraignment or involved in a legal action in some other way.  Two-thirds had been in jail or prison at some time in the past and one in five had been under DYS supervision when they were younger. 





            Probation              9%

            Parole                 7

            Pending Arraign.       3

            Other                  6

            None of the Above     76




               BEEN IN JAIL/PRISON?



                Jail          44%

                Prison        20

                No            36







   Involved w DYS When Younger?     18% (152)




     About half of the respondents had not had difficulty affording food, clothing or health care in the past year, while a third had experienced such difficulties at least pretty often. 




Difficulty Affording Food, Clothing or Health Care

in Past Year



         Never or Hardly Ever        28%

         Once in a While             20

         Sometimes                   21

         Pretty Often                13

         Always or Almost Always     17




     Three quarters were not working, and two in five of the unemployed were looking for work.  Almost all of the respondents had worked in the past and almost half of these had spent at least five years at one job.  Almost one-third had earned more than $10 per hour in at least one previous job; the median maximum hourly wage was $8.50 (the mean maximum hourly wage was $10.73.


                EMPLOYMENT STATUS




               Full-Time        15%           

               Part-Time        11

               Day Labor         1

               Not Working      73





      Looking for Work          43%

      Have Worked in Past       93





           5 or More Years       44%

           1-4 Years             42

           6-11 Months            9

           1-5 Months             3

           Less than 1 Month      2






             $3.00-5.50          13%

             $6.00-8.00          33

             $8.50-10.00         24

             $10.75-13.75        14                                             

             $14.00-20.00        10

             $20.00 +             6



     Guests at Woods-Mullen were more likely to be employed than were guests at Long Island.




     Two in five respondents were receiving financial benefits.  Social Security Income was the most common benefit, with welfare and general relief a close second.  Few persons received any other type of financial benefit.  No more than one respondent in ten reported having a representative payee who received the respondent's benefits.




            Welfare              19%

            Disability            4

            Unemployment          2

            SSI                  39

            V.A. Benefits         7

            Gen. Relief          15

            Food Stamps           7

            Grants                2

            Illegal               2

            Disability plus SSI   4






             Yes              9%

             No              88

             Don't Know       3





     The importance attached to receiving help varied markedly across the 13 services mentioned.  By far the most importance was attached to getting help with finding a place to stay:  four in five considered it extremely important.  The next most important service needs were help with financial benefits and AIDS education--about three in five respondents considered help in these areas extremely important.  


     Somewhat less importance was attached to receiving more education, help with physical health problems, job training and help with finding a job.  Two in five respondents rated these forms of help as extremely important, although one-quarter rated each of them as not at all important.  About one-third rated help with drug problems and with literacy as extremely important, but almost half rated these forms of help as not at all important.


     Help with making more friends and with psychological problems were rated as extremely important by only one-quarter and as not at all important by almost one-third.  The forms of help that were rated as least important were ehlp with an alcohol problem and help with legal problems:  one-quarter rated them as extremely important but almost three in five rated them as not at all important.




                    Not   Slight.  Mod.  Consid.  Ex-   Tot.   

                   At All                         trem.

Finding a Place      6%      6      6       4      79   101%

Financial Benefits  12%      6      7      16      58    99%

AIDS Education      13%     10     10      10      56    99%

Education/GED       27%      9      6      12      47   101%

Finding a Job       28%     14      7       7      45   101%

Physical Health     29%     13      8       9      42   101%

Job Training        28%     12      8      13      40   101%

Drug Problems       45%     11      4       5      35   100%

Literacy            45%      7      9       9      30   100%    

Psych. Problems     29%     21     11      13      27   101%

Alcohol Problems    58%      9      7       3      23   100%

Legal Problems      57%      5      5       5      28   100%

Making More Friends 30%     14     21      14      21   100%


     Getting help with alcohol and drug problems were rated as important by more guests at Woods-Mullen than at Long Island.


     Guests' sociodemographic characteristics varied markedly, but were similar in some respects to those found in earlier studies at Long Island and in research on other homeless populations.  In particular, the median age of 35 and the 20 percent who were women replicated findings in many other studies.  The proportion who were black or Hispanic, a figure that varies more between cities and regions, had risen markedly from earlier studies at Long Island, from forty to seventy percent, due in part to the opening of the Woods-Mullen Shelter.

     Resources available to the shelter guests were, if anything, even more variable.  The educational levels of grade school, high school and college were represented in equal proportions, and substantial proportions had low, medium and high levels of social support.  Family and shelter staff were important particularly as sources of social support.

     About equal proportions reported some and no physical health problems.  Symptoms of depression were common, symptoms of distorted perceptions were uncommon; about one in five had been psychiatrically hospitalized, as reported in many other similar studies.  Substance abuse was common.

     Other areas for concern were the high rate of reported legal problems and criminal victimization, with even higher rates of reported abuse as a child.

     Several guest characteristics were associated with a variety of other characteristics and problems:  substance abusers, those who had been abused as children, and, for certain problems, younger guests were particularly at risk (older guests, however, were more likely to report physical health problems and criminal victimization).  Those who had been hospitalized previously for psychiatric problems were currently more depressed, although they also were more likely to be receiving financial benefits.

     AIDS was a major concern.  Many worried about getting AIDS and knew someone with AIDS, many had been tested for AIDS and most wanted to learn more about AIDS.  Knowledge of basic HIV transmission facts was widespread, but many were concerned needlessly about improbable transmission methods.

     In most respects, the Long Island and Woods-Mullen shelters served the same population of homeless persons.  However, there were some important differences, most of which could be explained by differences in the shelters' physical design and their locations--Woods-Mullen is located near the center of Boston, next to Boston City Hospital, while Long Island is on an island in Boston Harbor that can be reached only by car or bus. 

     Woods-Mullen had a higher rate of participation in the contract bed program for workers; related to this, more of them reported being employed.  Woods-Mullen guests were more satisfied with the shelter's location and its physical condition (it had recently been refurbished), while Long Island guests were more satisfied with the shelter's level of privacy (beds were separated in clusters by partitions, while at Woods-Mullen they were arranged dormitory style).  Woods-Mullen guests reported more contact with service agencies and somewhat higher levels of social support.  Woods-Mullen guests reported more substance abuse but fewer symptoms of depression.  Woods-Mullen guests were more likely to be women, as planned by the shelter, and were more likely to be black or Hispanic. 

     In general, then, the inner city location of Woods-Mullen had both advantages and disadvantages:  employment, services and social supports were more readily available, but so were alcohol and drugs. 



1.  Provide support in the shelter for those who have experienced abuse as children or while homeless.  Abuse is very common and is associated with a wide range of other problems.

2.  Literacy help is needed by about one in five guests.

3.  Providing AIDS education should be a high prioirty.  AIDS has become a very great concern among shelter guests, with the importance of AIDS education ranked second only to help with finding a place to live.  Further education also should lessen resistance to prevention activities:  Although many were aware of prevention activities at the shelter, about one-third were not comfortable with these activities.

4.  Substance abuse counseling continues to be a priority need, and should be emphasized particularly among guests using the Woods-Mullen shelter. 

5.  Drug abuse should be given as much attention in shelter program planning as alcohol abuse.  These interview results identified a much higher level of drug abuse than had been found in case manager intake interviews.

6.  The location of Woods-Mullen Shelter seems conducive to employment outside the shelter and to maintaining service and social connections.  Some of these benefits might also be available to Long Island guests if day programs were increased at Woods-Mullen.

7.  The shelter can be useful points for restoring some stability to homeless persons and for delivering needed services.  Satisfaction with both shelters was high.

8.  Efforts to help guests move into regular housing should be given the highest priority.  The desire for "a place of my own" was seen as more important than any other service and was even more widespread than satisfaction with the shelters.

9.  Legal counselors should be made available on a trial basis at the shelter.  Law school interns might play a constructive role.  Legal problems in the past and at present were very common, and reflected in part problems of substance abuse and mental illness.

10. Efforts to increase support from guests' natural support systems should be expanded.  Family and friends were sources of support to many; with assistance, they might be able to help resolve the homelessness problem.

11. Homelessness prevention programs should be funded and publicized in the high risk neighborhoods:  Dorchester, Roxbury, the South End.

12. The design of the Woods-Mullen Shelter should be altered to increase privacy between beds.