Projects for Assistance in Transition from Homelessness (PATH) is a program created by the U.S. Congress in 1991 to help States provide community-based services for homeless people who have serious mental illnesses. It was authorized by the Stewart B. McKinney Homeless Assistance Amendments Act of 1990 (Public Law 101-645), and requires states to provide funding that is at least equal to one-third of the federal grant amount (U.S. Department of Health and Human Services [HHS], 1996).

PATH workers first identify, assess, and ensure the safety of those who are homeless and mentally ill. Later, PATH staff members help clients identify needs and resources, and link clients with services that can help them achieve permanent housing, recovery, and independence.

The MHS PATH program was one of the first in Ohio and the nation. There are now about 400 PATH programs in the U.S.

In the 2006 fiscal year that ended 30 June 2006, the MHS PATH program provided outreach services for 439 homeless men and women throughout Cuyahoga County, Ohio. Of those, PATH provided ongoing services to 160 (36%) who were homeless and severely mentally ill.

Twenty nine clients obtained housing, and maintained it for at least six months. Eighty nine clients became active participants in mental health and/or drug addiction treatment services.

Duration of homelessness
Most PATH clients have had long periods or repeated episodes of homelessness. More than half the homeless persons of Cuyahoga County enrolled in the MHS PATH program had been homeless for more than 90 days; 23% for 30-90 days; and 17% for less than a month. (Duration of homelessness could not be reliably determined for about 5%.) The proportion of those homeless for more than 90 days is much higher in Cuyahoga County than in the State. Of the 2,731 homeless individuals served by the 12 PATH programs in Ohio in 1996 (HHS, 1996, p. 40), about 38% had been homeless for more than 90 days; 25%, for 30-90 days; and 36% for less than a month. In Cuyahoga County, 25% of the PATH clients served by MHS were on the streets or in abandoned buildings or vehicles at the time of first contact Seventy percent were in homeless shelters, and many of the remaining five percent had just been released from prison or a hospital.

Sex and race
In Cuyahoga County, 58% of eligible PATH clients were male, and 71% were African-American. (In Ohio, 66% were male, and 46% were African American.) In Cuyahoga County and Ohio, about two-thirds were between 35 and 64 years of age, and 4% or fewer were Hispanic.

Psychiatric disorders
About two-thirds of PATH clients in Cuyahoga County had schizophrenic disorders characterized by delusions, hallucinations, and severe disturbances in thought, planning, and social functioning. Another two-thirds had severe mood disorders such as major depression or bipolar disorder. The remaining PATH clients had other severe mental disorders. Some of the most frequently occurring disorders are characterized by social withdrawal, irrational suspiciousness, and severe cognitive distortions that lead those affected to reject traditional services. As a result, many remain homeless for years. About two-thirds of PATH clients had co-occurring alcohol or drug addictions.

PATH services
PATH staff members go where homeless individuals stay, establish trusting relationships with them, and then support their participation in psychiatric and supportive services. At left, PATH staff members talk with a homeless man in response to a call from a downtown business. Below, a staff member looks for a client under a bridge.

Outreach is the first step toward the achievement of recovery, housing, and self-determination. Once a working relationship with the homeless person has been established, PATH staff members help their clients to find appropriate housing, and submit housing applications. PATH staff also help their clients to obtain identification, and apply for the income and healthcare benefits for which they are eligible. PATH clients are connected with doctors, dentists, and with providers of alcohol and drug treatment services.

Reference
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration, Center for Mental Health Services. (1996). Projects for assistance in transition from homelessness. A summary of fiscal years 1995 and 1996 state implementation reports. Rockville, MD: Author.

To learn about other MHS programs providing coordinated care
for homeless persons with disabilities, click on the links below.

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Mental Health Services for Homeless Persons, Inc. (MHS)
1744 Payne Avenue; Cleveland, Ohio 44114 U.S.A.
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It was most recently updated on 24 September 2007.
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