Three important client subgroups are used throughout this report and need to be defined for the reader. These are homelessness status, family status, and alcohol/drug/mental health (ADM) status. Also described is the geographic basis for the terms "central city," "suburbs/urban fringe," and "rural," and the time frames used in the report.

Defining Homelessness Status

The study adopted the same definition of "homeless" as that used in the Stewart B. McKinney Homeless Assistance Act of 1987, namely an individual who lacks a fixed, regular, and adequate nighttime residence, or an individual who has a primary nighttime residence that is: (a) a supervised publicly or privately operated shelter designed to provide temporary living accommodations (including welfare hotels, congregate shelters, and transitional housing for the mentally ill); (b) a public or private place that provides a temporary residence for individuals intended to be institutionalized; or (c) a public or private place not designed for, or ordinarily used as, regular sleeping accommodations for human beings.

The following specific conditions were used to classify NSHAPC clients as currently homeless:

• The clients reported staying in any of the following places on the day of the survey or during the seven-day period prior to being interviewed for NSHAPC:

  1. an emergency shelter or transitional housing program, or

  2. a hotel or motel paid for by a shelter voucher, or

  3. an abandoned building, a place of business, a car or other vehicle, or anywhere outside.

• Or the clients

  4. reported that the last time they had "a place of [their] own for 30 days or more in the same place" was more than seven days ago, or

  5. said their last period of homelessness ended within the last seven days, or

  6. were selected for inclusion in the NSHAPC client survey at an emergency shelter, transitional housing program, or

  7. reported getting food from "the shelter where you live" within the last seven days, or

  8. on the day of the interview, said they stayed in their own or someone else's place but that they "could not sleep there for the next month without being asked to leave."

Use of the first criterion (shelter use) classifies 34.9 percent of the sample as currently homeless. Criteria (voucher use) and three (places not meant for habitation) add 1.7 percent and 9.8 percent, respectively, for a total of 46.4 percent. The five remaining criteria together add another 7.1 percent, for a final total of 53.5 percent of the sample classified as currently homeless. All but the final criterion meet the McKinney Act definition of homelessness; the last criterion adds only 0.3 percentage points to the final proportion classified as currently homeless, and was included because the survey itself treats clients in this situation as homeless.

Many clients who were not literally homeless reported having been homeless at some earlier time in their lives (22 percent of the full sample). The circumstances used to classify clients as formerly homeless also meet the McKinney Act definition of homelessness. Clients were classified as formerly homeless if they

• did not meet any of the conditions qualifying them as currently homeless but at some point in their lives had stayed in any of the following:

  1. an emergency or transitional shelter, or

  2. a welfare/voucher hotel, or

  3. an abandoned building, a place of business, a car/other vehicle, or anywhere outside, or

  4. a permanent housing program for the formerly homeless; or

• said they had previously had a period when they were homeless.

The remaining 24 percent of NSHAPC clients had never been homeless according to the criteria used here, and also said they had never been homeless. They are referred to throughout this report as other service users.

Specifying Time Frames

All time periods discussed in this report relate to the day a client was interviewed for the study (between October 18 and November 14, 1996). Thus, "past week" or "past seven days" refers to the week before the interview; "past month" or "past 30 days" refers to the month before the interview; and "past year" refers to the year before the interview. "Lifetime"refers to the client's life up to the time of the interview.

Defining Family and Single Status

In this report, a client is considered to be in a family household if she or he lives with one or more of his or her own children under age 18. For the sake of simplicity throughout the report, these clients will be referred to as "clients in families." It is not possible to determine who else might be members of these family households, nor is it possible to say with certainty that a respondent is alone. However, for simplicity of language, the family status variable reported throughout this study classifies clients into two mutually exclusive groups: clients in families and single clients.

Defining Alcohol/Drug/Mental Health (ADM) Status

In general, individuals are classified as having an ADM problem if they have had at least one alcohol use, drug use, or mental health problem during the past month. Presence of each problem was defined as follows.

Clients were classified as having a past month alcohol use problem if any of the following conditions were met: (1) they scored 0.17 or higher on a modified Addiction Severity Index⁵ (ASI) measure, (2) they reported drinking to get drunk three or more times a week within the past month, (3) they reported being treated for alcohol abuse within the past month, or (4) they reported ever having been treated for alcohol abuse and drinking three or more times a week within the past month.

Clients were classified as having a past year alcohol use problem if they met these same criteria within the past year (including the past month), and as having a lifetime alcohol use problem if they met these same criteria in their lifetime or if they reported ever having had three or more alcohol-related problems (such as blackouts, tremors, and/or convulsions).

Clients were classified as having a past month drug use problem if any of the following conditions were met: (1) they scored 0.10 or higher on a modified ASI measure, (2) they reported being treated for drug abuse within the past month, (3) they reported using drugs intravenously (shooting up),⁶ or (4) they reported using any of a variety of specific drugs three or more times a week within the past month.⁷ Clients were classified as having a past year drug use problem if they met these same criteria within the past year (including the past month), and as having a lifetime drug use problem if they met these same criteria in their lifetime or if they reported ever having had three or more drug-related problems (such as blackouts, convulsions, withdrawal symptoms, and/or illegal activities to get money for drugs).

Clients were classified as having a past month mental health problem if any of the following conditions were met: (1) they scored 0.25 or higher on a modified ASI measure, (2) they reported receiving treatment or counseling or being hospitalized for emotional or mental problems within the past month, (3) they reported taking prescribed medications for psychological or emotional problems within the past month, (4) they reported that a mental health condition is the single most important thing keeping them from getting out of homelessness, or (5) they reported receiving treatment or counseling or being hospitalized for emotional or mental problems at some point in their lives and having one or more of the ASI's seven emotional or psychological conditions within the past month.⁸ Clients were classified as having a past year mental health problem if these same criteria were met within the past year (including the past month), and as having a lifetime mental health problem if these same criteria were met in their lifetime or if they reported ever having stayed in an client group home, crisis residence, or other housing for the mentally ill.

Describing Urban/Rural Location

A number of analyses focus on the geographic location where clients were found, including central cities, suburban and urban fringe areas, and rural areas. Central cities are the main or primary cities of metropolitan statistical areas (MSAs). Suburban and urban fringe areas are defined as what is left of MSAs after taking out the central cities, and may include smaller cities, suburbs, towns, and even open land if it is in the counties making up the MSA. Rural areas are defined as all areas outside of MSAs, and may include small cities (under 50,000 people), towns, villages, and open land.

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