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males over females is not a phenomenon unique to halfway houses. Males exceed females among additions (admissions and readmissions) with alcohol disorders to all psychiatric inpatient facilities. However, on comparing the ratio of males per 100 females in alcoholism halfway houses with the ratio in psychiatric inpatient facilities it is clear that the number of males per 100 females in Group I halfway houses is considerably higher than for any of the other facilities. (Table C) The ratio among the Group II halfway houses while considerably less than Group I is surpassed only by that for State and county mental hospital, among the psychiatric inpatient facilities.

Residents in alcoholism halfway houses, like additions with alcohol disorders to psychiatric inpatient facilities, are heavily clustered in the age groups 25-64 years of age. On further dividing this age group however, additions with alcohol disorders to psychiatric inpatient services among males are more heavily weighted in ages 45-64 years while male halfway house residents are nearly equally divided between the 25-44 and the 45-64 year age group. Among females the age distribution for additions with alcohol disorders to psychiatric inpatient services and halfway house residents are approximately the same. On comparing the median age of halfway house residents with the median age of persons admitted to psychiatric inpatient facilities with alcohol disorders, it is interesting to note that, with the exception of additions to community mental health centers, the halfway house residents tend to be younger (Table C).

Table C also shows that females tend to be younger among all of the facility types. There are, however, greater differences in median age between the sexes among halfway house residents than among additions with alcohol disorders to psychiatric inpatient facilities.

Since psychiatric treatment facilities are a potential source of halfway house residents, it is interesting to look at the relationship between the distribution of halfway house residents and additions with alcohol disorders to psychiatric inpatient facilities (Table D). In using the ratio between these two groups as one means for measuring halfway house utilization we can see a peak in the 18-24 year age group with a consistent decline as age increases. It also appears that halfway house utilization is lowest among persons aged 17 and under and those aged 65 and over, the youngest and oldest age groups. This pattern is the same for both sexes.

It was mentioned earlier in this Note that male halfway house residents outnumber female residents and are generally older. It is interesting to also compare the sex ratio and median age of the halfway house residents in relation to the facility characteristics (Table E). With respect to bedsize, among the Group I halfway houses the ratio of males per 100 females is lowest in halfway houses with 14 beds or less (226 males per 100 females) while the ratio in the larger halfway houses is much higher. The reverse occurs among the Group II halfway houses where there are 885 males for every 100 females in halfway houses with 50 beds and over while the ratio in the smaller halfway houses is considerably less.

The ratio of males to females is greatest in the Northeast region where there are over 1000 males for every 100 females in both Group I and Group II halfway houses. The ratio was lowest in the West among Group I halfway houses and the South for Group II halfway houses where the ratios were 569 and 303 males per 100 females respectively. The age differential between the sexes is most apparent in the government operated facilities where the median age of male residents in Group I halfway houses is nearly eight years higher than for females while in the Group II halfway houses it is five years higher. In looking at the sex difference in median age with respect to facility bedsize we see only slight differences among the smaller halfway houses (14 beds or less) while among the largest halfway houses (50 beds and over) male residents are seven to eight years older than the females.

Most alcoholism halfway house residents live in houses which restrict admission to members of one sex. Eighty-three percent of the total male residents and 65 percent of the total female residents in Group I halfway houses live in houses which have sex restrictions. The separation of the sexes is not as great in the Group II halfway houses where only 60 percent of the male residents and 52 percent of the female residents live in houses which restrict admissions to members of one sex (Table F).

The intention of most alcoholism halfway houses is to provide a temporary, as opposed to a permanent residence. Table G shows that about three-fourths of the residents in the alcoholism halfway houses had been there less than six months. The median stay in the Group II halfway houses was just slightly longer than for the Group I halfway houses, 3.4 versus 3.3 months, respectively (Table H). Since the median length of stay in psychiatric halfway houses tends to be longer (7.5 months) it would seem safe to assume that the longer average stay in the Group II halfway houses can be largely attributed to a longer stay among residents with diagnoses other than alcoholism in the Group II halfway houses. Considerable divergence in median length of stay occurs between the different ownership types. Among the Group I facilities the proprietary halfway house residents remained 4.2 months, twice as long as those in government facilities. Among the Group II halfway houses the residents in the proprietary facilities also had the longest median stay (8 months) while those in nonprofit facilities had the shortest median stay (3.1 months).

One of the major goals of most halfway houses is that their residents either be employed or seeking employment. Table I indicates that nearly two out of three residents in the alcoholism halfway houses are employed. Halfway houses are generally thought of as providing a gradual return to or a moratorium away from full scale independent living. With this in mind it is interesting to note that most alcoholism halfway house residents are employed and the majority work on a full time basis as opposed to a part-time

or intermittent basis. The proportion of unemployed residents is considerably lower in halfway houses serving males only (29%) than in those serving either both sexes (52%) or females only (57%). This is probably related to the fact that a larger proportion of halfway houses for males require employability as a condition of acceptance. An earlier study of alcoholism halfway houses notes that most male halfway house residents have had good employment background before drinking problems interfered while female halfway house residents did not have work skills of the same quality.3/

In looking at the proportion of employed halfway house residents with respect to the bedsize, ownership, and location of the halfway houses one notes that the facility size seems to have very little effect on the employment patterns of the residents (Table J). In contrast to the general pattern, fewer of the residents in halfway houses under proprietary auspices are employed, ranging from 48 percent of the residents in the Group I halfway houses to 19 percent of the residents in the Group II halfway houses. Among Group I houses there is little variation in the proportion of residents employed with respect to the geographic location of the halfway house. However, this does not hold true for the Group II houses where the proportion of residents employed ranges from a low of 43 percent in the Northeast to a high of 77 percent in the North Central Region.

FOOTNOTES

1/ Data included in this Note were collected in the Inventory of Transitional Mental Health Facilities conducted in August 1971 jointly by the Biometry Branch, NIMH and the National Center for Health Statistics. This survey identified 337 free-standing halfway houses which served predominately alcoholics. Of these, 275 or over four out of five, served alcoholics only; while 62 served alcoholics along with other problem groups such as the mentally ill, drug abusers, etc.

The August 1971 Inventory represented the second survey of these types of facilities. The initial Inventory of Transitional Mental Health Facilities, conducted in January 1970, identified 216 free-standing halfway houses which served alcoholics only. The increase in the number of halfway houses for alcoholics only which were identified in the later survey does not necessarily mean that 59 such halfway houses began operation between January 1970 and August 1971. The majority of this increase reflects more complete coverage of existing houses. Since the earlier survey did not include a category which corresponds to the halfway houses serving alcoholics and other problem groups, comparisons cannot be made between the two surveys for this group of facilities. While the August 971 Inventory was more complete than the ventory of January 1970, there were still no doubt some alcoolism halfway houses which escaped coverage, and the figure of 337 should be regarded as a minimum.

Data were not obtained in either survey for halfway house programs provided within the administrative structure of other mental health service programs which accept only patients from the parent facility (e.g., halfway house programs of State mental hospitals), or for halfway house. programs of alcohol treatment facilities. Other types of places not surveyed include nursing homes, satellite living programs without roundthe-clock staff, and various mission types of facilities providing emergency shelter and board.

2/

The actual numbers of facilities responding to the survey items on which the tables were based are shown below:

Data Item and

Type of Halfway House

Number Residents by

Number of
Facilities
Surveyed

Number of
Facilities
Responding

Percent
Responding

3/

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Although these halfway houses accept residents with a variety of problems

in addition to those with alcohol disorders they indicated that over 50 percent of their residents have problems with alcohol.

41

Cahn, Sidney: Alcoholism Halfway Houses: Relations to Other Programs and
Facilities, Soc. Work 14:50-60 (April) 1969.

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