A Multiple-City RCT of Housing First With Assertive Community Treatment for Homeless Canadians With Serious Mental Illness

Abstract

Housing First with ACT is an effective approach in various contexts for assisting individuals with serious mental illness to rapidly exit homelessness.

Quality of life, autonomy, satisfaction, and costs associated with mental health supported accommodation services in England: a national survey

“…A randomised controlled trial in Canada of 'Housing First', a floating outreach model targeted at mentally ill homeless people, reported benefits for housing stability but no advantage over usual care at two year follow up with regard to quality of life and satisfaction with services [30]. Our results appear to concur and suggest that supported housing might offer better value for money than floating outreach as it appears to be associated with better outcomes.…”

"Housing First" for Homeless Youth With Mental Illness

“…The 2-year outcomes associated with "Housing First" plus ACT and "Housing First" plus ICM in the full sample have been reported separately. 10,11 Participants Participants were currently homeless or precariously housed individuals ≥18 years in Moncton, Montreal, Toronto, and Winnipeg and ≥19 years in Vancouver with a mental disorder. Homeless was defined as no fixed place to stay for ≥7 nights and little likelihood of obtaining permanent housing in the coming month, and precariously housed was defined as living in a rooming house, single-room occupancy or hotel/motel with ≥2 episodes of homelessness in the past year.…”

“…Minimal data on housing stability were missing in the full sample (in the range of 4%). 10,11 For analysis of quality of life and exploratory outcomes, we applied a linear mixed models framework to perform repeated measures analysis of longitudinal continuous outcomes. We applied generalized estimating equations to repeated counts assuming the negative binomial distribution when outcomes were overdispersed.…”

“…9 In 2008, the Canadian government invested $110 million through the Mental Health Commission of Canada for At Home/ Chez Soi, the largest trial of "Housing First" to date. At Home/Chez Soi found that "Housing First" improved housing stability in homeless people with mental illness 10,11 ; participants who received more intensive psychosocial support also had improvements in quality of life and community functioning compared with usual care. 11 Paralleling its dissemination in homeless adults, "Housing First" is increasingly being applied to homeless youth; the US Department of Housing and Urban Development presents models based on "Housing First" principles as best practice for homeless youth.…”

Canadian Service Providers’ Perceptions of Barriers and Support Gaps in Housing and Mental Health

“…Nevertheless, given the success of the housing first model and its continued implementation across the country, the question is what proportion of housing stock in communities ought to be housing first and how much housing with even greater support is needed. Despite the especially positive findings that housing first has had in Canada, there is still a minority-roughly 25% of individuals-who do not achieve favourable housing outcomes via the model (Aubry et al, 2015b(Aubry et al, , 2016. Although the reasons why some people experience difficulties are not fully understood, it is crucially important to consider that housing first may not be a one-size-fits-all model in the development and implementation of future housing for people with mental illness.…”