Implementing housing first with families and young adults: challenges and progress toward self-sufficiency

Collins, Cyleste; Bai, Rong; Crampton, David; Fischer, Robert L.; D'Andrea, Rebecca; Dean, Kendra; Lalich, Nina; Chan, Tsui; Cherney, Emily C.

doi:10.1016/j.childyouth.2018.11.025

Cited by 14 publications

(33 citation statements)

References 39 publications

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“…There also exists extremely limited research in the area of housing and support interventions for children in families experiencing homelessness. Limited research suggests HF, permanent supportive housing, and housing subsidies or affordable housing are effective in improving housing status [ 63 – 65 ], but reaching housing stability in the long-term has been identified as an unsolved problem [ 64 ], with further investigation urgently needed [ 63 – 65 ]. One large multisite study involving 3 y of follow-up comprehensively studied the effects of random assignment to long-term rent subsidies, short-term rent subsidies, and transitional housing combined with support services all compared to TAU among families experiencing homelessness in the U.S.…”

Section: Discussionmentioning

confidence: 99%

The association between experiencing homelessness in childhood or youth and adult housing stability in Housing First

2021

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Background Researchers have pointed out the paucity of research investigating long-term consequences of experiencing homelessness in childhood or youth. Limited research has indicated that the experience of homelessness in childhood or youth is associated with adverse adjustment-related consequences in adulthood. Housing First (HF) has acknowledged effectiveness in improving housing outcomes among adults experiencing homelessness and living with serious mental illness, although some HF clients struggle with maintaining housing. The current study was conducted to examine whether the experience of homelessness in childhood or youth increases the odds of poorer housing stability following entry into high-fidelity HF among adults experiencing serious mental illness and who were formerly homeless. Methods Data were drawn from the active intervention arms of a HF randomized controlled trial in Metro Vancouver, Canada. Participants (n = 297) were referred to the study from service agencies serving adults experiencing homelessness and mental illness between October 2009 and June 2011. The Residential Time-Line Follow-Back Inventory was used to measure housing stability. Least absolute shrinkage and selection operator was used to estimate the association between first experiencing homelessness in childhood or youth and later housing stability as an adult in HF. Results Analyses indicated that homelessness in childhood or youth was negatively associated with experiencing housing stability as an adult in HF (aOR = 0.53; 95% CI = 0.31–0.90). Conclusions Further supports are needed within HF to increase housing stability among adult clients who have experienced homelessness in childhood or youth. Asking clients about the age they first experienced homelessness may be of clinical utility upon enrollment in HF and may help identify support needs related to developmental experiences. Results further emphasize the importance of intervening earlier in life in childhood and youth before experiencing homelessness or before it becomes chronic. Findings also contribute to a limited knowledge base regarding the adverse long-term consequences of childhood and youth homelessness. Trial registration Current Controlled Trials: ISRCTN57595077 and ISRCTN66721740. Registered on October 9, 2012.

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Section: Discussionmentioning

confidence: 99%

The association between experiencing homelessness in childhood or youth and adult housing stability in Housing First

2021

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“…Our data also highlighted an important need to provide vulnerable Black women with education and support related to workers' compensation and unemployment benefits, as well as affordable legal representation. Programs to increase affordable and stable housing, particularly with case management to assist with crises and consultation, are essential [30].…”

Section: Discussionmentioning

confidence: 99%

“…Participants in the recovery group were more likely to have used illicit substances when they exchanged sex in their past. This again highlights the need for structural interventions to assist Black women in finding housing and financial stability [30] to avoid the need to engage in survival sex. Further, individual-level HIV prevention interventions for this population should address the syndemic effects associated with IPV, substance use, and HIV risk behaviors, warranting multi-level interventions instead of brief, singular-focused interventions.…”

Section: Discussionmentioning

confidence: 99%

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Exploring patterns of substance use among highly vulnerable Black women at-risk for HIV through a syndemics framework: A qualitative study

Nydegger

Claborn

2020

PLoS ONE

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Black women who use alcohol, marijuana, and other drugs are disproportionately affected by health disparities. Black women's HIV diagnosis rates are 15 times higher than White women, and is among the leading causes of death among Black women in the US. Previous studies support the association between substance use and HIV risk, yet it is essential to better understand the specific factors experienced within the context of substance misuse and recovery among vulnerable Black women at-risk for substance misuse, HIV, and adverse life experiences. We conducted qualitative interviews with 31 black women (age M = 32.13, range 18-57) four times over six months. Eligible participants were 18+ years, identified as a Black/African-American woman, had unprotected vaginal or anal sex with a man in the past 30 days, and spoke fluent English. All transcripts were transcribed verbatim and were analyzed used thematic content analysis. Two groups of participants emerged: 1) those in recovery from their drug of choice (n = 11, 7 of whom misused alcohol or marijuana during the study), and 2) those who misused their drug of choice during the study (active use group; n = 20). Four themes emerged in the context of substance use: cultural factors, structural factors (i.e., housing and employment), past and present adverse life experiences, and individual factors (i.e., substance use to cope with stress, self-medicating with substances for mental health symptoms, intimate partner violence, and sex exchange). While participants in both groups used substances to cope with regard to these factors, the recovery group tended to use substances at lower frequencies and did not relapse with their drug of choice during the study. The active use group reported more substance use with regard to structural factors and recent adverse life events, had more difficulty regarding employment, and less instances of intimate partner violence (IPV) but were more likely to cope using substances. Substance use interventions tailored to vulnerable Black women should consider including trauma-informed interventions and support groups that address the structural, social, and individual factors to better serve their needs.

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“…Appel et al (2012) found that stable housing was associated with greater retention of methadone treatment, though Parpouchi et al (2018) found no difference. DeSilva, Manworren, and Targonski (2011) and Srebnik, Connor, and Sylla (2013) found the provision of stable housing saw less criminal activity and reoffending and Collins et al (2019) found a drop in use of the child welfare system. Whittaker et al (2017) looked at the variation in rates of criminal activity over a twelve-month follow-up period when Housing First participants were housed in either scattered sites, or congregated sites.…”

Section: Theme 7: Criminal Justice Outcomesmentioning

confidence: 99%

Outcomes Associated with Providing Secure, Stable, and Permanent Housing for People Who Have Been Homeless: An International Scoping Review

Carnemolla

Skinner

2021

Journal of Planning Literature

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As governments and service agencies across the world grapple with chronic rates of homelessness and housing instability, there is a growing need to understand the value that providing secure, stable housing brings to the lives of people who are homeless and the broader community. The complex nature of homelessness is revealed across a variety of academic fields including planning, pharmacology, urban affairs, housing policy, nutrition, psychiatry, sociology, public health, urban health, and criminology. We undertook a scoping review according to PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-analysis) that mapped the breadth and scale of the evidence-base and identified themes and gaps. We identified 476 reports and after excluding duplicates and ones that did not relate to our criteria, were left with 100 studies from eight countries. Each of them identified benefits and/or changes that occurred when people experiencing homelessness or housing insecurity transitioned into a secure, stable home. Outcomes measured were distributed across a range of domains including physical and mental health, well-being, mortality rates, criminal justice interaction, service use, and cost-effectiveness. Findings varied by degree but overwhelmingly found improvements in all domains once people were permanently housed. Housing provided a foundation for people to envisage a better life and make plans for the future. As one woman who had fled a violent home was quoted as saying: “housing made everything else possible.” The research identified savings for taxpayers and the wider community once people left homelessness for the stability of a permanent home, even after factoring in the cost of housing and rental help. We found numerous gaps. For example, there was a prevalence of studies that focused on those who are visibly homeless, in particular chronically homeless men with mental illness and/or substance use issues. Much less research looked at women whose patterns of homelessness are more varied and even less at homelessness involving children and families. Women who had left domestic and family violence were investigated in a very small number of studies and sample sizes were small. Few reports undertook the complex task of quantifying and comparing cost savings. Other notable gaps were older women, older people more generally, refugees, recent migrants, veterans, Indigenous people and those with a disability.

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Implementing housing first with families and young adults: challenges and progress toward self-sufficiency

Cited by 14 publications

References 39 publications

The association between experiencing homelessness in childhood or youth and adult housing stability in Housing First

The association between experiencing homelessness in childhood or youth and adult housing stability in Housing First

Exploring patterns of substance use among highly vulnerable Black women at-risk for HIV through a syndemics framework: A qualitative study

Outcomes Associated with Providing Secure, Stable, and Permanent Housing for People Who Have Been Homeless: An International Scoping Review

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