The Impact of Housing First on Criminal Justice Outcomes among Homeless People with Mental Illness: A Systematic Review

Abstract

Objective: Housing First is increasingly put forward as an important component of a pragmatic plan to end homelessness. The literature evaluating the impact of Housing First on criminal justice involvement has not yet been systematically examined. The objective of this systematic review is to examine the impact of Housing First on criminal justice outcomes among homeless people with mental illness. Method: Five electronic databases (PsycINFO, MEDLINE, Embase, CINAHL, Web of Science) were searched up until July 2018 for randomised and nonrandomised studies of Housing First among homeless people with a serious mental disorder. Results: Five studies were included for a total of 7128 participants. Two studies from a randomised controlled trial found no effect of Housing First on arrests compared to treatment as usual. Other studies compared Housing First to other programs or compared configurations of HF and found reductions in criminal justice involvement among Housing First participants. Conclusions: This systematic review suggests that Housing First, on average, has little impact on criminal justice involvement. Community services such as Housing First are potentially an important setting to put in place strategies to reduce criminal justice involvement. However, forensic mental health approaches such as risk assessment and management strategies and interventions may need to be integrated into existing services to better address potential underlying individual criminogenic risk factors. Further outcome assessment studies would be necessary.

A randomized trial of permanent supportive housing for chronically homeless persons with high use of publicly funded services

“…We found no differences in criminal justice system encounters between participants in the intervention and control groups, which is consistent with prior research 28 . Individuals experiencing homelessness are more likely to be arrested for offenses that can be directly attributed to the state of being homeless, 29 including trespassing, sleeping in vehicles, panhandling, and public use of illicit drugs and alcohol.…”

Examining the Relationships between Cumulative Childhood Adversity and the Risk of Criminal Justice Involvement and Victimization among Homeless Adults with Mental Illnesses after Receiving Housing First Intervention

“…With regard to CJI outcomes, a recent systematic review indicated that HF has little impact on reduction of CJI and did not systematically address criminogenic needs other than substance abuse in homeless persons with a mental illness. 20 However, results of studies using other selected subsamples of homeless individuals indicated that HF exposure decreases some of the CJI outcomes. For example, HF reduced jail time and bookings in chronically homeless individuals with severe alcohol problems, 21 arrests and incarcerations in persons with chronic homelessness and work-limiting disabilities, 22 the amount of criminal activity in individuals with chronic homelessness, 23 and number of days incarcerated for homeless individuals with severe mental disabilities.…”

A Typology of Lifetime Criminal Justice Involvement Among Homeless Individuals With Mental Illness: Identifying Needs to Better Target Intervention

“…Class 5 was defined by a greater number of drug charges, along with higher rates of drug use disorder, and was accordingly labeled Needs Associated with Drugs. Given their socioeconomic precarity as well as general criminal activity, individuals in these two groups may be more likely to benefit from initiatives such as Housing First coupled with forensic assertive community treatment or intensive case management (Cuddeback et al, 2013; Leclair et al, 2019; Morrissey et al, 2007; Woodhall-Melnik & Dunn, 2016). Moreover, individuals with Needs Associated with Drugs may benefit additionally from integrated dual disorder treatment (Peters et al, 2017) and drug treatment court (Wilson et al, 2006) to link them to appropriate services and decrease the criminalization of their substance use.…”