Housing First and Severe Mental Disorders: The Challenge of Exiting Homelessness. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Lachaud, James; Mejia-Lancheros, Cilia; Nisenbaum, Rosane; Stergiopoulos, Vicky; O'Campo, Patricia; Hwang, Stephen W.
• Other Names: Lee Barrett A. guest-editor.; Shinn Marybeth guest-editor.; Culhane Dennis P. guest-editor.
• Is Part Of: Annals of the American Academy of Political and Social Science. Volume 693:Issue 1(2021)
• Page Start: 178
• Page End: 192
• Publication Date: 2021-01
• Subjects: Housing First -- psychosis -- substance use -- exiting homelessness -- housing trajectory; Social sciences -- Periodicals; Social sciences -- United States -- Periodicals; Political science -- Periodicals; United States -- Politics and government -- Periodicals; 300
• DOI: 10.1177/0002716220987220
• Languages: English
• ISSNs: 0002-7162

Abstract

We examine the long-term housing trajectories of 543 program participants at the Toronto site of the At Home/Chez-Soi project, a randomized controlled trial of a Housing First (HF) intervention for adults with mental disorders. The average follow-up period for our study was 5.5 years. We find that the HF approach, which includes housing subsidies and support services, was strongly associated with rapid transitions to sustained housing (70.4 percent of HF participants vs. 27.9 percent of treatment as usual participants). Mood disorders with psychotic features and primary psychotic disorders were negatively associated with the rapid and sustained housing trajectory, and alcohol use disorders were positively associated with a rapid then declining housing trajectory. We argue that to understand the long-term impacts of housing programs, research needs to better explore comprehensive and personalized care to support individuals with severe mental disorders.