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Housing First and Severe Mental Disorders: The Challenge of Exiting Homelessness

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  • James Lachaud
  • Cilia Mejia-Lancheros
  • Rosane Nisenbaum
  • Vicky Stergiopoulos
  • Patricia O’Campo
  • Stephen W. Hwang

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.

Suggested Citation

  • James Lachaud & Cilia Mejia-Lancheros & Rosane Nisenbaum & Vicky Stergiopoulos & Patricia O’Campo & Stephen W. Hwang, 2021. "Housing First and Severe Mental Disorders: The Challenge of Exiting Homelessness," The ANNALS of the American Academy of Political and Social Science, , vol. 693(1), pages 178-192, January.
    • Handle: RePEc:sae:anname:v:693:y:2021:i:1:p:178-192
    DOI: 10.1177/0002716220987220
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    References listed on IDEAS

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    1. Tsemberis, S. & Gulcur, L. & Nakae, M., 2004. "Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals with a Dual Diagnosis," American Journal of Public Health, American Public Health Association, vol. 94(4), pages 651-656.
    2. Royston, Patrick & White, Ian R., 2011. "Multiple Imputation by Chained Equations (MICE): Implementation in Stata," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 45(i04).
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    1. Katherine M. O’Regan & Ingrid Gould Ellen & Sophie House, 2021. "How to Address Homelessness: Reflections from Research," The ANNALS of the American Academy of Political and Social Science, , vol. 693(1), pages 322-332, January.
    2. Francisca G.-C. Richter & Claudia Coulton & Robert L. Fischer & Nina Lalich, 2021. "Public Assistance and Homeless Shelter Trajectories," The ANNALS of the American Academy of Political and Social Science, , vol. 693(1), pages 123-140, January.
    3. Chris O'Leary & Rob Ralphs & Jennifer Stevenson & Andrew Smith & Jordan Harrison & Zsolt Kiss & Harry Armitage, 2024. "The effectiveness of abstinence‐based and harm reduction‐based interventions in reducing problematic substance use in adults who are experiencing homelessness in high income countries: A systematic re," Campbell Systematic Reviews, John Wiley & Sons, vol. 20(2), June.
    4. Debra J. Rog & Kathryn A. Henderson & Clara A. Wagner & Emily L. Abbruzzi, 2021. "Housing Matters, Services Might: Findings from the High Needs Families Program Evaluation," The ANNALS of the American Academy of Political and Social Science, , vol. 693(1), pages 209-229, January.
    5. Tim Aubry & Ayda Agha & Cilia Mejia-Lancheros & James Lachaud & Ri Wang & Rosane Nisenbaum & Anita Palepu & Stephen W. Hwang, 2021. "Housing Trajectories, Risk Factors, and Resources among Individuals Who Are Homeless or Precariously Housed," The ANNALS of the American Academy of Political and Social Science, , vol. 693(1), pages 102-122, January.

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