How did a Housing First intervention improve health and social outcomes among homeless adults with mental illness in Toronto? Two-year outcomes from a randomised trial.
O'Campo, Patricia;
Stergiopoulos, Vicky;
Nir, Pam;
Levy, Matthew;
Misir, Vachan;
Chum, Antony;
Arbach, Bouchra;
Nisenbaum, Rosane;
To, Matthew J;
Hwang, Stephen W;
(2016)
How did a Housing First intervention improve health and social outcomes among homeless adults with mental illness in Toronto? Two-year outcomes from a randomised trial.
BMJ open, 6 (9).
e010581-.
ISSN 2044-6055
DOI: https://doi.org/10.1136/bmjopen-2015-010581
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OBJECTIVES: We studied the impact of a Housing First (HF) intervention on housing, contact with the justice system, healthcare usage and health outcomes among At Home/Chez Soi randomised trial participants in Toronto, a city with an extensive service network for social and health services for individuals who are experiencing homelessness and mental illness. METHODS: Participants identified as high needs were randomised to receive either the intervention which provided them with housing and supports by an assertive community treatment team (HF+ACT) or treatment as usual (TAU). Participants (N=197) had in-person interviews every 3 months for 2 years. RESULTS: The HF+ACT group spent more time stably housed compared to the TAU group with the mean difference between the groups of 45.8% (95% CI 37.1% to 54.4%, p<0.0001). Accounting for baseline differences, HF+ACT group showed significant improvements over TAU group for community functioning, selected quality-of-life subscales and arrests at some time points during follow-up. No differences between HF+ACT and TAU groups over the follow-up were observed for health service usage, community integration and substance use. CONCLUSIONS: HF for individuals with high levels of need increased housing stability and selected health and justice outcomes over 2 years in a city with many social and health services. TRIAL REGISTRATION NUMBER: ISRCTN42520374.