Implementing housing first in rural areas: pathways Vermont.

Area of Science:

• Public Health
• Mental Health Services
• Homelessness Research

Background:

• Pathways Housing First (PHF) is proven effective for chronic homelessness in severe mental illness (SMI).
• Limited research exists on PHF implementation and effectiveness in rural settings.
• Rural areas present unique challenges for service delivery to vulnerable populations.

Purpose of the Study:

• To describe adaptations of the PHF model for rural Vermont.
• To evaluate the effectiveness of these adaptations in addressing chronic homelessness among individuals with SMI.
• To explore the role of technology in facilitating rural PHF implementation.

Main Methods:

• Described adaptations including hybrid assertive community treatment-intensive case management (ACT-ICM) teams.
• Utilized geographically based caseloads (1:20 staff/client ratio) and regional multidisciplinary specialists.
• Incorporated technology, including a pilot telehealth initiative, to enhance service delivery.

Main Results:

• Achieved an 85% housing retention rate over approximately 3 years.
• Consumers reported a significant decrease in time spent homeless.
• Program adaptations and technological enhancements demonstrated success in a rural context.

Conclusions:

• The adapted PHF model is effective in rural settings for individuals with SMI.
• Hybrid ACT-ICM teams and technological integration are key to successful rural implementation.
• This study provides a scalable model for addressing rural homelessness and severe mental illness.