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Housing First: exploring participants' early support needs.

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Housing First programs show most homeless adults with mental illness improve within six months, but some need more support for life skills and social connection. Early evaluation and adaptation are key for participant success.

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Area of Science:

  • Mental Health Research
  • Social Work Interventions
  • Homelessness Studies

Background:

  • Housing First is a widely adopted intervention for homeless adults with mental illness.
  • Limited understanding exists regarding early participant experiences and outcomes in Housing First programs.
  • This study investigates changes in key domains six months post-enrollment in a Canadian Housing First trial.

Purpose of the Study:

  • To examine participant changes in domains such as community integration, mental health, substance use, functioning, and quality of life.
  • To identify baseline factors associated with observed changes.
  • To explore participant and service provider perspectives on the Housing First experience.

Main Methods:

  • Mixed methods design utilizing quantitative and qualitative data.
  • Pre-post design with 301 participants at the Toronto site of the At Home/Chez Soi project.
  • Quantitative analysis included multivariate regression; qualitative analysis involved thematic analysis of interviews and focus groups.

Main Results:

  • 60-72% of participants showed expected improvement; others faced challenges.
  • Psychotic disorder diagnosis correlated with decreased quality of life; substance use disorders linked to improved mental health and quality of life.
  • Independent housing, strong working alliance, and addressing social isolation/life skills needs were associated with better outcomes.

Conclusions:

  • Additional strategies are needed to support early Housing First participants, particularly regarding life skills and social isolation.
  • Early and continuous evaluation, monitoring, and program adaptation are crucial for addressing participant needs.
  • Addressing specific challenges like loneliness and lack of life skills can enhance Housing First effectiveness.