Related Experiment Video
Updated: Apr 18, 2026
A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills
Published on: February 13, 2020
One-year outcomes of a randomized controlled trial of housing first with ACT in five Canadian cities
Tim Aubry1, Sam Tsemberis, Carol E Adair
1Dr. Aubry is with the Centre for Research on Educational and Community Services and the School of Psychology, University of Ottawa, Ottawa, Ontario, Canada (e-mail: taubry@uottawa.ca ). Dr. Tsemberis is with Pathways to Housing, Inc., New York. Dr. Adair is with the Department of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Mr. Veldhuizen and Dr. Goering are with the Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Goering is also with the Department of Psychiatry, University of Toronto, Toronto, where Dr. Streiner is also affiliated. Dr. Streiner is also with the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario. Dr. Latimer is with the Department of Psychiatry, McGill University, Montreal, Quebec, Canada. Dr. Sareen is with the Department of Psychiatry and the Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Dr. Patterson is with the Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada. Dr. McGarvey is with the Department of Psychiatry, University of British Columbia, Vancouver. Ms. Kopp and Ms. Hume are with the Mental Health Commission of Canada, Calgary.
Objective:
Housing First is a groundbreaking approach to ending chronic homelessness among people with mental illness. This article presents one-year findings from a multisite randomized controlled trial (RCT) comparing Housing First with treatment as usual.
Methods:
The study was a nonblind, parallel-group RCT conducted in five Canadian cities. A sample of 950 high-need participants with severe mental illness, who were either absolutely homeless or precariously housed, was randomly assigned to Housing First (N=469) or treatment as usual (N=481). Housing First participants received a rent supplement, assistance to find housing, and assertive community treatment. Treatment-as-usual participants had access to all other existing programs.
Results:
At one-year follow-up, 73% of Housing First participants and 31% of treatment-as-usual participants resided in stable housing (p<.001, odds ratio=6.35, covariate adjusted difference=42%, 95% confidence interval [CI]=36%-48%). Improvement in overall quality of life was significantly greater among Housing First participants compared with treatment-as-usual participants (p<.001, d=.31, CI=.16-.46). Housing First participants also showed greater improvements in community functioning compared with treatment-as-usual participants (p=.003, d=.25, CI=.09-.41).
Conclusions:
Compared with treatment as usual, Housing First produced greater improvements in housing stability, quality of life, and community functioning after one year of enrollment. The study provides support for adopting Housing First as an approach for ending chronic homelessness among persons with severe mental illness, even if they are actively symptomatic or using substances.
Related Concept Videos
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:11Clinical Trials: Overview
01:26Psychosis: Goals of Pharmacotherapy
01:24Treatment Strategies for Psychological Disorders
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...