Effectiveness of housing first with assertive community treatment in a multi-city Canadian trial: 12 month outcomes

This presentation examines the effectiveness of Housing First (HF) programs that provide a combination of subsidized scatter site housing and Assertive Community Treatment (ACT) services to people with severe mental illness and other complex needs who are homeless. This randomized control trial conducted across five Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, and Moncton) examines participants (N=500) access to housing, housing retention, and clinical and social outcomes as a function of receiving HF or treatment as usual (TAU). HLM statistical analyses was used to compare the two groups and showed that the HF group spent a greater proportion of time in housing in the first year of the study (obtained housing earlier) and that they remained housed for a longer period during that same time period. HF participants also reported greater improvements in their quality of life in the areas related to their living situation, safety, and leisure. Implications of the findings for modifying TAU programs as well as using a HF framework as a policy approach to addressing homelessness for people with complex needs will be discussed.