Housing First for older homeless adults with mental illness: a subgroup analysis of the At Home/Chez Soi randomized controlled trial
Abstract
OBJECTIVE: This study compares the effect of Housing First on older (≥50 years old) and younger (18-49 years old) homeless adults with mental illness participating in At Home/Chez Soi, a 24-month multisite randomized controlled trial of Housing First. METHOD: At Home/Chez Soi, participants (n = 2148) were randomized to receive rent supplements with intensive case management or assertive community treatment, based on their need level for mental health services, or usual care in their respective communities. A subgroup analysis compared older (n = 470) and younger (n = 1678) homeless participants across baseline characteristics and 24-month outcomes including housing stability (primary outcome), generic and condition-specific quality of life, community functioning, physical and mental health status, mental health symptom severity, psychological community integration, recovery, and substance use (secondary outcomes). RESULTS: At 24 months, Housing First significantly improved the percentage of days stably housed among older (+43.9%, 95% confidence interval [CI]: 38.4% to 49.5%) and younger homeless adults (+39.7%, 95% CI: 36.8% to 42.6%), compared with usual care, with no significant differences between age groups (difference of differences = +4.2%, 95% CI: -2.1% to 10.5%, p = 0.188). Improvements from baseline to 24 months in mental health and condition-specific quality of life were significantly greater among older homeless adults than among younger homeless adults. CONCLUSION: Housing First significantly improved housing stability among older and younger homeless adults with mental illness, resulting in superior mental health and quality of life outcomes in older homeless adults compared with younger homeless adults at 24 months. Copyright © 2017 John Wiley & Sons, Ltd.
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Housing First effectively stably houses people across the lifespan who have a mental illness, use substances, have chronic medical conditions, frequent emergency departments, and have cognitive and intellectual disabilities.
“This includes people across the lifespan who have a mental illness, use substances, have chronic medical conditions, frequent emergency departments, and have cognitive and intellectual disabilities (Chung et al., 2018; Durbin et al., 2018; Kerman et al., 2020a; Kozloff et al., 2016; Peng et al., 2020; Stergiopoulos et al., 2019b; Urbanoski et al., 2017).”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Chung et al., 2018
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References 37 · Cited by 59
- Authors
- Chung, T. E., Gozdzik, A., Palma Lazgare, L. I., To, M. J., Aubry, T., Frankish, J., Hwang, S. W., & Stergiopoulos, V.
- Affiliations
- St. Michael's Hospital (CA)
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute St. Michael's Hospital Toronto Ontario Canada
- University of Ottawa (CA)
- University of British Columbia (CA)
- Corresponding author
- Stergiopoulos, Vicky
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2017-02-16
- Volume
- 33
- Issue
- 1
- Pages
- 85-95
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- OpenAlex
- W2589829207
- Cited by
- 59
- References
- 37
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 6 · 2023: 5 · 2022: 6 · 2021: 11 · 2020: 6 · 2019: 7 · 2018: 7 · 2017: 1
- FWCI
- 9.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Health Canada (n/a)
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- Housing First, homelessness, older adults, mental illness, housing stability, case management, assertive community treatment, quality of life, community functioning, substance use, age differences
- MeSH terms
- Adult, Age Factors, Aged, Mental Disorders, Community Mental Health Services, Female, Health Status, Ill-Housed Persons, Humans, Male, Middle Aged, Public Housing, Quality of Life, Case Management, Substance-Related Disorders, Young Adult
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