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Cited by 220Homelessness and Social IssuesPsychiatric care and mental health servicesSchizophrenia research and treatment

A multiple-city RCT of housing first with assertive community treatment for homeless Canadians with serious mental illness

Aubry, Tim, Goering, Paula, Veldhuizen, Scott, Adair, Carol E., Bourque, Jimmy, Distasio, Jino, Latimer, Eric, Stergiopoulos, Vicky +3 more·2016·Psychiatric Services
DOI 10.1176/appi.ps.201400587
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Abstract

OBJECTIVE: Housing First with assertive community treatment (ACT) is a promising approach to assist people with serious mental illness to exit homelessness. The article presents two-year findings from a multisite trial on the effectiveness of Housing First with ACT. METHODS: The study design was a randomized controlled trial conducted in five Canadian cities. A sample of 950 participants with serious mental illness who were absolutely homeless or precariously housed were randomly assigned to receive either Housing First with ACT (N=469) or treatment as usual (N=481). RESULTS: Housing First participants spent more time in stable housing than participants in treatment as usual (71% versus 29%, adjusted absolute difference [AAD]=42%, p<.01). Compared with treatment-as-usual participants, Housing First participants who entered housing did so more quickly (73 versus 220 days, AAD=146.4, p<.001), had longer housing tenures at the study end-point (281 versus 115 days, AAD=161.8, p<.01), and rated the quality of their housing more positively (adjusted standardized mean difference [ASMD]=.17, p<.01). Housing First participants reported higher quality of life (ASMD=.15, p<.01) and were assessed as having better community functioning (ASMD=.18, p<.01) over the two-year period. Housing First participants showed significantly greater gains in community functioning and quality of life in the first year; however, differences between the two groups were attenuated by the end of the second year. CONCLUSIONS: Housing First with ACT is an effective approach in various contexts for assisting individuals with serious mental illness to rapidly exit homelessness.

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  • The sole randomized controlled trial (At Home/Chez Soi) did not find differences in substance-related problems over time between Housing First and treatment as usual (up to 6 years post-randomization).

    “The findings from the sole randomized controlled trial (At Home/Chez Soi), which examined an intervention with high fidelity to the Pathways Housing First model in five Canadian cities, did not find differences in substance-related problems over time between Housing First and treatment as usual (up to 6 years post-randomization; Aubry et al., 2016; Stergiopoulos et al., 2015, 2019a).”

    From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Aubry et al., 2016

  • In homeless adults with mental illness, both the HF and TAU groups had improvements in substance-related problems over 24 months.

    “Both the HF and TAU groups had improvements in substance-related problems over 24 months”

    From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Aubry et al. (2016)

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Authors
Aubry, T., Goering, P., Veldhuizen, S., Adair, C. E., Bourque, J., Distasio, J., Latimer, E., Stergiopoulos, V., Somers, J., Streiner, D. L., & Tsemberis, S.
Affiliations
Centre for Addiction and Mental Health (CA)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2016-03-01
Volume
67
Issue
3
Pages
275-281
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/appi.ps.201400587
OpenAlex
W2187246823
Semantic Scholar
24328f6e5c25c734576fe27e0ac5d2f4958a9c20
Cited by
220
References
47
Citations by year
2026: 11 · 2025: 15 · 2024: 21 · 2023: 19 · 2022: 30 · 2021: 34 · 2020: 25 · 2019: 17 · 2018: 17 · 2017: 18 · 2016: 9 · 2015: 3
FWCI
28.58
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
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 › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
Housing First, assertive community treatment, homelessness, severe mental illness, housing stability, housing tenure, quality of life, community functioning, Canadian cities
MeSH terms
Adult, Mental Disorders, Canada, Community Mental Health Services, Female, Ill-Housed Persons, Housing, Humans, Male, Middle Aged, Quality of Life, Linear Models, Case Management

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