Housing Retention in Single-Site Housing First for Chronically Homeless Individuals With Severe Alcohol Problems
Open accessAbstract
Objectives. We studied housing retention and its predictors in the single-site Housing First model. Methods. Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005–2008) conducted in Seattle, Washington. At baseline, participants responded to self-report questionnaires assessing demographic, illness burden, alcohol and other drug use, and psychiatric variables. Housing status was recorded over 2 years. Results. Participants were interested in housing, although a sizable minority did not believe they would be able to maintain abstinence-based housing. Only 23% of participants returned to homelessness during the 2-year follow-up. Commonly cited risk factors—alcohol and other drug use, illness burden, psychiatric symptoms, and homelessness history—did not predict resumed homelessness. Active drinkers were more likely to stay in this housing project than nondrinkers. Conclusions. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems.
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There is a robust evidence base demonstrating that Housing First is effective in stably housing a large majority of people experiencing chronic homelessness.
“There is a robust evidence base demonstrating that Housing First is effective in stably housing a large majority of people experiencing chronic homelessness (Aubry et al., 2020; Collins et al., 2013; Padgett et al., 2016; Stergiopoulos et al., 2019a; Woodhall-Melnik and Dunn, 2015).”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Collins et al., 2013
Over 75% of homeless adults with severe alcohol problems remain housed over 2 years in single-site HF.
“Subsequent studies have also demonstrated that over 75% of homeless adults with severe alcohol problems remain housed over 2 years32”
From Housing first is associated with reduced use of emergency medical services (2014) · cites this paper as [32]
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“To date, studies have been conducted on scattered-site Housing First programs and have shown high rates of housing retention, particularly compared with continuum-of-care or linear residential housing.(3,5,6,13) Studies have also examined housing retention in permanent supportive housing programs, of which Housing Fir…”
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Best practices for emergency shelters that serve male populations
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Homelessness and Vulnerably-Housed Defined: A Synthesis of the Literature
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Homelessness in America: An Overview
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- Authors
- Collins, S. E., Malone, D. K., & Clifasefi, S. L.
- Affiliations
- University of Washington (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2013-12
- Volume
- 103
- Issue
- S2
- Pages
- S269-S274
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3969126
- OpenAlex
- W2147824041
- Cited by
- 114
- References
- 24
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 15 · 2020: 7 · 2019: 7 · 2018: 11 · 2017: 16 · 2016: 11 · 2015: 12 · 2014: 7
- FWCI
- 18.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- Funders
- Robert Wood Johnson Foundation
- University of Washington
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (K22AA018384, K01AA021147, T32AA007455)
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Social Sciences › Urban Studies › Urban and Rural Development Challenges
- Keywords
- Housing First, housing retention, chronic homelessness, alcohol consumption, disease burden, psychiatric symptoms
- MeSH terms
- Adult, Age Factors, Alcoholism, Female, Health Status, Ill-Housed Persons, Housing, Humans, Male, Mental Health, Middle Aged, Risk Factors, Sex, Socioeconomic Factors, Time Factors, Substance-Related Disorders
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