Tim Aubry1, Paula Goering1, Scott Veldhuizen1, Carol E Adair1, Jimmy Bourque1, Jino Distasio1, Eric Latimer1, Vicky Stergiopoulos1, Julian Somers1, David L Streiner1, Sam Tsemberis1. 1. Dr. 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. Goering and Mr. Veldhuizen are with the Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Goering is also with the Department of Psychiatry, University of Toronto, where Dr. Streiner is affiliated. Dr. Streiner is also with the Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada. Dr. Adair is with the Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Dr. Bourque is with the Department of Education, Université de Moncton, Moncton, New Brunswick, Canada. Dr. Distasio is with the Department of Geography, University of Winnipeg, Winnipeg, Manitoba, Canada. Dr. Latimer is with the Department of Psychiatry, McGill University, Montreal, Quebec, Canada. Dr. Stergiopoulos is with the Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada. Dr. Somers is with the Department of Psychiatry, Simon Fraser University, Burnaby, British Columbia, Canada. Dr. Tsemberis is with Pathways to Housing, Inc., New York City.
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.
RCT Entities:
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.
Authors: Carol E Adair; Brianna Kopp; Jino Distasio; Stephen W Hwang; Jennifer Lavoie; Scott Veldhuizen; Jijian Voronka; Andrew F Kaufman; Julian M Somers; Stefanie R LeBlanc; Sonia Cote; Sindi Addorisio; Dominique Matte; Paula Goering Journal: J Urban Health Date: 2016-08 Impact factor: 3.671
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-03-09 Impact factor: 8.262
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-10-13 Impact factor: 8.262
Authors: Eric A Latimer; Daniel Rabouin; Zhirong Cao; Angela Ly; Guido Powell; Tim Aubry; Jino Distasio; Stephen W Hwang; Julian M Somers; Vicky Stergiopoulos; Scott Veldhuizen; Erica E M Moodie; Alain Lesage; Paula N Goering Journal: CMAJ Open Date: 2017-07-18
Authors: Emily Leickly; Jordan Skalisky; Oladunni Oluwoye; Sterling M McPherson; Debra Srebnik; John M Roll; Richard K Ries; Michael G McDonell Journal: Subst Abus Date: 2017-12-08 Impact factor: 3.716
Authors: Enrico G Castillo; Bowen Chung; Elizabeth Bromley; Sheryl H Kataoka; Joel T Braslow; Susan M Essock; Alexander S Young; Jared M Greenberg; Jeanne Miranda; Lisa B Dixon; Kenneth B Wells Journal: Harv Rev Psychiatry Date: 2018 Mar/Apr Impact factor: 3.732