Implementing housing first with families and young adults: challenges and progress toward self-sufficiency

The Housing First approach has shown promise in helping to combat homelessness among chronically homeless single males, but less is known about the approach when it is applied to families and young adults. This study examined data from a pilot Housing First program that served 78 families (n = 63) and single young adults (n = 15) with homeless histories and mental health and/or substance use disorders to explore program functioning and client service use patterns. Using an exploratory sequential mixed methods research design (Creswell & Plano Clark, 2011), qualitative interview data were conducted first, and quantitative administrative data and qualitative progress note data were then analyzed to explore ideas presented in the qualitative interviews. The in-depth qualitative interviews with staff (N = 9) collected information on program functioning and client successes and challenges. Quantitative data were collected on all 78 clients and sources included administrative data about return to homelessness, child welfare involvement, receipt of public assistance, and interactions with case managers. Qualitative exploration of a sample of client progress notes (N = 32) then followed. Integrating the findings, interviews suggested that clients faced many challenges, especially those related to having little to no income, multiple children, and stigmas, but that “success” would be indicated by needing their case managers less over time. We found that 89% remained enrolled in the program, 21% returned to shelter at some point, child welfare involvement decreased, and public assistance receipt increased after program entry. Content analysis of case management notes indicated that case managers worked with clients to develop independent living skills to improve clients' chances for becoming sufficient over the long-term. •79% of families and young adults participating in a Housing First pilot avoided re-entering shelter•Program participation was significantly associated with increased SNAP enrollment and decreased child welfare involvement•Case management topical content was significantly more focused on housing for families than young adults•The number of case management contacts and time spent within them decreased over time in the program•Self-sufficiency was hampered by crises but supported by case management focused on independent living skills