One-Year Outcomes of a Randomized Controlled Trial of Housing First With ACT in Five Canadian Cities

Objective:Housing First is a groundbreaking approach to ending chronic homelessness among people with mental illness. This article presents one-year findings from a multisite randomized controlled trial (RCT) comparing Housing First with treatment as usual.Methods:The study was a nonblind, parallel-group RCT conducted in five Canadian cities. A sample of 950 high-need participants with severe mental illness, who were either absolutely homeless or precariously housed, was randomly assigned to Housing First (N=469) or treatment as usual (N=481). Housing First participants received a rent supplement, assistance to find housing, and assertive community treatment. Treatment-as-usual participants had access to all other existing programs.Results:At one-year follow-up, 73% of Housing First participants and 31% of treatment-as-usual participants resided in stable housing (p