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-...
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| Veröffentlicht in: | Psychiatric services (Washington, D.C.) D.C.), 2015-05, Vol.66 (5), p.463-469 |
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| container_title | Psychiatric services (Washington, D.C.) |
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| creator | Aubry, Tim Tsemberis, Sam Adair, Carol E Veldhuizen, Scott Streiner, David Latimer, Eric Sareen, Jitender Patterson, Michelle McGarvey, Kathleen Kopp, Brianna Hume, Catharine Goering, Paula |
| description | 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 |
| doi_str_mv | 10.1176/appi.ps.201400167 |
| format | Article |
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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<.001, odds ratio=6.35, covariate adjusted difference=42%, 95% confidence interval [CI]=36%−48%). Improvement in overall quality of life was significantly greater among Housing First participants compared with treatment-as-usual participants (p<.001, d=.31, CI=.16–.46). Housing First participants also showed greater improvements in community functioning compared with treatment-as-usual participants (p=.003, d=.25, CI=.09–.41).Conclusions:Compared with treatment as usual, Housing First produced greater improvements in housing stability, quality of life, and community functioning after one year of enrollment. The study provides support for adopting Housing First as an approach for ending chronic homelessness among persons with severe mental illness, even if they are actively symptomatic or using substances.</description><identifier>ISSN: 1075-2730</identifier><identifier>EISSN: 1557-9700</identifier><identifier>DOI: 10.1176/appi.ps.201400167</identifier><identifier>PMID: 25639993</identifier><language>eng</language><publisher>United States: American Psychiatric Association</publisher><subject>Adult ; Canada ; Cities ; Community Mental Health Services - methods ; Community Mental Health Services - statistics & numerical data ; Comparative analysis ; Female ; Follow-Up Studies ; Homeless people ; Homeless Persons - statistics & numerical data ; Housing ; Housing - statistics & numerical data ; Humans ; Male ; Mental disorders ; Mental Disorders - therapy ; Mental health care ; Quality of life ; Rural Population - statistics & numerical data</subject><ispartof>Psychiatric services (Washington, D.C.), 2015-05, Vol.66 (5), p.463-469</ispartof><rights>Copyright © 2015 by the American Psychiatric Association 2015</rights><rights>Copyright American Psychiatric Publishing, Inc. May 1, 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a368t-9cfca99bc1d61bd416a84e668958ea184873a5d3323f9664411b024e4dd0e1b3</citedby><cites>FETCH-LOGICAL-a368t-9cfca99bc1d61bd416a84e668958ea184873a5d3323f9664411b024e4dd0e1b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/appi.ps.201400167$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/appi.ps.201400167$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,780,784,2855,21626,21627,21628,27924,27925,77794,77799</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25639993$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aubry, Tim</creatorcontrib><creatorcontrib>Tsemberis, Sam</creatorcontrib><creatorcontrib>Adair, Carol E</creatorcontrib><creatorcontrib>Veldhuizen, Scott</creatorcontrib><creatorcontrib>Streiner, David</creatorcontrib><creatorcontrib>Latimer, Eric</creatorcontrib><creatorcontrib>Sareen, Jitender</creatorcontrib><creatorcontrib>Patterson, Michelle</creatorcontrib><creatorcontrib>McGarvey, Kathleen</creatorcontrib><creatorcontrib>Kopp, Brianna</creatorcontrib><creatorcontrib>Hume, Catharine</creatorcontrib><creatorcontrib>Goering, Paula</creatorcontrib><title>One-Year Outcomes of a Randomized Controlled Trial of Housing First With ACT in Five Canadian Cities</title><title>Psychiatric services (Washington, D.C.)</title><addtitle>Psychiatr Serv</addtitle><description>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<.001, odds ratio=6.35, covariate adjusted difference=42%, 95% confidence interval [CI]=36%−48%). Improvement in overall quality of life was significantly greater among Housing First participants compared with treatment-as-usual participants (p<.001, d=.31, CI=.16–.46). Housing First participants also showed greater improvements in community functioning compared with treatment-as-usual participants (p=.003, d=.25, CI=.09–.41).Conclusions:Compared with treatment as usual, Housing First produced greater improvements in housing stability, quality of life, and community functioning after one year of enrollment. The study provides support for adopting Housing First as an approach for ending chronic homelessness among persons with severe mental illness, even if they are actively symptomatic or using substances.</description><subject>Adult</subject><subject>Canada</subject><subject>Cities</subject><subject>Community Mental Health Services - methods</subject><subject>Community Mental Health Services - statistics & numerical data</subject><subject>Comparative analysis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Homeless people</subject><subject>Homeless Persons - statistics & numerical data</subject><subject>Housing</subject><subject>Housing - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Mental Disorders - therapy</subject><subject>Mental health care</subject><subject>Quality of life</subject><subject>Rural Population - statistics & numerical data</subject><issn>1075-2730</issn><issn>1557-9700</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kVtr3DAQhUVpaG79AXkJgr70xVuNJevyGExuEFgoCyFPRrbkVostuZIdSH59tdltCoU-zTB858wwB6ELICsAwb_paXKrKa1KAowQ4OIDOoGqEoUShHzMPRFVUQpKjtFpSluSGQH8EzouK06VUvQEmbW3xZPVEa-XuQujTTj0WOPv2pswuldrcB38HMMw5HYTnR52wF1YkvM_8I2LacaPbv6Jr-oNdj5Pni2utdfGaY9rNzubztFRr4dkPx_qGdrcXG_qu-JhfXtfXz0UmnI5F6rrO61U24Hh0BoGXEtmOZeqklaDZFJQXRlKS9orzhkDaEnJLDOGWGjpGfq6t51i-LXYNDejS50dBu1tvrfJDxJSKmA8o1_-QbdhiT4flylJqQDFqkzBnupiSCnavpmiG3V8aYA0uwSaXQLNlJr3BLLm8uC8tKM174o_L8_Aag-8af-u_a_jb3m1j9g</recordid><startdate>20150501</startdate><enddate>20150501</enddate><creator>Aubry, Tim</creator><creator>Tsemberis, Sam</creator><creator>Adair, Carol E</creator><creator>Veldhuizen, Scott</creator><creator>Streiner, David</creator><creator>Latimer, Eric</creator><creator>Sareen, Jitender</creator><creator>Patterson, Michelle</creator><creator>McGarvey, Kathleen</creator><creator>Kopp, Brianna</creator><creator>Hume, Catharine</creator><creator>Goering, Paula</creator><general>American Psychiatric Association</general><general>American Psychiatric Publishing, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20150501</creationdate><title>One-Year Outcomes of a Randomized Controlled Trial of Housing First With ACT in Five Canadian Cities</title><author>Aubry, Tim ; Tsemberis, Sam ; Adair, Carol E ; Veldhuizen, Scott ; Streiner, David ; Latimer, Eric ; Sareen, Jitender ; Patterson, Michelle ; McGarvey, Kathleen ; Kopp, Brianna ; Hume, Catharine ; Goering, Paula</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a368t-9cfca99bc1d61bd416a84e668958ea184873a5d3323f9664411b024e4dd0e1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Canada</topic><topic>Cities</topic><topic>Community Mental Health Services - methods</topic><topic>Community Mental Health Services - statistics & numerical data</topic><topic>Comparative analysis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Homeless people</topic><topic>Homeless Persons - statistics & numerical data</topic><topic>Housing</topic><topic>Housing - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Mental disorders</topic><topic>Mental Disorders - therapy</topic><topic>Mental health care</topic><topic>Quality of life</topic><topic>Rural Population - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aubry, Tim</creatorcontrib><creatorcontrib>Tsemberis, Sam</creatorcontrib><creatorcontrib>Adair, Carol E</creatorcontrib><creatorcontrib>Veldhuizen, Scott</creatorcontrib><creatorcontrib>Streiner, David</creatorcontrib><creatorcontrib>Latimer, Eric</creatorcontrib><creatorcontrib>Sareen, Jitender</creatorcontrib><creatorcontrib>Patterson, Michelle</creatorcontrib><creatorcontrib>McGarvey, Kathleen</creatorcontrib><creatorcontrib>Kopp, Brianna</creatorcontrib><creatorcontrib>Hume, Catharine</creatorcontrib><creatorcontrib>Goering, Paula</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Psychiatric services (Washington, D.C.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aubry, Tim</au><au>Tsemberis, Sam</au><au>Adair, Carol E</au><au>Veldhuizen, Scott</au><au>Streiner, David</au><au>Latimer, Eric</au><au>Sareen, Jitender</au><au>Patterson, Michelle</au><au>McGarvey, Kathleen</au><au>Kopp, Brianna</au><au>Hume, Catharine</au><au>Goering, Paula</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One-Year Outcomes of a Randomized Controlled Trial of Housing First With ACT in Five Canadian Cities</atitle><jtitle>Psychiatric services (Washington, D.C.)</jtitle><addtitle>Psychiatr Serv</addtitle><date>2015-05-01</date><risdate>2015</risdate><volume>66</volume><issue>5</issue><spage>463</spage><epage>469</epage><pages>463-469</pages><issn>1075-2730</issn><eissn>1557-9700</eissn><abstract>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<.001, odds ratio=6.35, covariate adjusted difference=42%, 95% confidence interval [CI]=36%−48%). Improvement in overall quality of life was significantly greater among Housing First participants compared with treatment-as-usual participants (p<.001, d=.31, CI=.16–.46). Housing First participants also showed greater improvements in community functioning compared with treatment-as-usual participants (p=.003, d=.25, CI=.09–.41).Conclusions:Compared with treatment as usual, Housing First produced greater improvements in housing stability, quality of life, and community functioning after one year of enrollment. The study provides support for adopting Housing First as an approach for ending chronic homelessness among persons with severe mental illness, even if they are actively symptomatic or using substances.</abstract><cop>United States</cop><pub>American Psychiatric Association</pub><pmid>25639993</pmid><doi>10.1176/appi.ps.201400167</doi><tpages>7</tpages></addata></record> |
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| ispartof | Psychiatric services (Washington, D.C.), 2015-05, Vol.66 (5), p.463-469 |
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| source | MEDLINE; American Psychiatric Publishing Journals (1997-Present); EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Canada Cities Community Mental Health Services - methods Community Mental Health Services - statistics & numerical data Comparative analysis Female Follow-Up Studies Homeless people Homeless Persons - statistics & numerical data Housing Housing - statistics & numerical data Humans Male Mental disorders Mental Disorders - therapy Mental health care Quality of life Rural Population - statistics & numerical data |
| title | One-Year Outcomes of a Randomized Controlled Trial of Housing First With ACT in Five Canadian Cities |
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