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Review
. 2015 Nov;60(11):467-74.
doi: 10.1177/070674371506001102.

Housing First for People With Severe Mental Illness Who Are Homeless: A Review of the Research and Findings From the At Home-Chez soi Demonstration Project

Tim Aubry  1 , Geoffrey Nelson  2 , Sam Tsemberis  3
Affiliations
Review

Housing First for People With Severe Mental Illness Who Are Homeless: A Review of the Research and Findings From the At Home-Chez soi Demonstration Project

Tim Aubry et al. Can J Psychiatry. 2015 Nov.

Abstract
in English, French

Objective: To provide a review of the extant research literature on Housing First (HF) for people with severe mental illness (SMI) who are homeless and to describe the findings of the recently completed At Home (AH)-Chez soi (CS) demonstration project. HF represents a paradigm shift in the delivery of community mental health services, whereby people with SMI who are homeless are supported through assertive community treatment or intensive case management to move into regular housing.

Method: The AH-CS demonstration project entailed a randomized controlled trial conducted in 5 Canadian cities between 2009 and 2013. Mixed methods were used to examine the implementation of HF programs and participant outcomes, comparing 1158 people receiving HF to 990 people receiving standard care.

Results: Initial research conducted in the United States shows HF to be a promising approach, yielding superior outcomes in helping people to rapidly exit homelessness and establish stable housing. Findings from the AH-CS demonstration project reveal that HF can be successfully adapted to different contexts and for different populations without losing its fidelity. People receiving HF achieved superior housing outcomes and showed more rapid improvements in community functioning and quality of life than those receiving treatment as usual.

Conclusions: Knowledge translation efforts have been undertaken to disseminate the positive findings and lessons learned from the AH-CS project and to scale up the HF approach across Canada.

Objectif :: Offrir une revue de la littérature de recherche existante sur le Logement D’abord (LA) pour les personnes souffrant de maladie mentale grave (MMG) qui sont sans abri, et décrire les résultats du projet de démonstration At Home (AH)–Chez soi (CS) terminé récemment. L’approche LA représente un changement de paradigme de la prestation des services de santé mentale communautaires, grâce auxquels les personnes souffrant de MMG qui sont sans abri sont soutenues par un traitement communautaire actif ou une gestion de cas intensive pour emménager dans un logement régulier.

Méthode :: Le projet de démonstration AH–CS comportait un essai randomisé contrôlé mené dans 5 villes canadiennes entre 2009 et 2013. Des méthodes mixtes ont été utilisées pour examiner la mise en œuvre des programmes de LA et les résultats des participants, en comparant 1158 personnes recevant LA avec 990 personnes recevant des soins réguliers.

Résultats :: La recherche initiale menée aux États-Unis montre que LA est une approche prometteuse, qui donne des résultats supérieurs en ce qui concerne l’aid aux gens à sortir rapidement de l’itinérance et à s’établir dans un logement stable. Les résultats du projet de démonstration AH–CS révèlent que LA peut être adapté avec succès à différents contextes et pour différentes populations, sans perdre son intégrité. Les personnes recevant LA ont eu des résultats de logement supérieurs et ont fait preuve d’améliorations plus rapides du fonctionnement communautaire et de la qualité de vie que ceux recevant le traitement régulier.

Conclusions :: Des initiatives de transfert des connaissances ont été prises pour diffuser les résultats positifs et les leçons tirées du projet AH–CS, et pour étendre l’approche LA à tout le Canada.

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Figures

Figure 1
Figure 1. Site-specific per cent of time in stable housing in 3-month periods during 24 months
See this image and copyright information in PMC

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