Appendix E
Studies of Effectiveness of Permanent Supportive Housing
Studies included in this appendix were identified through a literature search, an examination of published systematic reviews on the effectiveness of permanent supportive housing, and published systematic reviews on interventions to improve the health of people experiencing homelessness.
Programs are grouped by study design, then listed in chronological order by year of first publication.
Study Design:
- RCT: comparison of outcomes among participants randomized to intervention and control groups (RCT) (rows shaded in gray)
- Quasi-experimental: comparison of outcomes among individuals who were allocated to or entered intervention and comparison groups on a non-randomized basis
- Single-group before-after studies are excluded from this table.
Homelessness:
- Information on duration or severity of homelessness among study participants is provided when available.
- Information on housing status at baseline is provided for studies in which not all participants were literally homeless at the time of entry into the study.
Outcomes:
- For each outcome, the group(s) with statistically significant better outcomes are identified as Control or Comparison (C), Intervention (I), Intervention 1 (I1), Intervention 2 (I2), etc.
- = denotes no statistically significant difference between groups for that outcome.
- For health care utilization, lower use of emergency departments and hospitals and higher use of outpatient services and substance abuse treatment services were defined as better outcomes, unless otherwise specified.
N/A denotes data not available.
| References | Site and Location | Study Participants | Interventions and Follow-up | Housing Outcomes | Health Care Utilization Outcomes | Physical Health, Mental Health, Quality of Life Outcomes | Substance Use, Incarceration, and Other Outcomes |
|---|---|---|---|---|---|---|---|
| Randomized Controlled Trials | |||||||
| Lipton 1988 | Bellevue Hospital Program
New York City |
Patients experiencing homelessness with chronic mental illness being discharged from a psychiatric inpatient unit
Enrolled: N=52 Intervention: n=26 Control: n=26 Sex: 65% male Age: mean 37 years |
Intervention: Residential treatment program providing permanent supportive housing, case management, meals, activity therapy, referrals to other programs, and on-site psychiatric care.
Control: Usual care Follow-up: 94% at 12 months |
% Nights in permanent housing: I
% Nights homeless: = % Nights homeless after discharge: I |
% Nights spent in hospital
(including index stay): I |
Psychiatric illness severity: = | |
| Hulburt 1996 | McKinney Homeless Research Demonstration Project
San Diego |
Persons experiencing homelessness and persons at high risk of homelessness with severe and persistent mental illness
Enrolled: N=362 Intervention 1, 2, 3, and 4: n=90 or 91 in each group Sex: 67% male Age: 18-29 years 25%, 30-39 years 42%, 40-49 years 24% Race/ethnicity: white 63%, black 20%, Hispanic 12% Homelessness: 64% homeless >1week in past 60 days. Total time homeless: <1 year 32%, 1-3 years 33%, 4+ years 34% Conditions: schizophrenia 55%, major depression 28%, bipolar disorder 16%. Due to eligibility criteria, many persons with severe alcohol or drug use were excluded. |
Intervention 1: Comprehensive case management + Section 8 housing certificate
Intervention 2: Traditional case management + Section 8 housing certificate Intervention 3: Comprehensive case management only Intervention 4: Traditional case management only Follow-up: 83% at 2 years |
Time to housing consistency: =
Stable independent housing pattern: I1 & I2 |
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| References | Site and Location | Study Participants | Interventions and Follow-up | Housing Outcomes | Health Care Utilization Outcomes | Physical Health, Mental Health, Quality of Life Outcomes | Substance Use, Incarceration, and Other Outcomes |
|---|---|---|---|---|---|---|---|
| Dickey 1996; Goldfinger 1999; Seidman 2003 |
Massachusetts Mental Health Center Program
Boston |
Adults experiencing homelessness with major mental illness living in shelters
Enrolled: N=118 Intervention 1: n=63 Intervention 2: n=55 Sex: 70% male Age: mean 37 years Race/ethnicity: black 41% Homelessness: N/A Conditions: schizophrenia 45%, schizoaffective 17%, bipolar disorder 14%, major depression 13%, alcohol/drug abuse ~50% |
Intervention 1: Case management + Placement in group housing with staff support and gradually increasing self-governance
Intervention 2: Case management + Placement in an independent apartment Follow-up: 86% at 18 months |
Housing stability index: =
Housing at 18 months: = Days homeless over 18 months: I1 |
Inpatient mental health services: =
Outpatient mental health services: = |
Neuropsychologic al functioning: = (10 of 11 measures), I1 (executive functioning measure) | |
| Rosenheck 2003; |
HUD-VA Supported Housing (HUD-VASH) Program
San Francisco, San Diego, New Orleans, Cleveland |
Veterans experiencing homelessness with major psychiatric disorder and/or substance abuse disorder who were receiving Veterans Affairs services
Enrolled: N=460 Intervention 1: n=182 Intervention 2: n=90 Control: n=188 Sex: 96% male Age: mean 42 years Race/ethnicity: N/A Homelessness: homeless >1 month 100% Conditions: serious psychiatric diagnoses 10%, alcohol or drug disorders 50%, dual diagnoses 35%, other psychiatric disorders 5% |
Intervention 1: Intensive case management + voucher providing immediate access to subsidized housing.
Intervention 2: Intensive case management alone Control: Usual care with short-term broker case management through outreach worker. Follow-up: 53% at 36 months Intervention 1=70% Intervention 2=48% Controls=40% |
Days housed in last 90 days: I1 | Outpatient VA mental health visits: I1 & I2 |
Medical problems: =
Psychiatric problems: = Psychological distress: = Quality of life: I1 |
Alcohol problems: =
Days intoxicated: = Drug problems: = Using multiple imputation analysis for missing data: Alcohol problems: I1 Days intoxicated: I1 Days of alcohol use: I1 Drug problems: I1 Days of drug use: I1 |
| Gulcur 2003; Tsemberis 2004; Padgett 2006 |
Pathways to Housing Program
New York City |
Persons experiencing chronic homelessness with severe Axis I mental illness
Enrolled: N=225 Intervention 1: n=99 Intervention 2: n=126 Sex: 77% male Age: mean 41 years Race/ethnicity: white 28%, black 40%, Hispanic 15% Homelessness: At enrollment: living on street/public place 51%, living in psychiatric hospital 36%. Conditions: psychosis 54%, bipolar disorder 13%, major depression 14%, history of alcohol or substance abuse disorder 90% |
Intervention 1: “Housing First” program provided immediate housing in an independent apartment without any prerequisite psychiatric treatment or sobriety. Clients were offered ACT and housing support services, but could refuse.
Intervention 2: “Continuum of Care” program provided outreach services, followed by treatment and transitional housing, then permanent supportive housing. Receipt of housing was contingent on sobriety and compliance with psychiatric treatment. Follow-up: 90% at 24 months, N/A at 48 months |
Proportion of time stably housed: I1 | Proportion of time hospitalized: I1 | Psychiatric symptoms: = |
Alcohol use: =
Drug use: = Use of substance abuse treatment programs: I2 |
| McHugo 2004 |
Integrated Housing Services Program
Washington, DC |
Adults with severe mental illness who were homeless or at high risk of homelessness
Enrolled: N=121 Intervention 1: n=60 Intervention 2: n=61 Sex: 48% male Age: mean 40 years Race/ethnicity: black 83% Homelessness: 85% homeless at baseline, mean proportion of time literally homeless in past 6 months 38% Conditions: schizophrenia spectrum disorders 74%, mood disorders 27%, mean 40 days of alcohol use in past 6 months, mean 25 days illicit drug use in past 6 months |
Intervention 1: Parallel Housing Services (PHS) with scattered-site housing owned by community landlords or housing agencies + ACT team services
Intervention 2: Integrated Housing Services (IHS) with congregate-site housing + case management, provided by teams within a single mental health agency There was substantial cross-over in housing types. Among participants stably housed at 18 months, housing was 53% vs. 47% in own apartment, 28% vs 21% in SROs, and 6% vs. 21% in group homes, in PHS and IHS respectively. Follow-up: 84% at 18 months |
Proportion of days in stable housing: I2
Housing satisfaction: = |
Medical or dental care: =
Psychiatric services: = |
Psychiatric symptoms: I2
Quality of life: I2 |
Days of alcohol use: =
Days of drug use: = |
| References | Site and Location | Study Participants | Interventions and Follow-up | Housing Outcomes | Health Care Utilization Outcomes | Physical Health, Mental Health, Quality of Life Outcomes | Substance Use, Incarceration, and Other Outcomes |
|---|---|---|---|---|---|---|---|
| Sadowski 2009; Buchanan 2009; Basu 2012 |
Chicago Housing for Health Partnership
Chicago |
Adults experiencing homelessness with at least 1 of 15 specified chronic medical illnesses who were enrolled while admitted to hospital
Enrolled: N=405 Intervention: n=201 Control: n=204 Sex: 77% male Age: mean 46 years Race/ethnicity: white 8%, black 78%, Hispanic 8% Homelessness: median duration of homelessness 30 months Conditions: HIV-seropositive 36%, major depression 42%, alcohol intoxication in past 30 days 60%, illicit drug use in past 30 days 59% |
Intervention: Case management + transitional care at respite facility after discharge from hospital + placement in permanent housing at group living facilities or scattered site apartments using Housing First model
Control: Usual care (routine discharge planning by hospital social worker; case management services as available in the community) Follow-up: 90% in intervention group and 74% in control group at 18 months |
Stable housing: I |
Unadjusted analysis:
Hospitalizations: = Hospital days: = Emergency department visits: = Analysis adjusted for baseline variables: Hospitalizations: I Hospital days: I Emergency department visits: I |
Quality of life: =
Among HIV-seropositive participants (intervention n=47, control n=47): Alive and with intact immunity (based on CD4 count and viral load) at 12 months: I |
|
| Wolitski 2010; Kidder 2007 |
Housing and Health Study
Baltimore, Chicago, Los Angeles |
HIV-seropositive adults who were experiencing homelessness or at severe risk of homelessness, with income <50% of median area income
Enrolled: N=630 Intervention: n=315 Control: n=315 Sex: 70% male (41% MSM, 29% male non-MSM) Age: 18-29 years 10%, 30-39 years 27%, 40-49 years 48%, 50+ years 14% Race/ethnicity: white 8%, black 78%, Hispanic 9% Homelessness: housing status in past 90 days: homeless 27%, unstably housed and severe risk of homelessness 69%, in own place and severe risk of homelessness 4% Conditions: AIDS diagnosis 39%. CD4 count: <200 24%, 200-349 25%, 350-500 20%, >500 30%. |
Intervention: Immediate Housing Opportunities for People with AIDS (HOPWA) rental assistance + case management
Control: Customary housing services + case management Follow-up: 87% in intervention group, 82% in comparison group at 18 months |
Housing status: I |
Any medical care: =
Appropriate medical care: = Emergency department visits: = Hospital admissions: = On HAART: = Medication adherence: = |
CD4 count: =
Viral load: = Overall physical health: I* Overall mental health: = Depression: I* Perceived stress: I* *Significant improvements in these outcomes at 6 and 12 months, but differences no longer significant at 18 months |
Sexual risk behaviors: = |
|
CD4 count: <200 24%, 200-349 25%, 350-500 20%, >500 30%. |
|||||||
| Aubry 2015; Aubry 2016 |
At Home/Chez Soi Study (High Needs stratum)
Vancouver, Winnipeg, Toronto, Montreal, and Moncton, Canada |
Adults with a current mental disorder, with or without a concurrent substance use disorder, who were absolutely homeless or precariously housed (≥2 episodes of homelessness in the past year) and not receiving ACT or ICM services; assessed to have high needs for treatment based on factors including psychiatric and substance use diagnoses, community functioning score, and pattern of hospitalizations or incarceration
Enrolled: N=950 Intervention: n=469 Control: n=481 Sex: 68% male Age: mean 39 years Race/ethnicity: white 60%, Aboriginal 19%, other racial or ethnic minority 21% Homelessness: absolutely homeless 82%, >24 months lifetime homelessness 59%, longest period homeless >1 year 51% Conditions: major depressive episode 43%, PTSD 27%, psychotic disorder 52%, substance-related problems 73% |
Intervention: Immediate supportive housing (mostly in private-market scattered-site units) using Housing First model + ACT team services (client required to accept contact at least once per week)
Control: Usual care Follow-up: 88% in intervention group, 77% in control group at 21-24 months |
Percentage of days in stable housing: I
Time to housing: I Self-reported housing quality: I |
Number of days in hospital: =
Emergency department visits: = |
Generic Quality of life: =
Condition-specific Quality of life: = Health status: = Mental health symptoms: = Community functioning: = |
Substance use problems: =
Number of Arrests: = Community integration: = |
| Stergiopoulous 2015; Kozloff 2016; Adair 2016; Somers 2015; Somers 2017 |
At Home/Chez Soi Study (Moderate Needs stratum)
Vancouver, Winnipeg, Toronto, and Montreal, Canada |
Adults with a current mental disorder, with or without a concurrent substance use disorder, who were absolutely homeless or precariously housed (≥2 episodes of homelessness in the past year) and not receiving ACT or ICM services; assessed to have moderate needs for treatment based on factors including psychiatric and substance use diagnoses, community functioning score, and pattern of hospitalizations or incarceration |
Intervention: Immediate supportive housing (mostly in private-market scattered-site units) using Housing First model + intensive case management services (client required to accept contact at least once per week)
Control: Usual care Follow-up: 85% at 24 months |
Percentage of days in stable housing: I
Proportion of participants never housed: I |
Number of days in hospital: =
Proportion of participants with any hospitalization: = Emergency department visits: = |
Generic Quality of life: =
Condition-specific Quality of life: I Health status: = Mental health symptoms: = Community functioning: = |
Substance use problems: =
Number of Arrests: = Community integration: = |
| References | Site and Location | Study Participants | Interventions and Follow-up | Housing Outcomes | Health Care Utilization Outcomes | Physical Health, Mental Health, Quality of Life Outcomes | Substance Use, Incarceration, and Other Outcomes |
|---|---|---|---|---|---|---|---|
|
Enrolled: N=1198 Intervention: n=689 Control: n=509 Sex: 66% male Age: mean 42 years Race/ethnicity: white 48%, Aboriginal 24%, other racial or ethnic minority 28% Homelessness: absolutely homeless 84%, mean lifetime duration of homelessness 4.6 years (median 2.5 years) Conditions: major depressive episode 59%, PTSD 31%, psychotic disorder 22%, alcohol abuse or dependence 55%, substance abuse or dependence 61% |
|||||||
| Shinn 2015; Samuels 2015 |
Family Critical Time Intervention (FCTI)
Westchester County, New York |
Families entering the homeless shelters system (excluding domestic violence shelters) in which the mother had a diagnosable mental illness or substance abuse problem and care for at least one child aged 1.5–16 years
Enrolled: N=200 Intervention: n=97 Control: n=103 Mothers: Age: mean 31 years Race/ethnicity: white 25%, black 65%, American Indian/Alaska Native 10%; Hispanic 26% Homelessness: N/A Conditions: N/A Children (N=311): Sex: male 51% Age: 1.5–5 years 32%, |
Intervention: Time-limited (9 months) continuous intensive case management services from a single caseworker with 12:1 caseload + move from shelter to permanent scattered site subsidized housing as soon as possible
Control: Routine case management with workers with 24-48:1 caseload + move from shelter to permanent scattered site subsidized housing only after meeting the caseworker’s standards for housing readiness Follow-up: 24 months |
Percentage of time housed in the community (0-9 months): I
Percentage of time housed in the community (9-24 months): = |
Mental health:
Children age 1.5-5: Internalizing problems: I Externalizing problems: I Children age 6-10: Internalizing problems: = Externalizing problems: = Self-reported school troubles: I Children age 11-16: Internalizing problems: = Externalizing problems: I Self-reported school troubles: I |
| Sosin 1995 |
Progressive Independence Model
Chicago |
Persons experiencing homelessness (or recently homeless) completing short-term substance abuse treatment program
Enrolled: N=419 Intervention 1: n=96 Intervention 2: n=136 Comparison: n=187 Sex: 75% male Age: mean 35 years Race/ethnicity: black 90% Homelessness: mean 26 months total homelessness over adult lifetime Conditions: alcohol abuse 75%, drug abuse ~75%, mean 18 days alcohol/drug use in past 30 days |
Intervention 1: Case management + assistance finding housing in the community
Intervention 2: Case management + provision of supported housing in independent apartments Comparison: Usual care (referrals to substance abuse agencies and welfare offices) Follow-up: 74% at 12 months |
Days housed in past 60 days: I1>I2>C |
Days of alcohol use in past 30 days: I1 & I2
Days of drug use in past 30 days: I1 & I2 |
||
| Culhane 2002 |
New York/New York (NY/NY) Housing Program
New York City |
Intervention group: Persons experiencing homelessness with severe mental illness who received NY/NY intervention
Comparison group: Persons experiencing homelessness who did not receive intervention, matched to persons in intervention group on sex, race, age, indicators of mental illness and substance abuse, and pattern of previous service use. Intervention group: N=4679 Matched pairs analyzed: n=3338 for days of shelter use (range n=294 to 570 for health care utilization outcomes) Sex: N/A Age: N/A Race/ethnicity: N/A Homelessness: N/A Conditions: N/A |
Intervention: NY/NY program placement, consisting of (1) independent housing linked to community-based or on-site service support or (2) community residence facilities (including long-term treatment facilities and group homes) providing on-site services, with participation mandated by the residence agreement.
Comparison: No NY/NY program placement Follow-up: assessment of service utilization 100% at 2 years after placement (service utilization during this period was compared to the 2-year period before placement) |
Days of homeless shelter use: I |
Inpatient days at: Hospitals (Medicaid): I Public hospitals (non-Medicaid): I VA hospitals: I State psychiatric hospitals: I
Outpatient visits and costs (Medicaid): I* *Lower outpatient visits and costs were defined as better |
| References | Site and Location | Study Participants | Interventions and Follow-up | Housing Outcomes | Health Care Utilization Outcomes | Physical Health, Mental Health, Quality of Life Outcomes | Substance Use, Incarceration, and Other Outcomes |
|---|---|---|---|---|---|---|---|
| Clark 2003 |
Pinellas County Program
Florida |
Individuals with severe mental illness entering one of two service programs
Enrolled: N=152 Intervention 1: n=69 Intervention 2: n=83 Sex: 52% male Age: mean 38 years Race/ethnicity: white 77%, black 20% Hispanic 3% Homelessness: history of homelessness 91%, homeless more than once 69% Conditions: Axis I diagnosis 100%, psychotic disorder ~50%, mood disorder 45% |
Intervention 1: Case management (outreach, counseling, medication management, housing assistance, linkage to other services)
Intervention 2: Case management as above + guaranteed access to housing and housing support services. Follow-up: 58% at 12 months Intervention 1: 36% Intervention 2: 76% |
Proportion of time in stable housing: =
Proportion of time in stable housing (in subgroup of subjects with high impairment at baseline): I2 |
Psychiatric symptoms: = |
Days of alcohol use in last 6 months: =
Days of illegal drug use in last 6 months: = |
|
| Siegel 2006 |
SAMHSA Study
New York City |
Adults with severe mental illness who were experiencing homelessness or at high risk of homelessness and entered one of two housing programs
Enrolled: N=139 Intervention 1: n=67 Intervention 2: n=72 Sex: 65% male Age: mean 41 years Race/ethnicity: white 22%, black 39%, Hispanic 26% Homelessness: N/A Conditions: schizophrenia 40%, schizoaffective 26%, bipolar 16% major depression 18%, substance abuse 55% |
Intervention 1: “Supported housing”: (A) scattered site apartments + ACT team services or (B) residential hotel with 30% of units for persons with mental illness + on-site case management
Intervention 2: “Community residences”: Single or shared rooms in buildings for persons with mental illness, with meal plan and common dining and meeting spaces, mandatory sobriety + case management services on site Comparison group matched by propensity score Follow-up: 18 months |
Proportion of tenants remaining in initial housing placement: =
Housing satisfaction: I1 |
Use of crisis services: = |
Mental health: =
Quality of life: = |
| Martinez 2006 |
Canon Kip Community House & Lyric Hotel “Low-Demand” Program
San Francisco |
Intervention group: Adults experiencing homelessness with qualifying disabilities (substance use disorder, mental illness and/or HIV/AIDS) who applied for supportive housing, received a random rank order, and received housing in the first year of the program
Comparison group: Adults experiencing homelessness with qualifying disabilities (substance use disorder, mental illness and/or HIV) who applied for supportive housing, received a random rank order, and received housing in the second year of the program (wait-list controls) Enrolled in main study: N=236 Comparison conducted in subset of participants: Intervention: n=100 Comparison: n=25 Data for main study participants (N=236): Sex: 73% male Age: mean 44 years Race/ethnicity: white 32%, black 53%, Hispanic 8%, Native American 5%, Asian 2% Homelessness: homeless >8 months at move-in 100%, documented homeless 2-8 years before move-in 59% Conditions: substance use disorder + mental illness 75%, substance use disorder + HIV 16%, mental illness + HIV 2%, substance use disorder + mental illness+ HIV 5%, substance use disorder only 4%, mental illness only 5% |
Intervention: Supportive housing at two single-site buildings (SRO units with rent subsidies) + on-site support services (including case management, psychiatric care, health care, and vocational training)
Comparison group: Usual care Follow-up: 1 year |
Any emergency department visit: I
Number of emergency department visits: I Any inpatient admission: = Number of inpatient days: = |
| References | Site and Location | Study Participants | Interventions and Follow-up | Housing Outcomes | Health Care Utilization Outcomes | Physical Health, Mental Health, Quality of Life Outcomes | Substance Use, Incarceration, and Other Outcomes |
|---|---|---|---|---|---|---|---|
| Larimer 2009; Collins 2013 |
Eastlake Housing First Program
Seattle |
Adults experiencing chronic homelessness with severe alcohol problems and high costs for use of emergency services, sobering center, and jail
Enrolled: N=134 Intervention: n=95 Comparison: n=39 Sex: 94% male Age: mean 48 years Race/ethnicity: white 39%, black 10%, Hispanic 6%, American Indian/Alaska Native 28% Homelessness: mean age 31 years when first became homeless, mean 2 periods of stable housing since first became homeless Conditions: mean 16 times treated for alcohol abuse in lifetime |
Intervention: Single-site housing program with meals provided and on-site health care services + on-site case managers. Residents not required to participate in treatment, and alcohol consumption allowed in residents’ rooms.
Comparison: Wait-listed individuals who were not housed prior to the 3-month assessment point Follow-up: 100% at 6 months for cost-use analysis Propensity scores were used in regression analyses to adjust for differences between groups |
Nights of homeless shelter use: I |
Hospital contacts: =
Emergency medical service contacts: = Detoxification days: = Sobering center use: I* *Lower use of sobering center was defined as better |
Days incarcerated: =
Jail bookings: = Total costs: I |
|
| Gilmer 2009 |
REACH Program
San Diego |
Intervention group: Adults experiencing homelessness with serious mental illness who entered the REACH program
Comparison group: Adults experiencing homelessness with serious mental illness with demographic and clinical characteristics similar to REACH clients who were initiating services at the same time Enrolled: N=338 Intervention: n=177 Comparison: n=161 Sex: 48% male Age: mean 42 years |
Intervention: Housing through transitional residential treatment program then SRO units and scattered-site apartments using Section 8 housing vouchers + ACT-team-based case management
Comparison: Usual care Comparison group matched by propensity score Follow-up: 1-2 years |
Data provided on costs (not utilization):
Case management costs: I>C Outpatient costs: = Inpatient or emergency costs: I<C |
Data provided on costs (not utilization):
Criminal justice system costs: I<C |
|
Race/ethnicity: white 58%, black 24%, Hispanic 11%, other 7% Homelessness: N/A Conditions: schizophrenia 53%, bipolar disorder 18%, major depression 20%, other psychotic disorder 4% |
|||||||
| Gilmer 2010 |
Full Service Partnership (FSP) Program
San Diego |
Intervention group: Adults experiencing homelessness with serious mental illness who entered the FSP program
Comparison group: Adults experiencing homelessness with serious mental illness with demographic and clinical characteristics similar to FSP clients who were initiating services at the same time Enrolled: N=363 Intervention: n=209 Comparison: n=154 Sex: 63% male Age: mean 44 years Race/ethnicity: white 61%, black 25%, Hispanic 10%, other 5% Homelessness: N/A Conditions: schizophrenia 60%, bipolar disorder 25%, major depression 15% |
Intervention: Subsidized permanent housing at scattered sites using Housing First model + ACT team supports
Comparison: Usual care Comparison group matched by propensity score Follow-up: 6 months – 1 year |
Outpatient mental health service use: I
Inpatient service use: I Emergency department use: I |
Quality of life: I | Justice system use: I |
| References | Site and Location | Study Participants | Interventions and Follow-up | Housing Outcomes | Health Care Utilization Outcomes | Physical Health, Mental Health, Quality of Life Outcomes | Substance Use, Incarceration, and Other Outcomes |
|---|---|---|---|---|---|---|---|
| Tsai 2010 |
Collaborative Initiative to Help End Chronic Homelessness (CICH)
Chattanooga, Chicago, Columbus, Denver, Fort Lauderdale, Los Angeles, Martinez, New York City, Philadelphia, Portland, San Francisco |
Adults experiencing chronic homelessness (unaccompanied individuals with a disabling condition who had been continuously homeless for ≥1 year or had ≥4 episodes of homelessness in the past 3 years) entering CICH-funded homeless services in one of 11 cities
Enrolled: N=709 Intervention 1: n=131 Intervention 2: n=578 Sex: 76% male Age: mean 46 years Race/ethnicity: white 37%, black 49%, Hispanic 8%, Asian/Pacific Islander 5% Homelessness: past year homeless 86%, mean days homeless in past 3 months 59 days Conditions: schizophrenia 19%, bipolar disorder 19%, depression 29%, alcohol abuse/dependence 53%, drug abuse/dependence 53% |
Intervention 1: Residential Treatment First (RTF), defined as participants who stayed in transitional/residential treatment for ≥2 weeks during the 3 months before or after entry into CICH
Intervention 2: Independent Housing First (IHF), defined as participants who had no days of transitional/residential treatment during the 3 months before or after entry into CICH Follow-up: up to 2 years |
Days in own place: =
Days homeless: = |
Days hospitalized: = |
Psychiatric symptoms: =
Overall physical health: = Overall mental health: = Quality of life: = |
Days incarcerated: I1
Alcohol use problems: = Drug use problems: = |
| Hanratty 2011 |
Heading Home Hennepin Program
Minneapolis, Hennepin County |
Intervention group: Individuals who had been homeless for ≥1 year or had ≥4 episodes of homelessness in the past 3 years, and with a disability that limited ability to work for ≥1 month
Comparison group: Individuals in public shelters at the same time as intervention group, but who were not placed into housing Enrolled: N=528 Intervention: n=264 Comparison: n=264 |
Intervention: Housing First program with rent subsidies for housing in scattered site apartments + case management services
Comparison: Usual care Comparison group matched by propensity score Follow-up: 59% at 18 months |
Public shelter use: I |
Mean number of arrests: I
Mean number of days in prisons or jails: I Mean days of health insurance coverage: I |
|
Sex: 77% male Age: mean 46 years Race/ethnicity: N/A Homelessness: mean shelter nights in past 3 years 156 nights Conditions: N/A |
|||||||
| Srebnik 2013 |
Begin at Home Program
Seattle |
Intervention group: Adults experiencing chronic homelessness (unaccompanied individuals with a disabling condition who had been continuously homeless for ≥1 year or had ≥4 episodes of homelessness in the past 3 years) who were referred with ≥60 sobering center visits or ≥$10,000 inpatient paid claims within the past year
Comparison group: Individuals who met the above criteria but who did not enter the program Enrolled: N=60 Intervention: n=29 Comparison: n=31 Sex: 72% male Age: mean 51 years Race/ethnicity: white 62%, black 17%, Hispanic 7%, American Indian/Alaska Native 14% Homelessness: N/A Conditions: N/A |
Intervention: Single-site Housing First supportive housing program + on-site medical, psychiatric, substance use, and case management services
Comparison: Usual care Follow-up: 1 year |
Emergency department visits: I
Sobering center use: I Number of hospital admissions: = Number of hospital days: = |
Number of jail bookings: =
Number of jail days: = |
REFERENCES FOR APPENDIX E
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