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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 8/2013

01-08-2013 | Original Paper

Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia

Authors: Michelle Patterson, Akm Moniruzzaman, Anita Palepu, Denise Zabkiewicz, Charles J. Frankish, Michael Krausz, Julian M. Somers

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 8/2013

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Abstract

Purpose

This study used an experimental design to examine longitudinal changes in subjective quality of life (QoL) among homeless adults with mental illness after assignment to different types of supported housing or to treatment as usual (TAU, no housing or supports through the study). We hypothesized that subjective QoL would improve over time among participants assigned to supported housing as compared to TAU, regardless of the type of supported housing received or participants’ level of need.

Methods

Participants (n = 497) were stratified by level of need (“high” or “moderate”) and randomly assigned to Housing First (HF) in scattered-site apartments, HF in a congregate setting (high needs only), or TAU. Linear mixed-effects regression was used to model the association between study arm and self-reported QoL at baseline and at 6 and 12 months post-baseline by need level.

Results

Based on the adjusted overall score on the QoL measure, participants randomized to HF reported significantly greater overall QoL as compared to TAU, regardless of need level or type of supported housing at both 6 and 12 months post-baseline. Scores on the safety and living situation subscales were significantly greater for both high and moderate need participants assigned to supported housing regardless of type at both 6 and 12 months post-baseline as compared to TAU.

Conclusions

Despite multiple health and social challenges faced by homeless individuals with mental illness, HF in both scattered-site and congregate models results in significantly greater perceived QoL as compared to individuals who do not receive HF even after a relatively short period of time.
Appendix
Available only for authorised users
Footnotes
1
Support services were available to participants assigned to Housing First (ACT, CONG, and ICM) but were not mandatory. The only requirement for housing was compliance with the terms of the rental lease and weekly visits with a case manager to ensure safety and well-being [28].
 
2
The CONG residence was located in downtown Vancouver in a neighborhood consisting of primarily businesses, including an inner-city hospital and a number of affluent condominiums.
 
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Metadata
Title
Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia
Authors
Michelle Patterson
Akm Moniruzzaman
Anita Palepu
Denise Zabkiewicz
Charles J. Frankish
Michael Krausz
Julian M. Somers
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 8/2013
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-013-0719-6

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