Data Points: Housing First and Homeless Individuals with Mental Illness

written by Sam Batko
October 8, 2013

This week is Mental Illness Awareness Week. With that in mind, I’m focusing today’s research post on the impact that Housing First has on the individuals with severe mental illness—particularly the impact on their involvement with the criminal justice system. The study we’re going to look at is a randomized control trial in Vancouver, Canada, that demonstrates benefits of Housing First among a homeless people with mental illness who were frequently involved with the justice system.

This trial found that:

  • Housing First programs—particularly scattered site Housing First programs—reduced re-offending and reconviction among people with mental illness;
  • The presence of a substance use disorder had no impact on re-offending or reconviction; and
  • Both scattered site and congregate Housing First programs reduced re-offending regardless of the severity of the individuals’ mental illness.

These findings suggest a number of important lessons. First, while both congregate and scattered site programs decrease re-offending, the scattered-site program may have been more effective in decreasing re-offending. This could be due to individuals joining an established community with a variety of household types. In contrast, the individuals assigned to the congregate setting in this study became members of a community that shared their immediate history of homelessness and offending.

Second, as the presence of a substance use disorder had no impact on re-offending or convictions, it appears that the harm reduction and lack of sobriety requirements that typify the Housing First approach likely contribute to public safety, in addition to the well-being of individuals in the program.

Lastly, as the severity of an individual’s mental illness had no impact on re-offending, it should be noted that screening individuals for scattered site or congregate program placement on the basis of the severity of their mental illness may be unnecessary.

For the purposes of this study:

  • Scattered site Housing First means independent apartments scattered in buildings throughout the city paired with an Assertive Community Treatment (ACT) team to provide supportive services; and
  • Congregate Housing First means living units within a single building, in the case of this study, a former hotel, with onsite supports intended to match the intensity of an ACT team.

This study is just one of several that were conducted with the randomized groups in the Vancouver Housing First programs. To learn more, please check out this study that measured the improvement in overall quality of life, and this one that looked at the trajectories of recovery of formerly homeless individuals with severe mental illness.