Housing stability among homeless individuals with serious mental illness participating in housing first programs

Background: The U.S. Department of Housing and Urban Development estimated that up to 200,000 chronically homeless individuals lived in the United States in 2005. Housing with services increases housing tenure and reduces hospital stays and days homeless for homeless single adults with serious mental illness and often co-occurring substance-related disorders. The housing first approach is designed to improve housing stability for these individuals, offering housing without requirements for treatment or sobriety.

Purpose: To present findings from a study of three housing first programs providing permanent supportive housing for single, homeless adults with serious mental illness and often co-occurring substance-related disorders.

Methods: The study team studied three housing first programs and tracked approximately 25 participants in each program for one year, measuring variables related to housing stability, mental health, and substance use. The team analyzed data to determine differences among programs.

Results: The housing first approach may help the hardest-to-serve chronically homeless achieve housing stability. Of the 80 participants, 84 percent remained in the program for at least one year and one-half spent every night in their housing first unit. Health-related outcomes did not change significantly over time.

Discussion: The housing first approach achieves positive housing outcomes for a population with high service needs. Program variations indicate that increased housing stability is related to a substantial supply of permanent housing and responsive staff to provide services and help participants to maintain housing.