Impact of a Housing First intervention on homeless Veterans with mental illness: a Canadian multisite randomized controlled trial

Abstract

Introduction: A large proportion of homeless Veterans live with severe mental health problems. We examine the impact of a Housing First program that included recovery-oriented initiatives (assertive community treatment or intensive case management) among those homeless Veterans who participated in a multisite demonstration project on homelessness and mental health. Methods: The data come from a Canadian multisite randomized trial (ISRCTN42520374), At Home/Chez Soi, with a volunteer sample of 2,285 homeless or precariously housed individuals living with mental health problems. Of this sample, 98 individuals reported being Veterans, of whom 57 were randomized to the intervention group and 41 to the control group. The data come from self-reported measures administered at baseline and after 6, 12, 18, and 24 months from Fall 2009 to Spring 2013. Data were analyzed by fitting a mixed model for each outcome variable, and special attention was given to the event × treatment × Veteran status interaction term. Results: The Housing First approach was effective in improving housing stability, social functioning, and quality of life in homeless Veterans with mental health problems. These results are consistent with the intervention’s effectiveness with other homeless Canadians with mental health problems. Discussion: These results are consistent with those of previous US studies and suggest that a Housing First approach that includes recovery-oriented support would effectively contribute to reducing homelessness in the Canadian Veteran population.