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Effectiveness of Housing First for Homeless Adults with Mental Illness Who Frequently Use Emergency Departments in a Multisite Randomized Controlled Trial | SpringerLink

Effectiveness of Housing First for Homeless Adults with Mental Illness Who Frequently Use Emergency Departments in a Multisite Randomized Controlled Trial

Abstract

Frequent emergency department (ED) users experiencing homelessness are associated with high costs for healthcare systems yet interventions for this group have been minimally investigated. This study used 24-month data from a multisite randomized controlled trial of Housing First (HF) to examine how effective the intervention is in helping frequent ED users with a mental illness to achieve housing stability, improve behavioural health and functioning, and reduce their ED use. Findings showed that HF is effective in stably housing frequent ED users despite their complex health needs. Reductions in ED use and substance use problems, and improvements in mental health symptoms and community functioning were found for frequent ED users in both the HF and treatment as usual conditions.

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Acknowledgements

This research has been made possible through a financial contribution from Health Canada provided to the Mental Health Commission of Canada (MHCC). This trial is registered as an International Standard Randomized Control Trial (registered as ISRCTN42520374). The authors thank Dr. Jayne Barker (2008–2011), Cameron Keller (2011–2014), Catharine Hume (2012–2013), and the MHCC At Home/Chez Soi national project leads; the late Dr. Paula Goering, the national research lead; the national research team; and the five site research teams, site coordinators, and service and housing providers, as well as the many persons with mental illness who have contributed to this project and the research. The MHCC did not have any role in the analysis and interpretation of the data or in the preparation, review, or approval of the manuscript. The views expressed herein solely represent the authors.

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Correspondence to Tim Aubry.

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This research was approved by the research ethics board of the Centre for Addiction and Mental Health and 11 local institutions affiliated with the lead investigators of the trial.

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Kerman, N., Aubry, T., Adair, C.E. et al. Effectiveness of Housing First for Homeless Adults with Mental Illness Who Frequently Use Emergency Departments in a Multisite Randomized Controlled Trial. Adm Policy Ment Health 47, 515–525 (2020). https://doi.org/10.1007/s10488-020-01008-3

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Keywords

  • Homelessness
  • Mental illness
  • Emergency departments
  • Service use
  • Housing first