Friday, April 1, 2016

It Works – A Sample of Research on the Efficacy of Housing First in Ending Homelessness – from Cindy J. Crain, MDHA President and CEO

Tasha Tsiaperas, Dallas Morning News, David Gruber, MDHA,
and two Baylor nursing students, on a tour of The Cottages in late January
It is wonderful to see that the issues we deal with and discuss every day in our work are getting out into the general media. You are probably hearing the term “Housing First” in the media the last few days. This is a great opportunity to clarify why and how the argument about this method, being demonstrated by the Cottages at Hickory Crossing, and long being used in our community, has been settled. Here is just a small sample of the research out there, which Cindy J. Crain, our President and CEO collected this morning, at my request:

1)     Tsemberis, Sam, Leyla Gulcur and Maria Nakae. Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis. April 2004, Vol 94, No. 4 | American Journal of Public Health 651-656

           Randomly selected 250 participants to compared Housing First with “treatment as usual” longitudinally

           Housing First group moved into housing quicker, remained stably housed and had more positive assessment of choice.

           For the control group (non-Housing First participants), the use of substance use treatment was higher; however, there were no differences found in substance use or psychiatric symptoms between the two groups.

           Housing First participants were able to achieve stable housing without negative impacts on psychiatric or substance use symptoms.         

2)     Gulcur, Leyla, A Stefancic, M Shinn, S Tsemberis and S Fischer. Housing, Hospitalization, and Cost Outcomes for Homeless Individuals with Psychiatric Disabilities Participating in Continuum of Care and Housing First Programmes. Journal of Community & Applied Social Psychology, 13: 171–186 (2003).
           225 participants were interviewed and randomly assigned to Housing First or service that made treatment and sobriety a prerequisite for housing, and then interviewed every six months over 2 years.

           Housing First participants spent much less time homeless and in psychiatric facilities, and experienced much less service costs than the comparison group.

3)     Tsemberis, Sam and Ronda Eisenberg. Pathways to Housing: Supported Housing for Street-Dwelling Homeless Individuals With Psychiatric Disabilities Psychiatric Services 51:487-493, April 2000.

           Compared 242 Housing First participants with 1,600 individuals receiving linear residential treatment over a five year period

           Over the five year period, 88% of the Housing First participants remained housed compared to 47% of the individuals receiving linear residential treatment

4)     Tsemberis, S, L Moran, M Shinn, S Asmussen, D Shern. Consumer Preference Programs for Individuals Who Are Homeless and Have Psychiatric Disabilities: A Drop-In Center and a Supported Housing Program. American Journal of Community Psychology. Volume 32, Numbers 3-4, 305-317.

           Two experimental programs examined: 1 compared a drop-in center without barriers to usual service delivery, and 2 compared Housing First to usual continuum with expectations of sobriety and treatment

           The drop in center without barriers was more successful than control programs in reducing homelessness, but after 2 years only 38% of participants had moved into housing.

           The Housing First program obtained 79% housing stability compared to 27% in the control group.

           In both instances, there were no differences in substance abuse or psychosocial outcomes.