Grant: Operating Grant

Homeless people with mental illness suffer from very poor health and many unmet health care needs. The Housing First model is an intervention that addresses the needs of this population by providing immediate access to subsidized housing in conjunction with supports. Although several studies of the effectiveness of Housing First have been conducted, several knowledge gaps remain. In particular, the long-term effectiveness and cost-effectiveness of this highly resource-intensive intervention is not known. In 2009, the Mental Health Commission of Canada initiated the At Home study, the world's largest randomized controlled trial of a Housing First intervention for people who are homeless and have mental illness. In Toronto, Ontario, the study enrolled 400 men and 175 women who were randomized to a Housing First intervention or treatment-as-usual and assessed regularly for 2 years following randomization. This study will extend the At Home study beyond this point to determine the long-term outcomes (up to 6 years) of the Housing First model for homeless people with mental illness. Knowledge about the long-term effectiveness and cost-effectiveness of this intervention will inform efforts to improve the health of this population and reduce adverse impacts on the health care, social service, and justice systems.