Grant: CIHR Fellowship

At Home/Chez Soi, sponsored by the Mental Health Commission of Canada with funding from Health Canada, is the largest trial to date of Housing First, a complex intervention that gives homeless people with mental illness immediate access to housing of their choice with the use of rent supplements and intensive mental health services without mandating sobriety or psychiatric treatment. The intervention was tested in over 2000 homeless individuals in 5 cities across Canada in 2009-13. While Housing First has been well-studied as an intervention in adults, it has not been broadly tested in young people, as studies to date have used definitions of chronic homelessness that have effectively excluded homeless youth. At Home/Chez Soi provides the first opportunity to test this intervention in a large sample of youth aged 18-24. Our team is about to begin studying the effect of Housing First on homeless youth with mental illness, which will likely lead to many more questions about why the intervention works for some but not others, how it is experienced by youth, and what modifications could be made to better tailor it to the unique needs of youth. Furthermore, a major argument for using Housing First with homeless adults has been its demonstrated cost savings through reduced use of emergency shelters, hospital emergency rooms, and other expensive services. The economic impact of Housing First has not yet been studied in youth. We propose to examine interviews of the youth participating in this study to determine how Housing First was experienced by homeless youth and its impact on them, and perform an economic "cost-effectiveness" analysis to explore the intervention's societal impact, including costs and cost offsets associated with the intervention. This will inform adaptations of Housing First to homeless youth in order to improve services and outcomes, with the goal of eventually eliminating homelessness in young people.