Society for Social Work and Research

Housing First (HF) is an evidence based intervention that effectively ends homelessness for persons with psychiatric disabilities by providing immediate access to independent, permanent scatter-site housing combined with community support services (Tsemberis et al. 2004). A key feature of HF is that it does not require sobriety (i.e., it practices harm reduction) or participation in treatment as a precondition for housing.. The model's effectiveness and cost savings relative to alternative or mainstream approaches have led to its rapid growth and dissemination across the United States and Canada. Moreover, its consumer driven service approach is compatible with the new paradigm of mental health recovery. This symposium presents the latest evidence on Housing First, focusing on how Housing First attains positive outcomes and its implementation in diverse settings.

Each of the four papers in this symposium represents different studies that used diverse methods in examining HF programs in the United States. The first paper uses quantitative methods to examine whether HF participants' quality of life improves as their housing tenure increases and whether any improvement is associated with increased community involvement during the first year after transitioning from homelessness to independent apartment living. The remaining three papers make use of qualitative methods including ethnographic observation and in-depth interviews with HF consumers and program staff in order to better understand: 1) the initial engagement process within a HF program; 2) what harm reduction means within HF; and, 3) whether and how HF can serve as an alternative to incarceration programs. The discussant, Dr. Deborah Padgett, will frame these presentations in light of her NIMH-funded qualitative study of Housing First and mental health recovery. Presenters and the discussant will conclude the symposium with a panel discussion of the cumulative evidence on HF—both positive and negative—and the challenges of implementation research in complex urban settings with deeply disadvantaged populations.