Are Housing First Programs Effective: A Review

Purpose. The purpose of this paper is to review, analyze, and synthesize studies comparing the effectiveness of various Housing First programs to Continuum of Care programs for outcomes related to housing retention, substance use, and mental health. Method. A literature search was completed entering the search term “Housing First” in electronic databases (PsycINFO, JSTOR, and Web of Science) to find potential studies. Of the 67 items produced by the literature search, after screening for outcome studies of Housing First programs that evaluate housing retention, substance use, and/or mental health in comparison to other programs or treatment as usual, 5 final studies were selected for inclusion in the review. Results. Of the five studies selected, all had recruited samples of either chronically homeless individuals or homeless individuals with a mental health diagnosis. All studies reported results favoring Housing First programs over Continuum of Care programs for outcomes related to housing retention. Substance use and mental health outcomes did not differ by program type, and several studies reported that substance use stayed consistent regardless of whether it was a Housing First or Continuum of Care program. Discussion. While Housing First does appear to show strong promise, the methodological flaws in the studies, including strong research affiliation with the Housing First agencies being evaluated, calls for more rigorous studies to be completed by more objective investigators. As neither program type led to favorable outcomes in reducing substance use, there also appears to be a need for more intervention research with substance use in this population.