Short-Term Outcomes Among Substance Using Participants in a Rapid Rehousing Program: The H.O.P.E. Project

Background: Rapid rehousing seeks to reduce the impact and duration of homelessness by rehousing individuals as quickly as possible after experiencing homelessness. Rapid rehousing is typically paired with supportive services and does not require participation in treatment or services as a condition for housing. However, prior research on rapid rehousing suggests mixed evidence on its impact, largely due to low methodological rigor, and a focus on clinical outcomes such as mental health and substance use symptoms. In the present study, we examine 6-month psychosocial outcomes of participants actively using drugs or alcohol in a rapid rehousing program using a pre-post research design across multiple psychosocial outcomes.

Methods: Sixty-nine participants were enrolled in a rapid rehousing program through a public mental health service provider titled the H.O.P.E. project (Housing, Outreach, Partnership & Empowerment) between August 2020 and August 2021. This program provided financial assistance for housing support, case management service coordination, medical care, integrated substance use and mental health care, and vocational training. Participants reported demographic characteristics at baseline. Assessment measures collected at baseline and 6-month follow up included frequency of drug and alcohol use, depression and anxiety symptoms related to substance use, criminal justice involvement (any arrests in past 30 days), employment status, satisfaction with living conditions, satisfaction with health, satisfaction with social relationships, and quality of life. These outcomes were examined using paired t-tests and chi-square tests for independence to establish any differences between baseline and 6-month follow-up. This study was reviewed and approved by the lead author’s university IRB.

Results: The average age of participants was 48 years. About 65% of participants identified as male and 52% of participants identified as non-Hispanic White. Comparisons between baseline and 6-month follow up showed no significant difference in frequency of drug and alcohol use. However, participants at follow-up reported fewer depression (t(68) = 3.84, p < .01) and anxiety symptoms (t(68) = 4.23, p < .01) related to substance use. Further, a significantly larger proportion of participants were employed at 6-month follow-up (X2 (2, N = 138) = 3.97, p < .05). Participants also reported higher satisfaction with living conditions (t(68) = 8.61, p < .01) , satisfaction with health (t(68) = 3.67, p < .01), satisfaction with social relationships (t(68) = 3.20, p < .01), and quality of life (t(68) = 7.08, p < .01) at 6-month follow-up. There was no difference in criminal justice involvement at 6 month follow up.

Conclusions: Rapid rehousing provides immediate benefit to persons across a multitude of factors including mental health, employment, and general life satisfaction. Social workers may use this research as they continue to advocate for the shift away from traditional models of care that require treatment compliance as a condition for entrance to independent housing. Additional areas for social work research include further addressing lengths of service enrollment in time-limited approaches to rehousing assistance programs and their outcomes, as well as identification of factors associated with stable housing following rapid rehousing program completion.