Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis

April 2004, Vol 94, No. 4 | American Journal of Public Health 651-656 © 2004 American Public Health Association

Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis
Sam Tsemberis, PhD, Leyla Gulcur, PhD and Maria Nakae, BA

The authors are with Pathways to Housing, Inc, New York, NY.

Correspondence: Requests for reprints should be sent to Sam Tsemberis, Pathways to Housing, 55 West 125th St, 10th Floor, New York, NY 10027 (e-mail: tsemberis@pathwaystohousing.org).

Objectives. We examined the longitudinal effects of a Housing First program for homeless, mentally ill individuals’ on those individuals’ consumer choice, housing stability, substance use, treatment utilization, and psychiatric symptoms.

Methods. Two hundred twenty-five participants were randomly assigned to receive housing contingent on treatment and sobriety (control) or to receive immediate housing without treatment prerequisites (experimental). Interviews were conducted every 6 months for 24 months.

Results. The experimental group obtained housing earlier, remained stably housed, and reported higher perceived choice. Utilization of substance abuse treatment was significantly higher for the control group, but no differences were found in substance use or psychiatric symptoms.

Conclusions. Participants in the Housing First program were able to obtain and maintain independent housing without compromising psychiatric or substance abuse symptoms.

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