title: Housing first improves residential stability in homeless adults with concurrent substance dependence and mental disorders.
abstract: OBJECTIVE
  We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study).
  
  
  METHODS
  The Vancouver At Home study in Canada included 2 randomized controlled trials of Housing First interventions. Eligible participants met the criteria for homelessness or precarious housing, as well as a current mental disorder. Residential stability was defined as the number of days in stable residences 12 months after randomization. We used negative binomial regression modeling to examine the independent association between residential stability and substance dependence.
  
  
  RESULTS
  We recruited 497 participants, and 58% (n = 288) met the criteria for substance dependence. We found no significant association between substance dependence and residential stability (adjusted incidence rate ratio = 0.97; 95% confidence interval = 0.69, 1.35) after adjusting for housing intervention, employment, sociodemographics, chronic health conditions, mental disorder severity, psychiatric symptoms, and lifetime duration of homelessness.
  
  
  CONCLUSIONS
  People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence.
authors.affiliation: Anita Palepu is with the Department of Medicine, University of British Columbia, Vancouver, British Columbia. Michelle L. Patterson, Akm Moniruzzaman, and Julian Somers are with the Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia. C. James Frankish is with the School of Public and Population Health, University of British Columbia, Vancouver.
authors.forename: Anita
authors.initials: A
authors.lastname: Palepu
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Patterson
authors.forename: Akm
authors.initials: A
authors.lastname: Moniruzzaman
authors.forename: C James
authors.initials: CJ
authors.lastname: Frankish
authors.forename: Julian
authors.initials: J
authors.lastname: Somers
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology