Outcome Trajectories among Homeless Individuals with Mental Disorders in a Multisite Randomised Controlled Trial of Housing First.
Housing First (HF) has been shown to improve housing stability, on average, for formerly homeless adults with mental illness. However, little is known about patterns of change and characteristics that predict different outcome trajectories over time. This article reports on latent trajectories of housing stability among 2140 participants (84% followed 24 months) of a multisite randomised controlled trial of HF.



Data were analyzed using generalised growth mixture modeling for the total cohort. Predictor variables were chosen based on the original program logic model and detailed reviews of other qualitative and quantitative findings. Treatment group assignment and level of need at baseline were included in the model.



In total, 73% of HF participants and 43% of treatment-as-usual (TAU) participants were in stable housing after 24 months of follow-up. Six trajectories of housing stability were identified for each of the HF and TAU groups. Variables that distinguished different trajectories included gender, age, prior month income, Aboriginal status, total time homeless, previous hospitalizations, overall health, psychiatric symptoms, and comorbidity, while others such as education, diagnosis, and substance use problems did not.



While the observed patterns and their predictors are of interest for further research and general service planning, no set of variables is yet known that can accurately predict the likelihood of particular individuals benefiting from HF programs at the outset.
1 Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta.
Carol E
CE
Adair
2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.|3 Department of Psychiatry, University of Toronto, Toronto, Ontario.
David L
DL
Streiner
4 Centre for Addiction and Mental Health, York University, Toronto, Ontario.
Ryan
R
Barnhart
5 Mental Health Commission of Canada, Calgary, Alberta.
Brianna
B
Kopp
2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.
Scott
S
Veldhuizen
6 Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia.
Michelle
M
Patterson
7 School of Psychology and Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, Ontario.
Tim
T
Aubry
8 Department of Criminology, Wilfrid Laurier University, Brantford, Ontario.
Jennifer
J
Lavoie
9 Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba.
Jitender
J
Sareen
10 Centre de recherche et de développement en éducation, Université de Moncton, Moncton, New Brunswick.
Stefanie Renée
SR
LeBlanc
3 Department of Psychiatry, University of Toronto, Toronto, Ontario.|4 Centre for Addiction and Mental Health, York University, Toronto, Ontario.
Paula
P
Goering
D000328:Adult; D002170:Canada; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011638:Public Housing / Q000706:statistics & numerical data*
generalized growth mixture modeling; homelessness; longitudinal data; mental disorders; trajectories