"Housing First" for Homeless Youth With Mental Illness.
"Housing First" has been shown to improve housing stability in homeless individuals with mental illness, but had not been empirically tested in homeless youth. We aimed to evaluate the effect of "Housing First" on housing stability in homeless youth aged 18 to 24 years participating in At Home/Chez Soi, a 24-month randomized trial of "Housing First" in 5 Canadian cities.



Homeless individuals with mental illness were randomized to receive "Housing First" (combined with assertive community treatment or intensive case management depending on their level of need) or treatment as usual. We defined our primary outcome, housing stability, as the percent of days stably housed as a proportion of days for which residence data were available.



Of 2148 participants who completed baseline interviews and were randomized, 7% (n = 156) were youth aged 18 to 24 years; 87 received "Housing First" and 69 received treatment as usual. In an adjusted analysis, youth in "Housing First" were stably housed a mean of 437 of 645 (65%) days for which data were available compared with youth in treatment as usual, who were stably housed a mean of 189 of 582 (31%) days for which data were available, resulting in an adjusted mean difference of 34% (95% confidence interval, 24%-45%; P < .001).



"Housing First" was associated with improved housing stability in homeless youth with mental illness. Future research should explore whether adaptations of the model for youth yield additional improvements in housing stability and other outcomes.
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; n.kozloff@mail.utoronto.ca.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Nicole
N
Kozloff
Departments of Psychiatry and.|Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Carol E
CE
Adair
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Luis I
LI
Palma Lazgare
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Daniel
D
Poremski
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.|Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Amy H
AH
Cheung
Dartington Social Research Unit, Dartington, Totnes, United Kingdom; and.
Rebeca
R
Sandu
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.|Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Vicky
V
Stergiopoulos
D000293:Adolescent; D002170:Canada; D019090:Case Management; D003156:Community Mental Health Services; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D018453:Homeless Youth; D006798:Housing; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D011788:Quality of Life; D055815:Young Adult