Housing first reduces re-offending among formerly homeless adults with mental disorders: results of a randomized controlled trial

Homelessness and mental illness have a strong association with public disorder and criminality. Experimental evidence indicates that Housing First (HF) increases housing stability and perceived choice among those experiencing chronic homelessness and mental disorders. HF is also associated with lowe...

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Bibliographic Details
Published in:PloS one 2013-09, Vol.8 (9), p.e72946-e72946
Main Authors: Somers, Julian M, Rezansoff, Stefanie N, Moniruzzaman, Akm, Palepu, Anita, Patterson, Michelle
Format: Article
Language:English
Subjects:
Adult
Adults
Alternative approaches
Clinical trials
Common lands
Convictions
Crime
Criminal justice
Criminality
Criminals
Drug abuse
Drug use
Female
Health sciences
Homeless people
Homeless Persons
Homelessness
Housing
Humans
Male
Medicine
Mental Disorders
Mental health care
Middle Aged
Patient compliance
Property
Public safety
Randomization
Recidivism
Recruitment
Residential preferences
Sentences
Social and Behavioral Sciences
Social disorganization
Studies
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Summary:Homelessness and mental illness have a strong association with public disorder and criminality. Experimental evidence indicates that Housing First (HF) increases housing stability and perceived choice among those experiencing chronic homelessness and mental disorders. HF is also associated with lower residential costs than common alternative approaches. Few studies have examined the effect of HF on criminal behavior. Individuals meeting criteria for homelessness and a current mental disorder were randomized to one of three conditions treatment as usual (reference); scattered site HF; and congregate HF. Administrative data concerning justice system events were linked in order to study prior histories of offending and to test the relationship between housing status and offending following randomization for up to two years. The majority of the sample (67%) was involved with the justice system, with a mean of 8.07 convictions per person in the ten years prior to recruitment. The most common category of crime was "property offences" (mean=4.09). Following randomization, the scattered site HF condition was associated with significantly lower numbers of sentences than treatment as usual (Adjusted IRR=0.29; 95% CI 0.12-0.72). Congregate HF was associated with a marginally significant reduction in sentences compared to treatment as usual (Adjusted IRR=0.55; 95% CI: 0.26-1.14). This study is the first randomized controlled trial to demonstrate benefits of HF among a homeless sample with mental illness in the domain of public safety and crime. Our sample was frequently involved with the justice system, with great personal and societal costs. Further implementation of HF is strongly indicated, particularly in the scattered site format. Research examining interdependencies between housing, health, and the justice system is indicated. ISRCTN57595077.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0072946