Anita Palepu

Background: Mental illness can directly worsen and prolong the experience of homelessness. Housing First has been a promising approach to dealing with chronic homelessness, demonstrating improvements in several areas except psychiatric symptoms. The purpose of this thesis is to examine the role that the Housing First approach plays on alleviating self-reported psychiatric symptoms of homeless adults with serious mental illness during a two year period.Methods: 497 participants were recruited as part of the Vancouver site of the At Home/ Chez Soi study, a national randomized control trial examining the impact of Housing First in five Canadian cities. Participants were allocated to either a High Needs or Moderate Needs arm based on their individual levels of need and psychosis. Within each study arm, participants were randomly assigned to different forms of Housing First and treatment support, or the usual treatment. The Colorado Symptom Index (CSI) was used to measure self-reported psychiatric symptoms at baseline and every 6 months for a period of 24 months. Total CSI mean scores were used to compare groups within each study arm at each time point.Results: There were no significant differences in total CSI mean scores at any time point during the 2 years between Housing First or treatment as usual groups of either study arm.Conclusion: Groups receiving Housing First and groups receiving treatment as usual reported similar decreases in psychiatric symptoms over time. Future research can examine individual service-use to shed more light on services most effective in alleviating psychiatric symptoms.

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