Results of the At Home project

The final report of the At Home/Chez Soi Project can accessed via the Mental Health Commission of Canada webpage

The project yielded three key conclusions.

  1. The Housing First approach is feasible in Montreal. The housing team found 73 landlords located in many different neighborhoods of Montreal who were willing to offer one or more of their apartments to Chez Soi participants. Almost all of the 285 participants who were recruited to an HF group were housed within about 3 months of recruitment, in apartments of their choice. The teams continued to provide services to the great majority of participants until the end of the study.

    As a result of sustained implementation efforts, the teams managed to follow aspects of the Housing First model more and more closely. Such higher fidelity to the model was found to be associated with greater effectiveness at the national level.
  1. The Housing First approach is effective. Housing First (HF) participants obtained and retained housing to a much greater extent than those in the treatment-as-usual (TAU) groups. Among high-need participants, in the last 6 months of the study, 60% of those in the HF group were housed all of the time, compared to 31% for the TAU group; and 21% none of the time, compared to 59% for the TAU group. The differences were larger among moderate-need participants: 72% housed all of the time, compared to 29% for the TAU group; and 7% none of the time, compared to 52% for the TAU group. Housing quality was similar on average, but with fewer extremes, for HF residences compared to TAU residences. Furthermore, moderate-need participants in Housing First reported a greater improvement in self-reported quality of life than their treatment-as-usual counterparts. The high-need HF group, and one of the moderate-need HF groups also showed more improvements in measures of interviewer-rated community functioning than comparable TAU groups. In-depth interviews conducted at study entry and 18 months later on a representative 10% sample of both high-need and moderate-need participants reveal many more benefits. Among others, HF participants were much more likely to report improvements in their mental health, decreases in stress and anxiety, greater re-establishment of connections with their family members, and reductions in substance abuse. For people with moderate needs especially, overall life trajectories were much more likely to be positive, compared to those of people receiving services as usual.
  1. Housing First reduces the costs of other services. On average, the intervention cost $22,882 per person per year for high need participants and $14,029 for moderate need participants. Over the two-year period following participants’ entry into the study, every $10 invested in HF services resulted in an average savings of $8.27 for high-need participants and $7.19 for moderate-need participants.

In short, the study has shown that it is feasible in Montreal to house many homeless people with mental illness in subsidized apartments of their choice and greatly increase the quality of their lives, at minimal cost to society.

Contact

For all questions related to the results of the At Home / Chez Soi project, please contact:
Eric Latimer, Ph. D.
Lead investigator, Montreal At Home project
eric_dot_latimer_At_mcgill_dot_ca