Tim Aubry

The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities

Introduction Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city,

Hospital costs and length of stay among homeless patients admitted to medical, surgical, and psychiatric services.

110 million demonstration project and provides the rationale for key scientific decisions. Methods A pragmatic, mixed methods, multi-site field trial of the effectiveness of Housing First in Vancouver, Winnipeg, Toronto, Montreal and Moncton, is randomising approximately 2500 participants, stratified by high and moderate need levels, into intervention and treatment as usual groups. Quantitative outcome measures are being collected over a 2-year period and a qualitative process evaluation is being completed. Primary outcomes are housing stability, social functioning and, for the economic analyses, quality of life. Hierarchical linear modelling is the primary data analytic strategy. Ethics and dissemination Research ethics board approval has been obtained from 11 institutions and a safety and adverse events committee is in place. The results of the multi-site analyses of outcomes at 12 months and 2 years will be reported in a series of core scientific journal papers. Extensive knowledge exchange activities with non-academic audiences will occur throughout the duration of the project. Trial registration number This study has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374.

Housing Choice and Control, Housing Quality, and Control over Professional Support as Contributors to the Subjective Quality of Life and Community Adaptation of People with Severe Mental Illness

BackgroundHomeless individuals often suffer from serious health conditions and are frequently hospitalized. This study compares hospitalization costs for homeless and housed patients, with and without adjustment for patient and service characteristics. MethodsAdministrative data on 93,426 admissions at an academic teaching hospital in Toronto, Canada, were collected over a 5-year period. These data included an identifier for patients who were homeless. Each admission was allocated a cost in Canadian dollars based on Ontario Case Costing methodology. Associations between homeless status and cost were examined for the entire sample and stratified by medical, surgical, and psychiatric services. ResultsData were analyzed for 90,345 housed patient admissions (mean cost,

One-Year Outcomes of a Randomized Controlled Trial of Housing First With ACT in Five Canadian Cities

12,555) and 3081 homeless patient admissions (mean cost,

Early implementation evaluation of a multi-site housing first intervention for homeless people with mental illness: A mixed methods approach

13,516). After adjustment for age, gender, and resource intensity weight, homeless patient admissions cost

Housing First for People with Severe Mental Illness Who are Homeless: A Review of the Research and Findings from the at Home—Chez soi Demonstration Project

2559 more than housed patient admissions (95% CI,

A Multiple-City RCT of Housing First With Assertive Community Treatment for Homeless Canadians With Serious Mental Illness

2053,

Substance Use and Access to Health Care and Addiction Treatment among Homeless and Vulnerably Housed Persons in Three Canadian Cities

3066). For patients on medical and surgical services, much of this difference was explained by more alternate level of care days spent in the hospital, during which patients did not require the level of services provided in an acute care facility. Homeless patient admissions on the psychiatric service cost

Identifying the Patterns of Emergency Shelter Stays of Single Individuals in Canadian Cities of Different Sizes

1058 more than housed patient admissions (95% CI,

Resilient Educational Outcomes: Participation in School by Youth With Histories of Homelessness

480,