Housing First Improves Residential Stability in Homeless Adults With Concurrent Substance Dependence and Mental Disorders
Housing First Improves Residential Stability in Homeless Adults With Concurrent Substance Dependence and Mental Disorders
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DOI：
10.2105/ajph.2013.301628
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发表时间：
2013-12-01
影响因子：
12.7
通讯作者：
Somers, Julian
中科院分区：
文献类型：
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作者：
Palepu, Anita;Patterson, Michelle L.;Somers, Julian
目标。我们考察了在随机接受住房优先计划或照常治疗(在研究期间没有住房或支持)12个月后，患有当前精神障碍的无家可归成年人的物质依赖与居住稳定性之间的关系。加拿大的温哥华居家研究包括2项住房优先干预的随机对照试验。符合条件的参与者符合无家可归或住房不稳定的标准，以及目前的精神障碍。居住稳定性被定义为随机12个月后稳定居住的天数。我们使用负二项回归模型来检验住宅稳定性与物质依赖之间的独立关联。我们招募了497名参与者，其中58%(n=288)符合物质依赖的标准。在调整了住房干预、就业、社会人口学、慢性健康状况、精神障碍严重程度、精神症状和终生无家可归时间后，我们发现物质依赖与居住稳定性没有显著关联(调整发生率比=0.97；95%可信区间=0.69，1.35)。精神障碍患者无论是否同时经历物质依赖，都可能从住房优先获得类似水平的住房稳定性。
Objectives. We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study).Methods. The Vancouver At Home study in Canada included 2 randomized controlled trials of Housing First interventions. Eligible participants met the criteria for homelessness or precarious housing, as well as a current mental disorder. Residential stability was defined as the number of days in stable residences 12 months after randomization. We used negative binomial regression modeling to examine the independent association between residential stability and substance dependence.Results. We recruited 497 participants, and 58% (n = 288) met the criteria for substance dependence. We found no significant association between substance dependence and residential stability (adjusted incidence rate ratio = 0.97; 95% confidence interval = 0.69, 1.35) after adjusting for housing intervention, employment, sociodemographics, chronic health conditions, mental disorder severity, psychiatric symptoms, and lifetime duration of homelessness.Conclusions. People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence.