Sam Tsemberis
Biographic Data
| ID | 5418668 |
|---|---|
| NAME | Sam Tsemberis |
| GIVEN NAMES | Sam |
| FAMILY NAME | Tsemberis |
| SIGNATURE | TSEMBERIS S |
| AFFILIATIONS | Pathways to Housing |
| VERIFIED | No |
| TOTAL WORKS | 32 |
| TOTAL CITATIONS | 601 |
| AUTHOR COUNT | 32 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1980 |
| LATEST PUBLICATION YEAR | 2024 |
| H-INDEX | 13 |
Predictors of housing instability and stability among Housing First participants: A 24-month study
This study examined the characteristics of people who experienced housing instability and stability after 24 months of being enrolled in Housing First (HF). A companion study addresses the same objective using qualitative methods. A sequential logistic regression was conducted to determine predictors of unstable and stable housing at 24 months of enrollment in HF in a randomized trial. We applied the Gelberg-Andersen. Behavioral Model for Vulnera…
Narratives of people with serious mental illness in Housing First: A qualitative analysis of factors contributing to housing instability and housing stability
There has been little previous research that has examined factors related to housing stability and instability among Housing First (HF) tenants. Qualitative research was used to determine themes related to housing stability and instability for people with mental illness participating in a HF program implemented in five Canadian cities. Data were gathered for all participants who completed qualitative interviews at baseline and an 18-month follow-…
Attempting Randomized Housing First Research in a Community Context: Reflections on Failure
Highlights Experimental housing research relying on existing community resources may face complex barriers. Key stakeholders present issues encountered in an attempted Housing First randomized trial. Lessons learned include enhancing buy‐in with partnering organizations and local policymakers
Systems change in the context of an initiative to scale up Housing First in Canada
In this study, we examine changes in the homeless‐serving system in the context of a training and technical assistance initiative to scale up Housing First (HF) in 6 Canadian communities. Based on qualitative data from focus groups and individual interviews with key stakeholders (k = 7, n = 35) and field notes gathered over a 3‐year period (n = 146), we found 2 main system changes: (a) changes in the capacity of the service delivery system at mul…
Understanding Systems Change in Early Implementation of Housing First in Canadian Communities: An Examination of Facilitators/Barriers, Training/Technical Assistance, and Points of Leverage
We present interim findings of a cross‐site case study of an initiative to expand Housing First ( HF ) in Canada through training and technical assistance ( TTA ). HF is an evidence‐based practice designed to end chronic homelessness for consumers of mental health services. We draw upon concepts from implementation science and systems change theory to examine how early implementation occurs within a system. Case studies examining HF early impleme…
Navigating Complex Implementation Contexts: Overcoming Barriers and Achieving Outcomes in a National Initiative to Scale Out Housing First in Canada
Highlights Housing First can be implemented beyond demonstration sites without new resources. Using an intentional implementation strategy communities implemented high‐fidelity programs. One key implementation challenge was accessing affordable housing and housing subsidies. By helping develop housing specialists and reflective practice, the TTA facilitated effective implementation
A Multiple-City RCT of Housing First With Assertive Community Treatment for Homeless Canadians With Serious Mental Illness
OBJECTIVE: Housing First with assertive community treatment (ACT) is a promising approach to assist people with serious mental illness to exit homelessness. The article presents two-year findings from a multisite trial on the effectiveness of Housing First with ACT. METHODS: The study design was a randomized controlled trial conducted in five Canadian cities. A sample of 950 participants with serious mental illness who were absolutely homeless or…
Housing First: Ending Homelessness, Transforming Systems, and Changing Lives
Little more than two decades ago, the 'Housing First' (HF) approach pioneered by Pathways to Housing, Incorporated was a small but determined challenge to the burgeoning yet ineffective service system for homeless persons. Today, the success of HF has brought about paradigm-shifting systems change not only in the homeless 'industry' but in related service systems. This book employs conceptual frameworks drawn from theories of institutional change…
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
OBJECTIVE: To provide a review of the extant research literature on Housing First (HF) for people with severe mental illness (SMI) who are homeless and to describe the findings of the recently completed At Home (AH)-Chez soi (CS) demonstration project. HF represents a paradigm shift in the delivery of community mental health services, whereby people with SMI who are homeless are supported through assertive community treatment or intensive case ma…
Implementing Housing First Across Sites and Over Time: Later Fidelity and Implementation Evaluation of a Pan‐Canadian Multi‐site Housing First Program for Homeless People with Mental Illness
This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and …
Housing First: The Pathways Model to End Homelessness for People with Mental Health and Substance Use Disorders
Implementing Housing First in Rural Areas: Pathways Vermont
The benefits of Pathways Housing First in addressing chronic homelessness for persons with severe mental illness have been well established. However, the implementation and effectiveness of such programs in rural areas has yet to be examined. We described the model’s adaptations in Vermont, including the use of hybrid assertive community treatment–intensive case management teams, which consisted of service coordinators with geographically based c…
Pathways Housing First for Homeless Persons with Psychiatric Disabilities: Program Innovation, Research, and Advocacy
This article describes how the Pathways Housing First (PHF) model of homelessness intervention evolved from a radical idea to the gold standard of service delivery for homelessness intervention programs that serve adults with psychiatric and/or substance abuse diagnoses, not only in the United States, but worldwide. Through the example of PHF we explain how the integration of rigorous research with consumer‐driven service delivery yielded an evid…
Health and Wellness Photovoice Project: Engaging Consumers With Serious Mental Illness in Health Care Interventions
People with serious mental illnesses (SMI) are at increased risk for cardiovascular disease and premature mortality. We used photovoice in two supportive housing agencies to engage consumers with SMI to inform the implementation of health care interventions. Sixteen consumers participated in six weekly sessions in which they took photographs about their health and discussed the meanings of these photographs in individual interviews and group sess…
Housing Stability and Recovery Among Chronically Homeless Persons With Co-Occuring Disorders in Washington, DC
Pathways Housing First provides access to housing, support, and treatment services to clients having the most complex needs—persons who have been homeless for at least 5 years and have both a psychiatric disability and substance dependency. In a 2-year Housing and Urban Development-funded demonstration project in Washington, DC, in 2007 and 2008, we observed promising outcomes in housing retention and reductions in psychiatric symptoms, alcohol u…
Psychological community integration among people with psychiatric disabilities and nondisabled community members
This study examined individual and neighborhood predictors of the psychological community integration of people with psychiatric disabilities and nondisabled community members. One hundred twenty‐three adults (60 psychiatrically disabled, 63 general community residents), completed measures of sense of community, life satisfaction, psychiatric symptoms, and perceptions of neighborhood. Mental health consumers living in independent scatter‐site apa…
Homelessness, Mental Illness, and Criminal Activity: Examining Patterns Over Time
This study examined whether street homelessness, sheltered homelessness, and the severity of psychological symptoms predicted non‐violent and violent crime among 207 mentally ill participants who were homeless at baseline. Participants were interviewed at 9 time points over 4 years. Hierarchical linear modeling (HLM) was used to examine whether changes in homelessness status and symptom severity predicted changes in criminal activity over time. R…
Housing First for Long-Term Shelter Dwellers with Psychiatric Disabilities in a Suburban County: A Four-Year Study of Housing Access and Retention
Measuring homelessness and residential stability: The residential time‐line follow‐back inventory
Reliable and valid longitudinal residential histories are needed to assess interventions to reduce homelessness and increase community tenure. This study examined the test‐retest reliability, sensitivity to change, and concurrent validity of the Residential Time‐Line Follow‐Back (TLFB) Inventory, a method used to record residential histories in the Collaborative Program to Prevent Homelessness ( n = 1,381). The Residential TLFB Inventory yielded …
ACT and Recovery: Integrating Evidence-Based Practice and Recovery Orientation on Assertive Community Treatment Teams
Community Integration of Adults with Psychiatric Disabilities and Histories of Homelessness
Housing First Services for People Who Are Homeless With Co-Occurring Serious Mental Illness and Substance Abuse
The literature on homeless adults with severe mental illness is generally silent on a critical issue surrounding service delivery—the contrast between housing first and treatment first program philosophies. This study draws on data from a longitudinal experiment contrasting a housing first program (which offers immediate permanent housing without requiring treatment compliance or abstinence) and treatment first (standard care) programs for 225 ad…
Decreasing Psychiatric Symptoms by Increasing Choice in Services for Adults with Histories of Homelessness
Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven "Housing First" program or "treatment as usual" requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choic…
Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis
Objectives. We examined the longitudinal effects of a Housing First program for homeless, mentally ill individuals’ on those individuals’ consumer choice, housing stability, substance use, treatment utilization, and psychiatric symptoms. Methods. Two hundred twenty-five participants were randomly assigned to receive housing contingent on treatment and sobriety (control) or to receive immediate housing without treatment prerequisites (experimental…
Community Integration in the Early Phase of Housing Among Homeless Persons Diagnosed with Severe Mental Illness: Successes and Challenges
Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis
Objectives. We examined the longitudinal effects of a Housing First program for homeless, mentally ill individuals’ on those individuals’ consumer choice, housing stability, substance use, treatment utilization, and psychiatric symptoms. Methods. Two hundred twenty-five participants were randomly assigned to receive housing contingent on treatment and sobriety (control) or to receive immediate housing without treatment prerequisites (experimental…
Housing First Services for People Who Are Homeless With Co-Occurring Serious Mental Illness and Substance Abuse
The literature on homeless adults with severe mental illness is generally silent on a critical issue surrounding service delivery—the contrast between housing first and treatment first program philosophies. This study draws on data from a longitudinal experiment contrasting a housing first program (which offers immediate permanent housing without requiring treatment compliance or abstinence) and treatment first (standard care) programs for 225 ad…
Housing, hospitalization, and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes
This article compares two approaches to housing chronically homeless individuals with psychiatric disabilities and often substance abuse. The experimental Housing First programme offered immediate access to independent housing without requiring psychiatric treatment or sobriety; the control Continuum of Care programmes made treatment and sobriety prerequisites for housing. A total of 225 participants were interviewed prior to random assignment an…
Community Integration in the Early Phase of Housing Among Homeless Persons Diagnosed with Severe Mental Illness: Successes and Challenges
Community Integration of Adults with Psychiatric Disabilities and Histories of Homelessness
Neighborhood Satisfaction Among Urban Dwellers
Three approaches to explaining and predicting neighborhood satisfaction are compared in a survey of 550 New York City residents. The models are: a belief‐affect approach which proposes that evaluations of specific aspects of a community are combined to yield overall satisfaction ratings; a commitment approach, which looks at the impact of emotional and economic ties to the neighborhood; and an availability approach, which emphasizes the impact of…
Consumer Preference Programs for Individuals Who Are Homeless and Have Psychiatric Disabilities: A Drop‐In Center and a Supported Housing Program
We illustrate Fairweather's approach to Experimental Social Innovation and Dissemination with two experimental studies of programs to reduce homelessness for 168 and 225 people with mental illness and often substance abuse. Literally homeless participants were randomly assigned to programs that emphasized consumer choice or to the usual continuum of care, in which housing and services are contingent on sobriety and progress in treatment. A drop‐i…
Measuring homelessness and residential stability: The residential time‐line follow‐back inventory
Reliable and valid longitudinal residential histories are needed to assess interventions to reduce homelessness and increase community tenure. This study examined the test‐retest reliability, sensitivity to change, and concurrent validity of the Residential Time‐Line Follow‐Back (TLFB) Inventory, a method used to record residential histories in the Collaborative Program to Prevent Homelessness ( n = 1,381). The Residential TLFB Inventory yielded …
Decreasing Psychiatric Symptoms by Increasing Choice in Services for Adults with Histories of Homelessness
Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven "Housing First" program or "treatment as usual" requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choic…
ACT and Recovery: Integrating Evidence-Based Practice and Recovery Orientation on Assertive Community Treatment Teams
Housing Stability and Recovery Among Chronically Homeless Persons With Co-Occuring Disorders in Washington, DC
Pathways Housing First provides access to housing, support, and treatment services to clients having the most complex needs—persons who have been homeless for at least 5 years and have both a psychiatric disability and substance dependency. In a 2-year Housing and Urban Development-funded demonstration project in Washington, DC, in 2007 and 2008, we observed promising outcomes in housing retention and reductions in psychiatric symptoms, alcohol u…
Implementing Housing First Across Sites and Over Time: Later Fidelity and Implementation Evaluation of a Pan‐Canadian Multi‐site Housing First Program for Homeless People with Mental Illness
This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and …
Housing satisfaction for persons with psychiatric disabilities
Provision of residential services to people with mental illness has assumed increasing importance since deinstitutionalization and as community‐ based services have increased. This large‐scale multisite study of housing programs specifically for persons with mental illness examines one of the factors that lead to successful residential tenure for persons with serious mental illness. To date, the Lehman Quality of Life Scale has been used primaril…
Health and Wellness Photovoice Project: Engaging Consumers With Serious Mental Illness in Health Care Interventions
People with serious mental illnesses (SMI) are at increased risk for cardiovascular disease and premature mortality. We used photovoice in two supportive housing agencies to engage consumers with SMI to inform the implementation of health care interventions. Sixteen consumers participated in six weekly sessions in which they took photographs about their health and discussed the meanings of these photographs in individual interviews and group sess…
Understanding Systems Change in Early Implementation of Housing First in Canadian Communities: An Examination of Facilitators/Barriers, Training/Technical Assistance, and Points of Leverage
We present interim findings of a cross‐site case study of an initiative to expand Housing First ( HF ) in Canada through training and technical assistance ( TTA ). HF is an evidence‐based practice designed to end chronic homelessness for consumers of mental health services. We draw upon concepts from implementation science and systems change theory to examine how early implementation occurs within a system. Case studies examining HF early impleme…
Pathways Housing First for Homeless Persons with Psychiatric Disabilities: Program Innovation, Research, and Advocacy
This article describes how the Pathways Housing First (PHF) model of homelessness intervention evolved from a radical idea to the gold standard of service delivery for homelessness intervention programs that serve adults with psychiatric and/or substance abuse diagnoses, not only in the United States, but worldwide. Through the example of PHF we explain how the integration of rigorous research with consumer‐driven service delivery yielded an evid…
Psychological community integration among people with psychiatric disabilities and nondisabled community members
This study examined individual and neighborhood predictors of the psychological community integration of people with psychiatric disabilities and nondisabled community members. One hundred twenty‐three adults (60 psychiatrically disabled, 63 general community residents), completed measures of sense of community, life satisfaction, psychiatric symptoms, and perceptions of neighborhood. Mental health consumers living in independent scatter‐site apa…
Systems change in the context of an initiative to scale up Housing First in Canada
In this study, we examine changes in the homeless‐serving system in the context of a training and technical assistance initiative to scale up Housing First (HF) in 6 Canadian communities. Based on qualitative data from focus groups and individual interviews with key stakeholders (k = 7, n = 35) and field notes gathered over a 3‐year period (n = 146), we found 2 main system changes: (a) changes in the capacity of the service delivery system at mul…
Navigating Complex Implementation Contexts: Overcoming Barriers and Achieving Outcomes in a National Initiative to Scale Out Housing First in Canada
Highlights Housing First can be implemented beyond demonstration sites without new resources. Using an intentional implementation strategy communities implemented high‐fidelity programs. One key implementation challenge was accessing affordable housing and housing subsidies. By helping develop housing specialists and reflective practice, the TTA facilitated effective implementation
Implementing Housing First in Rural Areas: Pathways Vermont
The benefits of Pathways Housing First in addressing chronic homelessness for persons with severe mental illness have been well established. However, the implementation and effectiveness of such programs in rural areas has yet to be examined. We described the model’s adaptations in Vermont, including the use of hybrid assertive community treatment–intensive case management teams, which consisted of service coordinators with geographically based c…
Attempting Randomized Housing First Research in a Community Context: Reflections on Failure
Highlights Experimental housing research relying on existing community resources may face complex barriers. Key stakeholders present issues encountered in an attempted Housing First randomized trial. Lessons learned include enhancing buy‐in with partnering organizations and local policymakers
Homelessness, Mental Illness, and Criminal Activity: Examining Patterns Over Time
This study examined whether street homelessness, sheltered homelessness, and the severity of psychological symptoms predicted non‐violent and violent crime among 207 mentally ill participants who were homeless at baseline. Participants were interviewed at 9 time points over 4 years. Hierarchical linear modeling (HLM) was used to examine whether changes in homelessness status and symptom severity predicted changes in criminal activity over time. R…
Neighborhood Satisfaction Among Urban Dwellers
Three approaches to explaining and predicting neighborhood satisfaction are compared in a survey of 550 New York City residents. The models are: a belief‐affect approach which proposes that evaluations of specific aspects of a community are combined to yield overall satisfaction ratings; a commitment approach, which looks at the impact of emotional and economic ties to the neighborhood; and an availability approach, which emphasizes the impact of…
Seclusion in context: Introducing a seclusion room into a children’s unit of a municipal hospital
To assess the effects of a seclusion room in context, the 15-month period before and after its introduction into a children's unit at a large municipal hospital was studied. Results indicate that frequency of restraints did not change, that restrained children stayed longer, and that staff and children preferred seclusion to other management interventions. The influence of hospital context on the use of seclusion and restraints is discussed
From streets to homes: An innovative approach to supported housing for homeless adults with psychiatric disabilities
This article describes a supported housing program that provides immediate access to permanent independent housing to individuals who are homeless and have psychiatric disabilities. Following housing placement, Assertive Community Treatment (ACT) teams provide treatment, support, and other needed services. The residential stability of tenants in this supported housing program was compared to that of tenants in a linear residential treatment progr…
Pathways to Housing: Supported Housing for Street-Dwelling Homeless Individuals With Psychiatric Disabilities
OBJECTIVE: This study examined the effectiveness of the Pathways to Housing supported housing program over a five-year period. Unlike most housing programs that offer services in a linear, step-by-step continuum, the Pathways program in New York City provides immediate access to independent scatter-site apartments for individuals with psychiatric disabilities who are homeless and living on the street. Support services are provided by a team that …
Housing, hospitalization, and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes
This article compares two approaches to housing chronically homeless individuals with psychiatric disabilities and often substance abuse. The experimental Housing First programme offered immediate access to independent housing without requiring psychiatric treatment or sobriety; the control Continuum of Care programmes made treatment and sobriety prerequisites for housing. A total of 225 participants were interviewed prior to random assignment an…
Consumer Preference Programs for Individuals Who Are Homeless and Have Psychiatric Disabilities: A Drop‐In Center and a Supported Housing Program
We illustrate Fairweather's approach to Experimental Social Innovation and Dissemination with two experimental studies of programs to reduce homelessness for 168 and 225 people with mental illness and often substance abuse. Literally homeless participants were randomly assigned to programs that emphasized consumer choice or to the usual continuum of care, in which housing and services are contingent on sobriety and progress in treatment. A drop‐i…
Housing satisfaction for persons with psychiatric disabilities
Provision of residential services to people with mental illness has assumed increasing importance since deinstitutionalization and as community‐ based services have increased. This large‐scale multisite study of housing programs specifically for persons with mental illness examines one of the factors that lead to successful residential tenure for persons with serious mental illness. To date, the Lehman Quality of Life Scale has been used primaril…
Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis
Objectives. We examined the longitudinal effects of a Housing First program for homeless, mentally ill individuals’ on those individuals’ consumer choice, housing stability, substance use, treatment utilization, and psychiatric symptoms. Methods. Two hundred twenty-five participants were randomly assigned to receive housing contingent on treatment and sobriety (control) or to receive immediate housing without treatment prerequisites (experimental…
Community Integration in the Early Phase of Housing Among Homeless Persons Diagnosed with Severe Mental Illness: Successes and Challenges
Housing First Services for People Who Are Homeless With Co-Occurring Serious Mental Illness and Substance Abuse
The literature on homeless adults with severe mental illness is generally silent on a critical issue surrounding service delivery—the contrast between housing first and treatment first program philosophies. This study draws on data from a longitudinal experiment contrasting a housing first program (which offers immediate permanent housing without requiring treatment compliance or abstinence) and treatment first (standard care) programs for 225 ad…
Decreasing Psychiatric Symptoms by Increasing Choice in Services for Adults with Histories of Homelessness
Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven "Housing First" program or "treatment as usual" requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choic…
Housing First for Long-Term Shelter Dwellers with Psychiatric Disabilities in a Suburban County: A Four-Year Study of Housing Access and Retention
Measuring homelessness and residential stability: The residential time‐line follow‐back inventory
Reliable and valid longitudinal residential histories are needed to assess interventions to reduce homelessness and increase community tenure. This study examined the test‐retest reliability, sensitivity to change, and concurrent validity of the Residential Time‐Line Follow‐Back (TLFB) Inventory, a method used to record residential histories in the Collaborative Program to Prevent Homelessness ( n = 1,381). The Residential TLFB Inventory yielded …
ACT and Recovery: Integrating Evidence-Based Practice and Recovery Orientation on Assertive Community Treatment Teams
Community Integration of Adults with Psychiatric Disabilities and Histories of Homelessness
Homelessness, Mental Illness, and Criminal Activity: Examining Patterns Over Time
This study examined whether street homelessness, sheltered homelessness, and the severity of psychological symptoms predicted non‐violent and violent crime among 207 mentally ill participants who were homeless at baseline. Participants were interviewed at 9 time points over 4 years. Hierarchical linear modeling (HLM) was used to examine whether changes in homelessness status and symptom severity predicted changes in criminal activity over time. R…
Psychological community integration among people with psychiatric disabilities and nondisabled community members
This study examined individual and neighborhood predictors of the psychological community integration of people with psychiatric disabilities and nondisabled community members. One hundred twenty‐three adults (60 psychiatrically disabled, 63 general community residents), completed measures of sense of community, life satisfaction, psychiatric symptoms, and perceptions of neighborhood. Mental health consumers living in independent scatter‐site apa…
Housing Stability and Recovery Among Chronically Homeless Persons With Co-Occuring Disorders in Washington, DC
Pathways Housing First provides access to housing, support, and treatment services to clients having the most complex needs—persons who have been homeless for at least 5 years and have both a psychiatric disability and substance dependency. In a 2-year Housing and Urban Development-funded demonstration project in Washington, DC, in 2007 and 2008, we observed promising outcomes in housing retention and reductions in psychiatric symptoms, alcohol u…
Implementing Housing First in Rural Areas: Pathways Vermont
The benefits of Pathways Housing First in addressing chronic homelessness for persons with severe mental illness have been well established. However, the implementation and effectiveness of such programs in rural areas has yet to be examined. We described the model’s adaptations in Vermont, including the use of hybrid assertive community treatment–intensive case management teams, which consisted of service coordinators with geographically based c…
Pathways Housing First for Homeless Persons with Psychiatric Disabilities: Program Innovation, Research, and Advocacy
This article describes how the Pathways Housing First (PHF) model of homelessness intervention evolved from a radical idea to the gold standard of service delivery for homelessness intervention programs that serve adults with psychiatric and/or substance abuse diagnoses, not only in the United States, but worldwide. Through the example of PHF we explain how the integration of rigorous research with consumer‐driven service delivery yielded an evid…
Health and Wellness Photovoice Project: Engaging Consumers With Serious Mental Illness in Health Care Interventions
People with serious mental illnesses (SMI) are at increased risk for cardiovascular disease and premature mortality. We used photovoice in two supportive housing agencies to engage consumers with SMI to inform the implementation of health care interventions. Sixteen consumers participated in six weekly sessions in which they took photographs about their health and discussed the meanings of these photographs in individual interviews and group sess…
Housing First: Ending Homelessness, Transforming Systems, and Changing Lives
Little more than two decades ago, the 'Housing First' (HF) approach pioneered by Pathways to Housing, Incorporated was a small but determined challenge to the burgeoning yet ineffective service system for homeless persons. Today, the success of HF has brought about paradigm-shifting systems change not only in the homeless 'industry' but in related service systems. This book employs conceptual frameworks drawn from theories of institutional change…
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
OBJECTIVE: To provide a review of the extant research literature on Housing First (HF) for people with severe mental illness (SMI) who are homeless and to describe the findings of the recently completed At Home (AH)-Chez soi (CS) demonstration project. HF represents a paradigm shift in the delivery of community mental health services, whereby people with SMI who are homeless are supported through assertive community treatment or intensive case ma…
Implementing Housing First Across Sites and Over Time: Later Fidelity and Implementation Evaluation of a Pan‐Canadian Multi‐site Housing First Program for Homeless People with Mental Illness
This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and …
Housing First: The Pathways Model to End Homelessness for People with Mental Health and Substance Use Disorders
Homelessness and Social Issues (27 works) · Psychology (27 works) · Medicine (26 works) · Psychiatry (26 works) · Mental health (22 works) · Mental illness (18 works) · Housing First (15 works) · Supportive housing (13 works) · Housing, Finance, and Neoliberalism (12 works) · Nursing (12 works)