Keys To Ending Homelessness

A team of 15 researchers across Canada wanted to find out what services helped people experiencing homelessness who are living with a mental illness. They reviewed every published study that has evaluated a program providing permanent supportive housing and/or income assistance. The findings have just been published.

There is good evidence that permanent supportive housing and income assistance programs improve housing stability for people who have experience of homelessness.

There is also good evidence that permanent supportive housing and income assistance do not contribute to additional harms. This means that the effects of supportive housing and/or income support are the same whether the people in the programs used substances or not. This finding directly addresses the earlier program models, which excluded people who used substances.

This study stands out for a few reasons:

• It demonstrates that these programs are effective over a six year period. Earlier reviews used shorter time frames to assess long term stability (typically 12 to 18 months).¹
• People with lived experience of homelessness participated in the research working group. The article discusses how this affected the research methodology. This represents a new direction for academic literature.²
• It reports on the cost effectiveness of permanent supportive housing and income assistance programs. All of the published evaluations of cost effectiveness were reviewed. Some of the evaluations demonstrate cost effectiveness for people with severe and persistent mental illness. Claims of cost effectiveness for people with moderate mental illness are less clear. This means that people advocating for more permanent supportive housing should not rely on claims of cost effectiveness to make their case.

For more on this research, see in The Lancet: Effectiveness Of Permanent Supportive Housing And Income Assistance Interventions For Homeless Individuals In High-Income Countries: A Systematic Review

1. This is not through any fault of the earlier study designs, but reflects the context in which these studies were completed.
2. For another example, try: Homeless Services For Indigenous People In Canada Get A Boost