At Home / Chez Soi — Housing First

Summary

At Home/Chez Soi is the largest Housing First RCT ever conducted. The standard model of homeless services required people to demonstrate sobriety and treatment compliance before receiving permanent housing ('treatment first'). Housing First reverses this: provide housing immediately, then offer (but don't require) supports. The experiment showed dramatically higher housing stability with Housing First, improved quality of life, and comparable mental health outcomes. The cost per housed day was substantially lower than continued shelter system use. Housing First is now the evidence-backed standard of care for chronic homelessness in Canada, most of Europe, and increasingly the US.

Research question

"Does Housing First (immediate permanent housing with supports, no treatment prerequisites) outperform standard care for chronically homeless people with mental illness?"

Methodology

Result

Positive

Housing stability: 73% of time housed (HF) vs. 32% (control) at 24 months; quality of life significantly improved; community functioning improved; mental health symptoms not significantly different; cost per additional day housed much lower than shelter system

Evidence strength

Strong

Randomized trial, replicated across multiple sites or studies.

Replication status

Replicated