{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:26:50Z","timestamp":1789712810964,"version":"4.0.1"},"reference-count":38,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,7,26]]},"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We studied the impact of a Housing First (HF) intervention on housing, contact with the justice system, healthcare usage and health outcomes among At Home\/Chez Soi randomised trial participants in Toronto, a city with an extensive service network for social and health services for individuals who are experiencing homelessness and mental illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants identified as high needs were randomised to receive either the intervention which provided them with housing and supports by an assertive community treatment team (HF+ACT) or treatment as usual (TAU). Participants (N=197) had in-person interviews every 3\u2005months for 2\u2005years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The HF+ACT group spent more time stably housed compared to the TAU group with the mean difference between the groups of 45.8% (95% CI 37.1% to 54.4%, p&lt;0.0001). Accounting for baseline differences, HF+ACT group showed significant improvements over TAU group for community functioning, selected quality-of-life subscales and arrests at some time points during follow-up. No differences between HF+ACT and TAU groups over the follow-up were observed for health service usage, community integration and substance use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HF for individuals with high levels of need increased housing stability and selected health and justice outcomes over 2\u2005years in a city with many social and health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ISRCTN42520374.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-010581","type":"journal-article","created":{"date-parts":[[2016,9,12]],"date-time":"2016-09-12T21:49:12Z","timestamp":1473716952000},"page":"e010581","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":66,"title":["How did a Housing First intervention improve health and social outcomes among homeless adults with mental illness in Toronto? Two-year outcomes from a randomised trial"],"prefix":"10.1136","volume":"6","clinical-trial-number":[{"clinical-trial-number":"isrctn42520374","registry":"10.18810\/isrctn"}],"author":[{"given":"Patricia","family":"O'Campo","sequence":"first","affiliation":[{"name":"Centre for Research on Inner City Health, St Michael's Hospital, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Stergiopoulos","sequence":"additional","affiliation":[{"name":"Centre for Research on Inner City Health, St Michael's Hospital, Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pam","family":"Nir","sequence":"additional","affiliation":[{"name":"Cota, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vachan","family":"Misir","sequence":"additional","affiliation":[{"name":"Centre for Research on Inner City Health, St Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony","family":"Chum","sequence":"additional","affiliation":[{"name":"Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouchra","family":"Arbach","sequence":"additional","affiliation":[{"name":"Cota, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosane","family":"Nisenbaum","sequence":"additional","affiliation":[{"name":"Centre for Research on Inner City Health, St Michael's Hospital, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"To","sequence":"additional","affiliation":[{"name":"Centre for Research on Inner City Health, St Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W","family":"Hwang","sequence":"additional","affiliation":[{"name":"Centre for Research on Inner City Health, St Michael's Hospital, Toronto, Ontario, Canada"},{"name":"Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,9,12]]},"reference":[{"key":"2025121223070682000_6.9.e010581.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1310121"},{"key":"2025121223070682000_6.9.e010581.2","first-page":"816","article-title":"Policy shift or program drift? 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