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Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction Manual



This step-by-step manual provides a solid foundation for introducing the evidence-based Housing First approach--provide housing first, followed by supportive treatment services--into new locations, and evolving existing programs into those based on the ideals of the Pathways Model to End Homelessness. It guides you in structuring policies and programs that respect and respond to the voices of men, women, and families in your community, and provides easy-to-follow tools and tips for implementation.
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Sam Tsemberis (2010)
Housing First: The Pathways Model to End
Homelessness for People with Mental Illness
and Addiction Manual
Minnesota: Hazelden, 244 pp. appr. 50
Housing First is the most discussed method in Europe in terms of combatting
homelessness. Within a relatively short period of time the concept has been widely
disseminated, but what is the Housing First model, exactly? A lot of questions have
been raised in recent years: what components and elements must be included in
this model? Who is the target group? Is Housing First a slogan, a philosophy, a
programme, a brand – or a policy? Many have looked forward to reading this book.
Homelessness is a widespread social problem, and the struggle is ongoing
throughout Europe to combat the problem. Conditions in various countries differ
widely, but many actors have realized that a new approach is necessary. In
Sweden, for example, an individual perspective dominated for a long time, and
homelessness has been mainly analysed and explained with reference to indi-
vidual factors such as substance abuse and dependence, mental disabilities or
other social problems; if these problems disappear then it should also be possible
to solve the problem of homelessness. Gradually, however, this explanation has
changed. To a large extent, a multifactorial explanatory model has been adopted
in its place, where structural factors like the structure of the housing market are
of vital importance. Other structural factors are exclusion from the housing
market, unemployment and discrimination. One of the fundamental ideas of the
Housing First model is to separate treatment from housing. This renders the
structural and individual factors visible, and it becomes clear that homelessness
is much more than just an individual problem.
The interest in evidence-based practice (EBP) has grown in our part of Europe. The
search for effective, well-researched methods is ongoing, and a method that has
proven to be efficient in randomized trials is difficult to dismiss; the Pathways
Housing First (PHF) programme is one such method, with well-established efficacy
in reducing homelessness for a particular group of individuals.
ISSN 2030-2762 / ISSN 2030- 3106 online
236 European Journal of Homelessness _ Volume 5, No. 2, Decembe r 2011
The author of this book, Sam Tsemberis, created the Pathways Housing First
model, which subsequently partly inspired the Housing First movement. Dr.
Tsemberis is Greek-born and holds a Ph.D. in clinical psychology. From his Greek
background he inherited certain values, including the belief that housing is a funda-
mental right for all people, including people with mental illness.. Tsemberis is based
in the Department of Psychiatry in Colombia University Medical Center, and is also
the lead trainer and consultant for the Pathways Housing First Training Institute.
Primarily, the book is to be characterized as a kind of manual; the first part
contains an introduction followed by eight chapters, while in the second part, the
Pathways Housing First Training Institute is introduced. The book also contains a
number of appendices.
One question often raised when discussing how to help homeless individuals is:
can people with both substance abuse and mental illness manage to live in their
own apartments, even with tailored support? Is it really possible? It required a lot
of courage to introduce this programme before research had proved its effective-
ness, and research has been crucial for the development of PHF as an evidence-
based programme. The book’s introduction describes the history of the programme
and the ideas on which PHF is based; each of the book’s chapters is then intro-
duced briefly so the reader knows what to expect, and at the end of this introduc-
tion a list of particularly relevant terms is provided.
Chapter 1 introduces the Pathways Housing First programme on recovery-oriented
service and its philosophical assumptions. Why does it work? By providing a home
for a person, the programme offers dignity and hope. For many clients, the result
is the beginning of a process of change. PHF offers an alternative to the previously
most common model used in the U.S and Europe – Continuum of Care (CC) or
Linear Residential Treatment (LRT). Within this model, the client gradually improves
their living situation; the steps or actions often begin through contact with an
outreach team, followed by stays in various types of shelter or transitional housing;
the last step is into permanent accommodation. ‘Gaining’ permanent housing is
frequently associated with meeting conditions such as participation in treatment
and demonstrating sobriety. For a client with a psychiatric disorder and substance
abuse dependence, the path to housing is often not straightforward; many fail and
fall into homelessness again. In the Continuum of Care the terms ‘treatment
resistant’ or ‘hard to house’ are used.
PHF started as an alternative to this model, finding that housing is fundamental to
survival and to meeting the basic human needs of refuge and safety. The principles
of Housing First are: housing as a basic human right; respect, warmth and compas-
sion for all clients; a commitment to work with clients as long as they need it;
scatted-site housing; independent apartments; the separation of housing and
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services; consumer choice and self-determination; a recovery orientation; and
harm reduction. The emphasis is on values and the attitudes towards clients.
Chapter 1 goes on to describe these principles in detail.
Chapter 2 covers the initial steps involved in PHF. The target group and require-
ments for joining the programme are described; the client must be long-term
homeless, have a severe mental illness, and show interest in taking part in the
programme – maybe not initially but over time. The client must also fulfil two core
requirements: first, payment of rent – thirty percent of the “monthly income”
should go to rent; and secondly, weekly visits by PHF team member. The chapter
points out that engagement is one of the most important phases of the PHF
programme and first impressions of the programme are very important. Four
principles are emphasized as being behind the success of the programme:
accepting the client’s priority for housing; providing a flexible service; removing
obstacles whenever possible; and taking responsibility for follow-up. While the
general philosophy in working with homeless people is to tell the clients what they
need to do, PHF, in contrast, involves continually asking: “How can I help?”, and
then listening to the answer.
Chapter 3 is about housing and housing support services. The desire for a regular
dwelling is at the top of almost all clients’ priority lists. Approximately 95% have a
preference for a private apartment within the community. This chapter explains
what might be involved in the process of finding the right apartment for the client.
One client said: “I walked around for years without a single key: a key to a car, a key
to a house, a key to anything… I do not think people understand what a key typifies.
It is something that belongs to you. It is something huge” (p.57). Various aspects of
housing are described in the chapter. Difficulties like loneliness are discussed, as
well as questions about having pets. The importance of relationships with landlords
is highlighted, and many practical issues such us handling keys and plumbing
problems are raised. Challenges like health and safety issues, and relationships
with family and children are also discussed briefly, as well as what happens when
clients fail; team members understand that relapses are part of mental illness and
addiction, and sometimes relocation is necessary. The home visit is described in
this chapter as serving many purposes that fall into two areas: housing related
issues and human clinical issues. Home visits provide an opportunity for staff to
get an idea of, and observe the kind of assistance the client requires to maintain
their apartment in the best way. The following is an insightful quote from a staff
member in this regard: “The home visit is the heart and soul of the work we do,
because I think that’s ultimately where you want the change to happen, you know,
in the person’s environment” (p.48).
238 European Journal of Homelessness _ Volume 5, No. 2, Decembe r 2011
Chapter 4 describes the two types of teams that provide treatment and support
services within the Pathways Housing First model. By using the Assertive
Community Treatment (ACT) and the Intensive Case Management (ICM), the same
staff can conduct outreach and provide support for clients living on the street,
assist them in finding and moving into apartments, and then continue to provide
treatment and support until the client graduates from the programme. The ACT
serves people with severe psychiatric disabilities and the ICM serves people with
more moderate disabilities. One of the main challenges is to recruit and train staff
members, and to ensure that they share the human and social justice values on
which the programme is based. In this chapter, information is provided about
practical tools that can be used in daily work, such as the WRAP (Wellness Recover y
Action Plan), which is based on the client’s strength, needs, interests and goals.
Chapters 5 and 6 are about the two models (ACT) and (ICM) used in the context of
the PHF model. These chapters are a detailed manual and explanation of how the
models can best be used in the PHF framework.
Chapter 7 briefly describes a number of evidence-based practice and clinical
interventions. In order to be able to offer the clients the necessary support, other
methods and models than the ACT and the ICM may be used. All of the models
mentioned are based on the same client-driven and human values principles that
are fundamental to the PHF programme. Harm reduction is an important component
of the PHF programme, where the aim is to reduce the negative effects of abuse
and dependence; “The goal in harm reduction is to help the client live a better life,
but is not a permanent solution. Harm reduction is about observing and celebrating
small positive steps and it requires an individualized approach.” Engagement in
treatment is the primary goal of PHF, but staff members do not insist on treatment,
nor do they challenge a client’s point of view. Most PHF clients have dual problems
with mental illness and substance abuse. Integrated dual disorders treatment
(IDDT) is described as the most effective approach to addressing these problems,
while two other well known models are also mentioned in this chapter: the Stages
of Change, and Motivational Interviewing (MI). Chapter 8 is about how to adapt the
PHF programme to ‘your’ community.
The Housing First model has been highlighted as a big success, but it has also been
questioned and criticized. The main issue has been: what is Housing First? The
extremely positive outcomes demonstrated in randomized studies raise questions:
does this positive effect apply to all Housing First programmes? Which compo-
nents or elements should be included in order to achieve such good results? What
groups should be targeted? These questions are not all answered in this book; the
book obviously only deals with the Pathways Housing First programme, and it is
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clear that the target group for the programme is long-term homeless people with
severe mental illness and addiction problems. The book is neither a research report
nor a book on theory, but a manual for a specific programme in the U.S.
In the EU there is an ambition to broaden the term Housing First. The final report
from the European Consensus Conference on Homelessness 2010 suggested the
term ‘Housing Led’, to describe all policy approaches that identify the provision of
stable housing with security of tenure as the initial step in solving homelessness.
“How can I help?” is the main question in the book. Suddenly the perspective is
changed; the client is the expert and the staff assists him/her to achieve the goals.
The programme Pathways Housing First must adapt to the client’s needs and not
the other way round, where the client is supposed to fit into the programme. “How
can I help?” The question is asked again and again. Its strength is in this sentence,
and this particular feeling permeates the entire book; it arouses a desire to partici-
pate in a process of change and provides an excellent description of how such work
can be carried out.
The Housing First programme has sometimes been criticized for being a Housing
Only solution, in that housing will be offered without the individualized support that
is necessary and that also requires a lot of resources. The book shows that tailored
support is crucial for success in the Pathways Housing First programme. Above all,
it is the client’s objectives that guide the entire programme. PHF is impressively
structured and systematized with a number of tools. There is a variety of methods
and programmes mentioned, as well as practical guidelines and checklists on how
the planning can be done with the client in a structured way, and how objectives
are then followed up. However, the most radical aspect of the approach is, as
previously mentioned, that the client’s perspective is the fundamental value that
influences every measure taken. The discussion in the book about ‘failures’ is a
good illustration of these values. It is a fact that clients sometimes relapse and that
relocations are necessary; up to 30% of clients move from their first home, and a
number move two or three times. In these cases, it is vital to have a non-judgmental
attitude and to realize that those who suffer most are the clients; it is essential to
ask continually: “How can I help?”
The fact that this book is written in the U.S. influences its approach. In European
countries, a more moderate mode of expression is generally used, and words like
‘success’ may be considered shallow. However, the book is refreshingly positive.
Anyone who expected a book on theory or a research study might be disappointed;
the analysis has already been done, and the Housing First model is the only solution
to end homelessness. Will this book really make a difference in the fight against
homelessness? Yes; adapted to the situation in different countries it can be an
important source of knowledge and inspiration. Research, evaluation and follow-up
240 European Journal of Homelessness _ Volume 5, No. 2, December 2011
are needed in the European context; a variety of measures are required for different
target groups, and knowledge has to be increased with regard to those differences.
This book is, however, of undoubted use for many categories of staff and researchers
because the necessary components of PHF are well-described. The book can also
play an important role in changing attitudes towards homeless people and the
homelessness problem in general. The biggest challenge for European countries
is to achieve a real change of perspective and to adopt the conviction that ending
homelessness is possible.
Annika Remaeus and Ann Jönsson
Programme Officers,
The National Board of Health and Welfare, Stockholm, Sweden.
... Housing First HF is an approach to ending chronic homelessness for people with mental illness and/or addictions that provides participants with a rent subsidy and support in finding scattered-site housing so that they can obtain the housing of their choice without any preconditions, and clinical treatment and support to achieve their life goals (Tsemberis, 2015). HF is based on four principles: "(a) immediate provision of housing and consumer-driven services, (b) separation of housing and clinical services, (c) providing supports and treatment with a recovery orientation, and (d) an emphasis on promoting community integration" (Aubry et al., 2015, p. 469). ...
... Social relationships are important for HF participants with histories of homelessness, mental illness, and substance use, but past relationships are often plagued with problems and those in HF seek better, more positive relationships (Golembiewski et al., 2017;Padgett et al., 2008). In HF research, social relationships are often framed in terms of community integration (Tsemberis, 2015) or social networks (Golembiewski et al., 2017). ...
... All HF participants had access to rent supplements to ensure that their housing costs were no greater than 30% of their income (Goering et al., 2011). Service provision was based on the pathways HF model (Tsemberis, 2015), where assertive community treatment (ACT) teams supported people with high needs, and Intensive Case Management (ICM) was provided for people with moderate needs (Goering et al., 2011). In Winnipeg, one ACT program and two ICM programs were adapted for Indigenous participants (DeVerteuil & Wilson, 2010;Distasio et al., 2019). ...
Objective: To examine the impacts of Housing First (HF) on parent-child relationships for Indigenous and non-Indigenous parents experiencing homelessness and mental illness. Method: Data on parent-child relationships were obtained through baseline and 18-month narrative interviews with parents (N = 43). Participants were randomly assigned to HF (N = 27) or treatment as usual (TAU; N = 16). Parent-child relationship changes were coded as positive or no change. Comparisons between HF and TAU groups were examined for Indigenous parents (N = 21) and non-Indigenous parents (N = 22). Results: Parents in HF reported more positive changes, proportionally, in their relationships with their children, when compared with parents in the TAU group. Among Indigenous parents, proportionally more in HF (eight of 13 parents) reported positive changes in their relationships with their children, compared with those in TAU (one of eight parents). For non-Indigenous parents, however, those in HF (five of 14 parents) reported proportionally similar positive changes in relationships with their children to those in TAU (two of eight parents). Narratives of Indigenous parents in HF showed that they made considerable progress over 18 months in reconciling with their children. Conclusions and implications for practice: Findings underscore the potential of HF to promote positive parent-child relationships. For Indigenous parents, HF programs that are designed, implemented, and staffed by Indigenous service-providers; guided by Indigenous worldviews; and employ culturally relevant and culturally safe practices are exemplars for understanding how HF programs can be adapted to positively impact parent-child relationships. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
... Housing First is an approach that takes housing as a human right and prioritises agency in determining what treatments are attempted. (Tsemberis, 2011) This study does not challenge the inherent virtues of Housing First to end homelessness (Waegemakers Schiff & Schiff, 2014). Nor does this study endorse the transitional housing model per se. ...
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This study set out to investigate the psychosocial impact of homelessness and homelessness services on one's own wellbeing. Homelessness is associated with higher levels of psychological distress, on average, approximately, 1.2 on a scale from 0 to 24, ceteris paribus. This result is likely an underestimate. In terms of homelessness services, the results indicate that facing difficulties with welfare services is associated with higher levels of psychological distress. Further, the results indicate that for homeless people, legal services are uniquely associated with a certain degree of psychological burden. Furthermore, using financial services for people experiencing homeless, corresponds to a substantial reduction in psychological distress equivalent to an approximately one-unit change in psychological distress on a scale of 0 to 24. Further research is needed on what homelessness means for people's social networks and correspondingly, what social networks mean for the wellbeing of people experiencing homelessness.
... In response to the need for more affordable and accessible housing, there are a range of housing models that have been developed to address homelessness. Housing First has demonstrated effectiveness in increasing housing stability for people experiencing homelessness, especially those with mental health and substance use diagnoses in North America (Aubry et al., 2015;Tsai, 2020;Tsemberis, 2010). Despite the positive outcomes found from Housing First, communities continue to struggle with having enough affordable housing stock and often lack resources to fully implement the model and provide the intensity of support that can make the housing transition successful. ...
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The identified prevalence of cognitive impairment in people experiencing homelessness has placed a focus on the use of measures of cognition to predict functioning and ability to move successfully into housing. Functional cognition is the cognitive ability to perform daily life tasks, incorporating cognitive functioning, performance skills, and patterns. Given the increased research on cognitive status and functional skills within people experiencing homelessness, a scoping review was conducted to synthesize the existing literature and identify how functional cognition is evaluated in this population, and identify implications for homeless and housing services. This scoping review was conducted using the Joanna Briggs Institute protocol. Included studies assessed functional cognition, or assessed a component of cognition and related it to functional performance. Of 8,848 articles retrieved from the initial search, thirty-seven articles were determined to meet the inclusion criteria for data extraction. Categories for data extraction included functional domain addressed, tools used for assessment of cognition and/or function, and how reported outcomes were interpreted. Narrative analysis identified domains of cognition and function assessed, and relationships between cognition and function domains. Only the functional domain of Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) were found to have a consistent relationship between cognition and performance and primarily when performance-based assessments were used. Challenges with generalizing study findings broadly include: study populations do not reflect demographics of those experiencing homelessness; a variety of assessment tools for cognition and function are utilized; and the broad use of the term function encompasses several different areas of independent living in the community. Several studies identified that even with the presence of decreased cognition, those with the experience of homelessness are able to maintain housing when given individualized and appropriate supports. This scoping review indicates inconsistent methods to assess cognition and functional cognition within people experiencing homelessness. Performance-based assessments of ADL/IADL are more likely to identify the impact of cognition on function, while neurocognitive assessments are more beneficial to assess social/community integration. Findings indicate that to support the transition from homelessness to housing and increase the likelihood of housing stability; assessments should focus on identifying strengths and necessary/individualized ongoing supports.
... Fourth, screening and assessment tools were described or used for specific types of high-risk behaviours and challenges in four studies. Despite the dearth of research on risk assessment instruments, clinical assessment is a core component of PSH service delivery, which may include an examination of risk-related behaviours [81,82]. More investigation is warranted into the risk assessment tools currently being used to assess high-risk behaviours and challenges in PSH, and the comprehensiveness and effectiveness of these instruments. ...
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Permanent supportive housing is an effective intervention for stably housing most people experiencing homelessness and mental illness who have complex support needs. However, high-risk behaviours and challenges are prevalent among this population and have the potential to seriously harm health and threaten housing tenures. Yet, the research on the relationship between high-risk issues and housing stability in permanent supportive housing has not been previously synthesized. This rapid review aimed to identify the housing-related outcomes of high-risk behaviours and challenges in permanent supportive housing settings, as well as the approaches used by agencies and residents to address them. A range of high-risk behaviours and challenges were examined, including risks to self (overdose, suicide/suicide attempts, non-suicidal self-injury, falls/fall-related injuries), and risks to multiple parties and/or building (fire-setting/arson, hoarding, apartment takeovers, physical/sexual violence, property damage, drug selling, sex trafficking). The search strategy included four components to identify relevant academic and grey literature: (1) searches of MEDLINE, APA PsycINFO, and CINAHL Plus; (2) hand searches of three journals with aims specific to housing and homelessness; (3) website browsing/searching of seven homelessness, supportive housing, and mental health agencies and networks; and (4) Advanced Google searches. A total of 32 articles were eligible and included in the review. Six studies examined the impacts of high-risk behaviours and challenges on housing tenancies, with overdose being identified as a notable cause of death. Twenty-six studies examined approaches and barriers to managing high-risk behaviours and challenges in PSH programs. These were categorized into eight types of approaches: (1) clinical, (2) relational/educational, (3) surveillant, (4) restrictive, (5) strategic, (6) design-based, (7) legal, and (8) self-defence. Consistent across all approaches was a lack of rigorous examination of their effectiveness. Further, some approaches that are legal, restrictive, surveillant, or strategic in nature may be used to promote safety, but may conflict with other program objectives, including housing stability, or resident empowerment and choice. Research priorities were identified to address the key evidence gaps and move toward best practices for preventing and managing high-risk behaviours and challenges in permanent supportive housing.
... Housing First (HF) is a person-centred philosophy of practice which emphasizes that individuals are housing ready from the moment that they are born, and do not need to prove their ability to be "housing ready" prior to being offered permanent housing [4]. HF emerged out of criticisms of the "treatment first" or "staircase model" approach, which emphasized the treatment of mental health and substance use challenges before an individual could be regarded as "housing ready." ...
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Date Presented 04/19/2023 A growing number of OTs are involved in research and practice with persons who experience homelessness. To support OT research and practice in this area, our team developed the Bridging the Transition Framework (BTTF). This workshop will provide an overview of the BTTF and its various components and engage attendees in activities that illustrate ways of using the BTTF in research and practice using videos conducted with persons with lived experience. Primary Author and Speaker: Carrie Anne Marshall Additional Authors and Speakers: Rebecca Gewurtz, Skye Pamela Barbic, Patti Y. Plett, Corinna Easton, Abrial Cooke
This chapter provides a brief introduction to the relational dynamics underlying ‘multiple exclusion homelessness’ and an approach to working in this area. Adults experiencing multiple exclusion homelessness have often, during their developmental years, experienced multiple homes, disrupted attachments, un-forecasted endings, multiple and short-lived figures of support – all experiences that can lead a person to develop an understandable anxiety about trusting anyone to remain stable in their life. These dynamics may inadvertently be recreated in the person’s adult life through the impermanency of different organisations they are involved with. Multiple exclusion homelessness can be understood as a late emerging symptom of underlying difficulties in someone’s relationships with care. A psychologically informed approach for staff working in the homeless sector is outlined. The staff-service user relationship, while often viewed as important within mainstream services, is commonly seen as a vehicle through which treatments can be completed rather than as the treatment itself. By contrast, a psychologically informed service for people experiencing multiple exclusion homelessness understands that the reverse is often more accurate: that the tasks and activities are really just the vehicle through which a relationship can develop that carries the possibility of developing a sense of safety, trust, and continuity.
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Despite Canada’s commitment to several international human rights instruments recognizing the right to housing, homelessness remains widespread nationwide. Informed by critical political economy theory and critical discourse studies, we examined relevant literature focusing on homelessness policy-related documents in the Canadian context. The findings demonstrate interrelated homelessness policy discourses: 1) emergency shelters, 2) housing first, 3) social determinants of health, 4) human rights, and 5) political economy approach. We conclude that a critical political economy approach offers the most helpful way of understanding and responding to the homelessness crisis in Canada. Homelessness is a socioeconomic and political problem requiring nurses and health professionals to take sociopolitical actions. As nurses and health justice advocates, we stand in solidarity with labour movements to protect public health. This study can be adopted in local, national, and global settings.
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Importance: Intimate partner violence (IPV) is a leading cause of homelessness and a serious threat to public health and well-being. Objective: To determine whether the Domestic Violence Housing First (DVHF) model improves safety, housing stability, and mental health over 2 years. Design, setting, and participants: This longitudinal comparative effectiveness study interviewed IPV survivors and reviewed their agency records. All unstably housed or homeless IPV survivors entering domestic violence (DV) services were eligible to participate in the study, ensuring capture of typical variability in service delivery (eg, some survivors would enter services when agencies had the capacity to provide DVHF and others would receive services as usual [SAU]). Clients from 5 DV agencies (3 rural and 2 urban) referred by agency staff in a Pacific Northwest state of the United States were assessed between July 17, 2017, and July 16, 2021. Interviews were conducted in English or Spanish at entry into services (baseline) and at 6-, 12-, 18-, and 24-month follow-up visits. The DVHF model was compared with SAU. The baseline sample included 406 survivors (92.7% of 438 eligible). Of the 375 participants retained at the 6-month follow-up (92.4% retention), 344 had received services and had complete data across all outcomes. Three hundred sixty-three participants (89.4%) were retained at the 24-month follow-up. Intervention: The DVHF model has 2 components: housing-inclusive advocacy and flexible funding. Main outcomes and measures: Main outcomes included housing stability, safety, and mental health, which were assessed using standardized measures. Results: Of the 344 participants (mean [SD] age, 34.6 [9.0] years) included in the analyses, 219 (63.7%) received DVHF and 125 (36.3%) received SAU. Most participants identified as female (334 [97.1%]) and heterosexual (299 [86.9%]). Two hundred twenty-one participants (64.2%) were from a racial and ethnic minority group. Longitudinal linear mixed-effects models showed that receiving SAU was associated with greater housing instability (mean difference, 0.78 [95% CI, 0.42-1.14]), DV exposure (mean difference, 0.15 [95% CI, 0.05-0.26]), depression (mean difference, 1.35 [95% CI, 0.27-2.43]), anxiety (mean difference, 1.15 [95% CI, 0.11-2.19]), and posttraumatic stress disorder (mean difference, 0.54 [95% CI, 0.04-1.04]) compared with receiving the DVHF model. Conclusions and relevance: Evidence in this comparative effectiveness study suggests that the DVHF model was more effective than SAU in improving the housing stability, safety, and mental health of survivors of IPV. The DVHF's amelioration of all of these interconnected public health issues-relatively quickly and with long-term continuance-will be of substantial interest to DV agencies and others working to support unstably housed IPV survivors.
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Homelessness and poverty are significant challenges facing Greater Port Harcourt City in Nigeria. This paper discusses these issues and proposes a solution through the development of an inclusive and sustainable agropolitan residential housing project. The project aims to provide affordable housing for young unmarried, newly married, and married individuals with young children, falling within the income groups of 'No income,' 'Low Income,' and 'Lower Medium Income' as defined by the 2012 National Housing Policy Document (NHPD) of Nigeria. It will create sustainable, mainly agro-based livelihoods through integrated farming and other activities, such as real estate, power generation, waste management, and recycling. This will enable beneficiaries to take care of their housing and other needs while generating employment and revenue. The proposed housing project aligns with the Greater Port Harcourt City Master Plan and will complement the city's proposed beautiful townscape. The paper concludes that eradicating homelessness and improving the living standards of the poorest in Greater Port Harcourt City requires sustainable and inclusive housing solutions that provide access to employment and income-generating activities. A comprehensive and collaborative approach involving various stakeholders such as the government, private sector, and non-profit organizations is necessary to address this complex issue.
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