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Vancouver at home study: housing first plus assertive community treatment versus congregate housing plus supports versus treatment as usual
DOI 10.1186/ISRCTN57595077
ClinicalTrials.gov identifier
EudraCT number
Public title Vancouver at home study: housing first plus assertive community treatment versus congregate housing plus supports versus treatment as usual
Scientific title Research demonstration project on homelessness and mental health– Vancouver BC
Acronym N/A
Serial number at source N/A
Study hypothesis Individuals assigned to either Housing First plus Assertive Community Treatment or those assigned to Congregate Housing plus Supports will have superior outcomes (i.e., health, quality of life, housing stability, emergency service use, justice system contacts) than individuals assigned to treatment as usual.
Lay summary Lay summary under review 2
Ethics approval 1. Research Ethics Board at Simon Fraser University (primary site), 22 June 2009
2. University of British Columbia: 28 July 2009
3. Providence Healthcare: 30 August 2011
4. Vancouver Coastal Health Research Institute approval pending
Study design Randomized controlled trial
Countries of recruitment Canada
Disease/condition/study domain Homelessness, precarious housing, mental illness
Participants - inclusion criteria 1. Legal adult status (19 years of age or over)
2. Presence of a current mental disorder, and
3. Being absolutely homeless or precariously housed.
3.1. Absolute homelessness was defined as living on the streets or in a shelter for at least two weeks
during the past year.
3.2. Precariously housed was defined as living in a rooming house, hotel or other form of transitional housing with at least one episode of absolute homelessness in the past year.
Participants - exclusion criteria Does not meet inclusion criteria
Anticipated start date 15/10/2010
Anticipated end date 31/12/2013
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 500
Interventions 300 people who are both homeless and mentally ill randomized to 1of 3 conditions:
1. Housing First (HF) + Assertive Community Treatment
2. Congregate Housing + Supports
3. Treatment as usual (TAU)

Housing First (Tsemberis & Eisenberg, 2000) offers homeless people with mental illness immediate access to independent apartments with a market lease, without any requirements around sobriety or engagement in treatment. Housing First participants are provided access to an array of treatment and social services, but they retain the right to choose their level of participation.

Assertive Community Treatment consists of a multi-disciplinary health and social service team working 24 hours a day, 7
days a week with a case load ranging from 50 to 100 clients. The team responds directly to most of their clients community based care needs.

Congregate Housing with Supports differs from HF by locating individuals in the same building rather than promoting housing in “scattered sites” where individuals are neighbored by the full diversity of people living in market housing. The supports associated with Congregate Housing in the present study are comparable in intensity (i.e., budget and composition) to those of the Assertive Community Treatment team. However, in the congregate condition these supports are provided on site while the ACT team visits clients in their scattered apartments.
Primary outcome measure(s) 1. Service use changes drawn from administrative data concerning healthcare, social services, and justice system events.
2. Costs related to these events in relation to costs of providing services.
Sources of data for these measures are the government departments responsible for health, justice, and social welfare services. Data will be collected pending participant consent for access. Data will be requested for several years prior to participant enrollment in the Vancouver At Home Study, and will be refreshed following the completion of the 24-month study period in order to monitor longer-term changes in the level and type of service use associated with participants in the years following the completion of the study.
Secondary outcome measure(s) Numerous questionnaires and additional cross-sectional sources of data include qualitative interviews and physical health examinations with subsets of the total study cohort. These additional measures are gathered to characterize the sample and better understand participant experiences but they are not considered outcome measures.
Sources of funding Mental Health Commission of Canada (Canada)
Trial website
Publications 2013 results in: http://www.ncbi.nlm.nih.gov/pubmed/24023796
2013 results in: http://www.ncbi.nlm.nih.gov/pubmed/24176253
Contact name Dr  Julian  Somers
  Address Simon Fraser University
8888 University Drive
  City/town Burnaby
  Zip/Postcode V5A 1S6
  Country Canada
  Tel +1 778 782-5049
  Email jsomers@sfu.ca
Sponsor Mental Health Commission of Canada (Canada)
  Address 10301 Southport Lane
SW Suite 800
  City/town Calgary
  Zip/Postcode T2W 1S7
  Country Canada
  Tel +1 613 683-3755
  Fax +1 613-798-2989
  Email info@mentalhealthcommission.ca
  Sponsor website: http://www.mentalhealthcommission.ca
Date applied 07/08/2012
Last edited 04/11/2013
Date ISRCTN assigned 09/10/2012
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