This Campbell systematic review examines the effectiveness of interventions to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless. Forty‐three studies were included in the review, 37 of which are from the USA.
Included interventions perform better than the usual services at reducing homelessness or improving housing stability in all comparisons. These interventions are:
High intensity case management
Housing First
Critical time intervention
Abstinence‐contingent housing
Non‐abstinence‐contingent housing with high intensity case management
Housing vouchers
Residential treatment
These interventions seem to have similar beneficial effects, so it is unclear which of these is best with respect to reducing homelessness and increasing housing stability.
Plain Language Summary
Interventions to reduce homelessness and improve housing stability are effectiveThere are large numbers of homeless people around the world. Interventions to address homelessness seem to be effective, though better quality evidence is required.
What is this review about?There are large numbers of homeless people around the world. Recent estimates are over 500,000 people in the USA, 100,000 in Australia and 30,000 in Sweden. Efforts to combat homelessness have been made on national levels as well as at local government levels.This review assesses the effectiveness of interventions combining housing and case management as a means to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless.
What studies are included?Included studies were randomized controlled trials of interventions for individuals who were already, or at‐risk of becoming, homeless, and which measured impact on homelessness or housing stability with follow‐up of at least one year.A total of 43 studies were included. The majority of the studies (37) were conducted in the United States, with three from the United Kingdom and one each from Australia, Canada, and Denmark.
What are the main findings of this review?Included interventions perform better than the usual services at reducing homelessness or improving housing stability in all comparisons. These interventions are:
High intensity case management
Housing First
Critical time intervention
Abstinence‐contingent housing
Non‐abstinence‐contingent housing with high intensity case management
Housing vouchers
Residential treatment
These interventions seem to have similar beneficial effects, so it is unclear which of these is best with respect to reducing homelessness and increasing housing stability.
What do the findings of this review mean?A range of housing programs and case management interventions appear to reduce homelessness and improve housing stability, compared to usual services.However, there is uncertainty in this finding as most the studies have risk of bias due to poor reporting, lack of blinding, or poor randomization or allocation concealment of participants. In addition to the general need...