Housing First (HF) is an effective intervention for reducing homelessness and service utilization among vulnerable adults and is most often focused on individuals experiencing chronic homelessness. This study explored the effectiveness of a single‐site HF program for 2 groups of people with serious mental illness: those experiencing chronic street homelessness, and those whose homelessness was limited but had high psychiatric service needs, often experiencing multiple hospitalizations or residential treatment. A sample of 91 HF and 91 matched usual care comparison participants were obtained from administrative records. Those in HF spent significantly less time homeless and psychiatrically hospitalized compared to usual care. Ninety percent of HF residents were housed after 1 year compared to 35% of the comparison group.
Homelessness and hospitalization outcomes were unrelated to homelessness history. This study provides initial evidence for HF's effectiveness for promoting community stability among a population previously requiring a high level of intensive psychiatric care.