Community participation and belonging among formerly homeless adults with mental illness after 12 months of Housing First in Vancouver, British Columbia: a randomized controlled trial.

This study examines community integration among homeless adults with mental illness 6 and 12 months after random assignment to Housing First (independent apartments or congregate residence) with support services or to treatment as usual (TAU). Residence in independent apartments was associated with increased 'psychological integration' for participants with less severe needs; however, no significant improvement in 'physical integration' was observed among any of the intervention groups. Analysis of individual items on the Psychological Integration subscale revealed that, compared to TAU, participants assigned to independent apartments were more likely to endorse statements related to the emotional components of community but not statements related to neighboring. Participants assigned to the congregate residence were more likely to endorse knowing their neighbors, but not interacting with neighbors or the emotional components of community. Findings are discussed in terms of housing program as well as broader contextual factors.