An Interesting Argument on Housing First Interventions for Homeless People

We have reported previously on ‘Housing First’ interventions for homeless people.[1] ‘Housing first’ means that a person is given secure accommodation as a first step towards rehabilitation; detoxification, improved nutrition, and help in finding a job can come later. Before and after studies showed that ‘housing first’ interventions are cost-saving, but high quality RCTs show that they are at best cost-neutral. Before and after studies, of course, suffer from biases, such as regression to the mean (a form of bias discussed in a recent News Blog). However, a powerful article in the New England Journal of Medicine [2] argues that ‘Housing First’ is still a fine intervention and cost-effective, even at RCT estimates of effectiveness. Even if ‘Housing First’ is not cost-releasing it is much more cost-effective than many widely used therapeutic interventions. The CLAHRC WM Director is persuaded by the argument, and remains a fan of ‘Housing First’ interventions.

— Richard Lilford, CLAHRC WM Director


  1. Lilford RJ. Health of the Homeless and Inclusive Health Services. NIHR CLAHRC West Midlands News Blog. September 11, 2015.
  2. Kertesz SG, Baggett TP, O’Connell JJ, Buck DS, Kushel MB. Permanent Supportive Housing for Homeless People – Reframing the Debate. N Engl J Med. 2016; 375(22): 2115-7.

One thought on “An Interesting Argument on Housing First Interventions for Homeless People”

  1. In the UK some of the immediate impact of providing housing to the homeless is that it provides the recipient with an address. This enables access to both benefits and employers (and also easier access to primary healthcare).

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s