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Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders.

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Title: Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders.
Authors: Aquin, Joshua P. (AUTHOR), Roos, Leslie E. (AUTHOR), Distasio, Jino (AUTHOR), Katz, Laurence Y. (AUTHOR), Bourque, Jimmy (AUTHOR), Bolton, James M. (AUTHOR), Bolton, Shay-Lee (AUTHOR), Wong, Jacquelyne Y. (AUTHOR), Chateau, Dan (AUTHOR), Somers, Julian M. (AUTHOR), Enns, Murray W. (AUTHOR), Hwang, Stephen W. (AUTHOR), Frankish, James C. (AUTHOR), Sareen, Jitender (AUTHOR), At Home/Chez Soi Investigators (CORPORATE AUTHOR)
Source: Canadian Journal of Psychiatry. Jul2017, Vol. 62 Issue 7, p473-481. 9p. 1 Diagram, 4 Charts.
Subjects: Homelessness, Suicidal behavior, Homeless persons, Services for people with mental illness, Mental health services for homeless people, People with mental illness, Suicide prevention, Mental health, Government policy, Rehabilitation of people with mental illness, Public housing, Statistical sampling, Randomized controlled trials, Social services case management, Suicidal ideation
Geographic Terms: Canada
Abstract (English): Objective: This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour.Method: The At Home/Chez Soi project is an unblinded, randomised control trial conducted across 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, Moncton) from 2009 to 2013. Homeless adults with a diagnosed major mental health disorder were recruited through community agencies and randomised to HF ( n = 1265) and TAU ( n = 990). HF participants were provided with private housing units and received case management support services. TAU participants retained access to existing community supports. Past-month suicidal ideation was measured at baseline and 6, 12, 18, and 21/24 months. A history of suicide attempts was measured at baseline and the 21/24-month follow-up.Results: Compared to baseline, there was an overall trend of decreased past-month suicidal ideation (estimate = -.57, SE = .05, P < 0.001), with no effect of treatment group (i.e., HF vs. TAU; estimate = -.04, SE = .06, P = 0.51). Furthermore, there was no effect of treatment status (estimate = -.10, SE = .16, P = 0.52) on prevalence of suicide attempts (HF = 11.9%, TAU = 10.5%) during the 2-year follow-up period.Conclusion: This study failed to find evidence that HF is superior to TAU in reducing suicidal ideation and attempts. We suggest that HF interventions consider supplemental psychological treatments that have proven efficacy in reducing suicidal behaviour. It remains to be determined what kind of suicide prevention interventions (if any) are specifically effective in further reducing suicidal risk in a housing-first intervention. [ABSTRACT FROM AUTHOR]
Abstract (French): Objectif: Cette étude tentait de déterminer si l’approche Logement d’abord (LD) a diminué l’idéation suicidaire et les tentatives de suicide comparativement au Traitement habituel (TH) chez les personnes sans abri souffrant de troubles mentaux, une population ayant manifestement un risque élevé de comportement suicidaire. Méthode: Le projet At Home/Chez Soi est un essai randomisé contrôlé sans insu mené dans 5 villes canadiennes (Vancouver, Winnipeg, Toronto, Montréal, Moncton) de 2009 à 2013. Des adultes sans abri ayant reçu un diagnostic de trouble de santé mentale majeur ont été recrutés dans des organismes communautaires et randomisés à Logement d’abord (n = 1265) et au Traitement habituel (n = 990). Les participants à Logement d’abord ont reçu un logement privé et des services de soutien de la gestion des cas. Les participants au Traitement habituel ont conservé l’accès aux soutiens communautaires existants. L’idéation suicidaire du mois précédent a été mesurée au départ, puis à 6, 12, 18, et 21 mois sur 24. Les antécédents de tentatives de suicide ont été mesurés au départ puis au suivi de 21 mois sur 24. Résultats: Comparativement au départ, il y a eu une tendance générale à la diminution de l’idéation suicidaire du mois précédent (Estimation = –0,57; ET = 0,05; p < 0,001), sans effet du groupe de traitement (c.-à-d., Logement d’abord contre Traitement habituel; Estimation = –0,04; ET = 0,06; p = 0,51). En outre, il n’y avait pas d’effet du type de traitement (Estimation = –0,10; ET = 0,16, p = 0,52) sur la prévalence des tentatives de suicide (LD = 11,9 %, TH = 10,5 %) durant le suivi de deux ans. Conclusion: Cette étude n’a pas réussi à prouver que l’approche Logement d’abord est supérieure au Traitement habituel pour réduire l’idéation suicidaire et les tentatives de suicide. Nous suggérons que les interventions de Logement d’abord envisagent des traitements psychologiques supplémentaires qui se sont révélés efficaces pour réduire le comportement suicidaire. Il reste à déterminer quel type d’interventions de prévention du suicide (le cas échéant) sont particulièrement efficaces pour réduire davantage le risque de suicide dans une intervention de Logement d’abord. [ABSTRACT FROM AUTHOR]
Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Canadian+Journal+of+Psychiatry%22&quot;&gt;Canadian Journal of Psychiatry&lt;/searchLink&gt;. Jul2017, Vol. 62 Issue 7, p473-481. 9p. 1 Diagram, 4 Charts.
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  Data: &lt;bold&gt;Objective: &lt;/bold&gt;This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour.&lt;bold&gt;Method: &lt;/bold&gt;The At Home/Chez Soi project is an unblinded, randomised control trial conducted across 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, Moncton) from 2009 to 2013. Homeless adults with a diagnosed major mental health disorder were recruited through community agencies and randomised to HF ( n = 1265) and TAU ( n = 990). HF participants were provided with private housing units and received case management support services. TAU participants retained access to existing community supports. Past-month suicidal ideation was measured at baseline and 6, 12, 18, and 21/24 months. A history of suicide attempts was measured at baseline and the 21/24-month follow-up.&lt;bold&gt;Results: &lt;/bold&gt;Compared to baseline, there was an overall trend of decreased past-month suicidal ideation (estimate = -.57, SE = .05, P &lt; 0.001), with no effect of treatment group (i.e., HF vs. TAU; estimate = -.04, SE = .06, P = 0.51). Furthermore, there was no effect of treatment status (estimate = -.10, SE = .16, P = 0.52) on prevalence of suicide attempts (HF = 11.9%, TAU = 10.5%) during the 2-year follow-up period.&lt;bold&gt;Conclusion: &lt;/bold&gt;This study failed to find evidence that HF is superior to TAU in reducing suicidal ideation and attempts. We suggest that HF interventions consider supplemental psychological treatments that have proven efficacy in reducing suicidal behaviour. It remains to be determined what kind of suicide prevention interventions (if any) are specifically effective in further reducing suicidal risk in a housing-first intervention. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (French)
  Group: Ab
  Data: Objectif: Cette &#233;tude tentait de d&#233;terminer si l’approche Logement d’abord (LD) a diminu&#233; l’id&#233;ation suicidaire et les tentatives de suicide comparativement au Traitement habituel (TH) chez les personnes sans abri souffrant de troubles mentaux, une population ayant manifestement un risque &#233;lev&#233; de comportement suicidaire. M&#233;thode: Le projet At Home/Chez Soi est un essai randomis&#233; contr&#244;l&#233; sans insu men&#233; dans 5 villes canadiennes (Vancouver, Winnipeg, Toronto, Montr&#233;al, Moncton) de 2009 &#224; 2013. Des adultes sans abri ayant re&#231;u un diagnostic de trouble de sant&#233; mentale majeur ont &#233;t&#233; recrut&#233;s dans des organismes communautaires et randomis&#233;s &#224; Logement d’abord (n = 1265) et au Traitement habituel (n = 990). Les participants &#224; Logement d’abord ont re&#231;u un logement priv&#233; et des services de soutien de la gestion des cas. Les participants au Traitement habituel ont conserv&#233; l’acc&#232;s aux soutiens communautaires existants. L’id&#233;ation suicidaire du mois pr&#233;c&#233;dent a &#233;t&#233; mesur&#233;e au d&#233;part, puis &#224; 6, 12, 18, et 21 mois sur 24. Les ant&#233;c&#233;dents de tentatives de suicide ont &#233;t&#233; mesur&#233;s au d&#233;part puis au suivi de 21 mois sur 24. R&#233;sultats: Comparativement au d&#233;part, il y a eu une tendance g&#233;n&#233;rale &#224; la diminution de l’id&#233;ation suicidaire du mois pr&#233;c&#233;dent (Estimation = –0,57; ET = 0,05; p &lt; 0,001), sans effet du groupe de traitement (c.-&#224;-d., Logement d’abord contre Traitement habituel; Estimation = –0,04; ET = 0,06; p = 0,51). En outre, il n’y avait pas d’effet du type de traitement (Estimation = –0,10; ET = 0,16, p = 0,52) sur la pr&#233;valence des tentatives de suicide (LD = 11,9 %, TH = 10,5 %) durant le suivi de deux ans. Conclusion: Cette &#233;tude n’a pas r&#233;ussi &#224; prouver que l’approche Logement d’abord est sup&#233;rieure au Traitement habituel pour r&#233;duire l’id&#233;ation suicidaire et les tentatives de suicide. Nous sugg&#233;rons que les interventions de Logement d’abord envisagent des traitements psychologiques suppl&#233;mentaires qui se sont r&#233;v&#233;l&#233;s efficaces pour r&#233;duire le comportement suicidaire. Il reste &#224; d&#233;terminer quel type d’interventions de pr&#233;vention du suicide (le cas &#233;ch&#233;ant) sont particuli&#232;rement efficaces pour r&#233;duire davantage le risque de suicide dans une intervention de Logement d’abord. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1177/0706743717694836
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 9
        StartPage: 473
    Subjects:
      – SubjectFull: Homelessness
        Type: general
      – SubjectFull: Suicidal behavior
        Type: general
      – SubjectFull: Homeless persons
        Type: general
      – SubjectFull: Services for people with mental illness
        Type: general
      – SubjectFull: Mental health services for homeless people
        Type: general
      – SubjectFull: People with mental illness
        Type: general
      – SubjectFull: Suicide prevention
        Type: general
      – SubjectFull: Mental health
        Type: general
      – SubjectFull: Government policy
        Type: general
      – SubjectFull: Rehabilitation of people with mental illness
        Type: general
      – SubjectFull: Public housing
        Type: general
      – SubjectFull: Statistical sampling
        Type: general
      – SubjectFull: Randomized controlled trials
        Type: general
      – SubjectFull: Social services case management
        Type: general
      – SubjectFull: Suicidal ideation
        Type: general
      – SubjectFull: Canada
        Type: general
    Titles:
      – TitleFull: Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders.
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              Text: Jul2017
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