Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature
Abstract Background Housing First is an evidence-based practice intended to serve chronically homeless individuals with co-occurring serious mental illness and substance use disorders. Despite housing active substance users, harm reduction is an often-overlooked element during the Housing First impl...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12954-017-0158-x |
| _version_ | 1818419056897687552 |
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| author | Dennis P. Watson Valery Shuman James Kowalsky Elizabeth Golembiewski Molly Brown |
| author_facet | Dennis P. Watson Valery Shuman James Kowalsky Elizabeth Golembiewski Molly Brown |
| author_sort | Dennis P. Watson |
| collection | DOAJ |
| description | Abstract Background Housing First is an evidence-based practice intended to serve chronically homeless individuals with co-occurring serious mental illness and substance use disorders. Despite housing active substance users, harm reduction is an often-overlooked element during the Housing First implementation process in real-world settings. In this paper, we explore the representation of the Housing First model within the open-access scholarly literature as a potential contributing factor for this oversight. Methods We conducted a rapid review of the US and Canadian open-access Housing First literature. We followed a document analysis approach, to form an interpretation of the articles’ content related to our primary research questions. Results A total of 55 articles on Housing First were included in the final analysis. Only 21 of these articles (38.1%) included explicit mention of harm reduction. Of the 34 articles that did not discuss harm reduction, 22 provided a description of the Housing First model indicating it does not require abstinence from substance use; however, descriptions did not all clearly indicate abstinence was not required beyond program entry. Additional Housing First descriptions focused on the low-barrier entry criteria and/or the intervention’s client-centeredness. Conclusions Our review demonstrated a lack of both explicit mention and informed discussion of harm reduction in the Housing First literature, which is likely contributing to the Housing First research-practice gap to some degree. Future Housing First literature should accurately explain the role of harm reduction when discussing it in the context of Housing First programming, and public agencies promoting Housing First uptake should provide resources for proper implementation and monitor program fidelity to prevent model drift. |
| first_indexed | 2024-12-14T12:32:31Z |
| format | Article |
| id | doaj.art-28a58370fca34398a5fdf9dc98d0fad0 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-12-14T12:32:31Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-28a58370fca34398a5fdf9dc98d0fad02022-12-21T23:01:08ZengBMCHarm Reduction Journal1477-75172017-05-0114111310.1186/s12954-017-0158-xHousing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literatureDennis P. Watson0Valery Shuman1James Kowalsky2Elizabeth Golembiewski3Molly Brown4Department of Social and Behavioral Sciences, Indiana University Fairbanks School of Public HealthHeartland Health Outreach, Midwest Harm Reduction InstituteHeartland Health Outreach, Midwest Harm Reduction InstituteDepartment of Health Policy and Management, Indiana University Fairbanks School of Public HealthDepartment of Psychology, DePaul UniversityAbstract Background Housing First is an evidence-based practice intended to serve chronically homeless individuals with co-occurring serious mental illness and substance use disorders. Despite housing active substance users, harm reduction is an often-overlooked element during the Housing First implementation process in real-world settings. In this paper, we explore the representation of the Housing First model within the open-access scholarly literature as a potential contributing factor for this oversight. Methods We conducted a rapid review of the US and Canadian open-access Housing First literature. We followed a document analysis approach, to form an interpretation of the articles’ content related to our primary research questions. Results A total of 55 articles on Housing First were included in the final analysis. Only 21 of these articles (38.1%) included explicit mention of harm reduction. Of the 34 articles that did not discuss harm reduction, 22 provided a description of the Housing First model indicating it does not require abstinence from substance use; however, descriptions did not all clearly indicate abstinence was not required beyond program entry. Additional Housing First descriptions focused on the low-barrier entry criteria and/or the intervention’s client-centeredness. Conclusions Our review demonstrated a lack of both explicit mention and informed discussion of harm reduction in the Housing First literature, which is likely contributing to the Housing First research-practice gap to some degree. Future Housing First literature should accurately explain the role of harm reduction when discussing it in the context of Housing First programming, and public agencies promoting Housing First uptake should provide resources for proper implementation and monitor program fidelity to prevent model drift.http://link.springer.com/article/10.1186/s12954-017-0158-xHarm reductionHousing FirstRapid reviewDocument analysisHousingSubstance use |
| spellingShingle | Dennis P. Watson Valery Shuman James Kowalsky Elizabeth Golembiewski Molly Brown Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature Harm Reduction Journal Harm reduction Housing First Rapid review Document analysis Housing Substance use |
| title | Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature |
| title_full | Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature |
| title_fullStr | Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature |
| title_full_unstemmed | Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature |
| title_short | Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature |
| title_sort | housing first and harm reduction a rapid review and document analysis of the us and canadian open access literature |
| topic | Harm reduction Housing First Rapid review Document analysis Housing Substance use |
| url | http://link.springer.com/article/10.1186/s12954-017-0158-x |
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