Individual and process factors influencing user’s satisfaction with Housing First services

Abstract

Abstract Objectives Housing First models aim to give homeless with severe drugs and mental health problems a permanent home and assertive care team support. Concern persists that user satisfaction and retention rate are key values in the evaluation of such inclusive-care programs, to secure good outcomes. The aims of this study were 1) to explore user’s satisfaction with Housing First services, and 2) to determine individual or contextual factors influencing user’s satisfaction. Methods Based on the French Un Chez Soi d’Abord sample, we analysed data from homeless people with severe mental problems assigned to the Housing First and followed during 3 years. Measures included team tracking frequency, service users’ needs, and a Client Satisfaction Questionnaire (CSQ-8). Generalized estimating equations were used with a random effect for site to identify relevant baseline confounders for the CSQ score. Results At 36-month follow-up, 131 HF participants completed the services user’s needs and CSQ-8 questionnaires. 94% were still housed. Respondents reported needs from the HF team for managing housing (74%), administrative assistance (63%) and mental illness (43%). The mean total CSQ-8 score was 25.6 (SD = 5.2) out of 32. Four predictors of a higher CSQ score were: higher frequency of visits (regression coefficients 8.2), lower user’s education (-2.2), ever been a tenant (1.4), and suffering of schizophrenia disorder (0.9) (p<.001). Conclusions The users’ perception of the quality of HF services appears to be high. Our results underscore the interaction of individual and process factors influencing user satisfaction. These findings suggested that HF intervention in France is a promising strategy for high quality of services to homeless people with mental illness. Key messages He users’ perception of the quality of Housing First services appears to be high. Housing First intervention in France is a promising strategy for high quality of services to homeless people with mental illness.