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Summary

This program placed adults experiencing homelessness with cocaine dependency and nonpsychotic mental disorders in housing and provided outpatient services and work experience to program participants to increase their employment. This evaluation directly compared rent-free non-abstinence-contingent housing (NACH) to a separate intervention that offered rent-free abstinence-contingent housing (ACH), in order to better understand which of the two interventions might be more effective; the distinctive feature of NACH is the provision of housing regardless of drug test results.

This program provided housing and services for adults experiencing homelessness with cocaine dependency and nonpsychotic mental disorders. The intervention was delivered in two phases:

  • In the first phase, participants received rent-free furnished housing after two urine drug tests, regardless of results. Participants were tested twice per week during the intervention period and remained in program housing regardless of results. Participants also received one to two months of outpatient treatment at Birmingham Health Care (BHC) to reduce cocaine dependency. For about six hours per day, participants received counseling, psychological evaluation, group-based educational therapy, and routine drug testing. Participants set therapeutic goals and were incentivized to meet these goals (receiving $5 or $10 debit cards). Transportation was provided to and from BHC.
  • In the second phase of the intervention, participants received three to five months of work experience and aftercare at BHC. Participants worked 6.5 hours per day in food service, landscaping, or construction jobs and earned $5.25 per hour. In this phase of the intervention, participants were charged $161 per month to remain in program housing but were not evicted if unable to provide payment.

Services lasted for six months across both phases. The program served cocaine-dependent adults with nonpsychotic mental disorders who either met federal criteria for homelessness or were deemed at serious risk for homelessness. This program was offered in Birmingham, AL.

The effectiveness of NACH when compared to ACH indicates the effect of being referred to a set of services that includes those unique to NACH; the comparison indicates how much better the offer of NACH meets participants’ needs than the offer of ACH. Participants in NACH received housing received housing regardless of drug test results. In contrast, participants in ACH received the same housing dependent upon negative drug test results. This evaluation also examined both types of rent-free housing as compared to outpatient services and work experience with no housing.

03119.03R-Rent-Free, Non-Absti
Populations and employment barriers: Homelessness, Mental illness, Substance use disorder

Studies of this intervention

Study quality rating Study counts per rating
Low Low 1
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Implementation details

Characteristics of research participants
Black or African American
94%
Unknown or not reported
6%

The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.

State(s) where implemented

AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Canada

The Pathways Clearinghouse refers to interventions by the names used in study reports or manuscripts. Some intervention names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.

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