Transitions through homelessness and factors that predict them: residential outcomes in the Chicago Target Cities treatment sample

Abstract The course of homelessness was examined among adult substance abusers entering treatment in the Chicago Target Cities treatment sample. The research objectives were (1) examine client movement in and out of homelessness over for 2 years post entry into the index treatment episode, and (2) determine the treatment and non-treatment factors that predict achieving and sustaining residential stability. The sample, recruited from treatment programs on Chicago's West Side, was 59% female and predominantly African-American (87%), unemployed (86%), and unmarried (90%). Approximately one-third self-presented as homeless. Descriptive results showed that 73% of initially homeless clients had improved their residential status at 6 months, and 60% were stably housed at 24 months. By contrast, 28% of initially housed clients were not stably housed at 6 months (the majority of these had gone into residential treatment), and only 16% were homeless at 24 months. Sample-wide, homelessness was reduced by 37% between baseline and the 2-year follow-up. The high percentage of homeless substance abusers that achieved and maintained stable housing is consistent with a conclusion that treatment reduced homelessness in the Chicago Target Cities sample. Alternative explanations cannot be entirely ruled out, but are insufficient to nullify the general conclusion. Factors discriminating homeless and housed clients at baseline were consistent with prior literature. Several treatment and non-treatment factors predicted 6- and 24-month housing outcomes in conditional logistic regression models, although the significance and direction of effect estimates varied across conditions. The most consistent predictors were crack as the primary substance, which appears to be a persistent risk factor for becoming and remaining homeless, and whether or not the participant reported that persons were dependent on him/her for food/shelter, which appears to be a persistent protective factor for achieving housing and preventing homelessness. Implications for program planning are discussed.