Outline of the Study

This groundbreaking review represents the first comprehensive meta (statistical) analysis which compares types of accommodation-based interventions for people experiencing homelessness and their impact on housing stability, health and other outcomes. The review involved 28 studies, covering 51 accommodation interventions and 8,390 participants. .

The review creates a typology that categorises interventions based on level of support (basic, moderate, high) and conditionality (conditional vs unconditional).The network meta-analysis methodology enables direct comparison of some interventions for the first time and provides crucial evidence for policy makers and practitioners about which approaches achieve the best outcomes.
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Findings in brief
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• Programmes, such as Housing First, which offer intensive, individualised and unconditional support, result in significantly better housing stability outcomes than other approaches
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• Accommodation which offers basic and unconditional interventions may be harmful in terms of people’s housing stability and health outcomes suggesting these approaches should be reconsidered
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• Most quantitative evidence comes from the USA and findings may not directly translate into the UK context
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• ‍Accommodation-based interventions which offered moderate, generic and conditional support and/or high unconditional support both helped improve health outcomes
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• There is limited evidence on the impact of accommodation-based interventions on employment, crime, and wellbeing outcomes
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• programmes which offer higher support consistently outperformed those with lower support, regardless of expectations to engage with this support
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• Both congregate and dispersed housing models are effective when combined with appropriate support levels
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• Qualitative evidence indicates that successful programmes require person-centred approaches, effective staff training, sustainable funding, and strong joint working between relevant services. However, success also relates to national welfare policy and housing market access. 
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Recommendations in brief
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• Prioritise investment in Housing First and other models which offer intensive and unconditional support for people with complex needs
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• Review the cost-effectiveness of basic/unconditional accommodation-based interventions
  
  
• Commission rigorous UK-based evaluations, to: understand the effectiveness of accommodation-based interventions outside the USA context; better understand the relative effectiveness of interventions for people who need medium and high support; measure outcomes beyond housing and health, such as employability, crime and wellbeing and cost effectiveness
  
  
• Ensure future research routinely gathers data around service user demographics, level of support needed and current accommodation type and continues to utilise the typology, to facilitate comparison of interventions ‍
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• Ensure all accommodation-based interventions use person-centred practice, have qualified and trained staff, sustainable funding, and effective joint working relationships. ‍‍

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