An Integrated Housing Intervention for People Involved in the Criminal–Legal System: Contributors to Successfully Moving Along the Housing Continuum

OBJECTIVES: People impacted by the criminal-legal system face challenges to securing and sustaining permanent housing. This study was designed to deliver an integrated housing, medical, and behavioral health services intervention to individuals with criminal-legal involvement. METHODS: After a baseline needs assessment, participants were linked to services and completed quarterly study visits for up to 12 months. We used descriptive statistics to assess frequency and multivariate logistic regression to assess correlates of housing status at last follow-up. RESULTS: Between June 2019 and November 2023, 187 participants were enrolled in Project CHANGE (Comprehensive Housing and Addiction Treatment Network of Greater New Haven). At baseline, 43% of participants were unstably housed, 37% were homeless, and the remaining resided in a shelter or institution. At the time of last follow-up, 49 participants (26.2%) reported improved housing outcomes, and an additional 121 participants' (64.7%) housing situation did not worsen. In multivariate models, individuals who were older (adjusted odds ratio [AOR] = 1.1; 95% CI, 1.0-1.1), unstably housed at baseline (AOR = 7.6; 95% CI, 3.8-15.9), and enrolled in the study for longer (AOR = 1.2; 95% CI, 1.1-1.3) had higher odds of being housed at last follow-up, whereas those with high-severity substance use had lower odds of being housed (AOR = 0.3; 95% CI, 0.1-0.6). CONCLUSIONS: In this comprehensive program, integrated housing and health services were time and cost intensive but were associated with positive housing outcomes. People involved in the criminal-legal system face unique barriers to housing, particularly when compounded by substance use.