Research and Evidence
Octavia’s Options is grounded in evidence-based practices that prioritize stability, accessibility, and long-term outcomes. We intentionally chose to center our work around the Housing First model because it is one of the most extensively studied and consistently supported approaches to addressing homelessness. Housing First provides immediate access to housing without preconditions such as sobriety or treatment participation, removing barriers that often prevent people from ever getting inside.
Across multiple countries and populations, including individuals with serious mental illness and substance use challenges, this model has repeatedly shown strong outcomes. The most consistent finding across the research is simple but powerful: people are far more likely to obtain and keep housing when it is offered first, without conditions.
A systematic review and meta-analysis by Baxter et al. (2019) examined randomized controlled trials comparing Housing First with traditional treatment-first approaches. Participants in Housing First programs were significantly more likely to achieve and maintain stable housing over time. Several studies within the review also showed reductions in emergency department visits and hospitalizations, pointing to a broader impact beyond housing alone. In practice, this means fewer crises, fewer emergency interventions, and more stability in daily life.
Large-scale randomized trials reinforce these findings. In the At Home/Chez Soi study, one of the most comprehensive Housing First trials conducted across five Canadian cities, participants receiving Housing First were housed approximately 73 percent of the time, compared to 32 percent for those receiving standard services (Aubry et al., 2016; Tsai, 2020). That difference is substantial and reflects how quickly stable housing can change someone’s trajectory. It also demonstrates faster exits from homelessness and significantly higher long-term housing retention.
Housing First has also proven effective across different populations and service settings. Aubry et al. (2015) found that individuals with serious mental illness transitioned out of homelessness more quickly and were more likely to remain housed when compared to control groups. These outcomes were consistent across demographic groups, suggesting that the model is flexible and broadly applicable rather than limited to one specific population.
Another important outcome is the impact on public systems. A systematic review by Peng et al. (2020) found that individuals in Housing First programs used fewer emergency services, including hospital care and crisis response systems. Stable housing reduces the need for high-cost interventions and allows people to engage with services in a more consistent and preventative way. This leads to reduced strain on healthcare systems and more efficient use of public resources.
There are often questions about how Housing First addresses substance use and mental health. Research shows that while housing alone does not automatically reduce substance use, it does not increase harm and instead creates a more stable environment where people can engage in services voluntarily (Kerman et al., 2021). Rather than requiring people to be “ready” before receiving housing, this approach recognizes that stability comes first. From there, individuals are more likely to build trust, access care, and make meaningful changes. This reflects the importance of pairing housing with support, leading to greater engagement in voluntary services and stronger long-term outcomes.
An umbrella review by Fornaro et al. (2022) reinforces this idea. Housing is not a complete solution on its own, but it is a critical starting point. When someone has a stable place to live, they are better able to focus on treatment, employment, and rebuilding relationships. In other words, housing creates the conditions where progress becomes possible. This is why combining housing with services results in improved quality of life and increased opportunities for long-term stability.
More recent research continues to support these conclusions. Loubière et al. (2022) found that Housing First is effective in stabilizing housing for individuals with severe mental illness, particularly when ongoing supports are available. Similarly, emerging research shows that individuals who use substances still benefit significantly from Housing First, with consistent improvements in housing retention and service engagement (Saldanha et al., 2025).
Across all of this research, the pattern is clear. Housing First leads to increased housing stability, reduced homelessness, decreased reliance on emergency systems, and improved overall well-being. When supportive services are offered alongside housing, outcomes are even stronger, including greater service engagement, better health outcomes, and more sustainable long-term independence.
This is exactly why Octavia’s Options is built around this model. We do not view housing as something people must earn. We view it as the starting point. By removing barriers and pairing housing with supportive services, we are creating a pathway where individuals have a real chance to stabilize, recover, and move forward with dignity.