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Housing First is a housing intervention for people with serious mental illness who have experienced long-term homelessness. This approach is backed by decades worth research in the United States, Canada, and Europe. It has been identified as a preferred housing intervention in national, state, or provincial housing policy in the United States and Canada, and increasingly across Europe as well.

This paper examines factors affecting the evolution and growth of Housing First from the perspectives of those who have been directly involved in practice, policy, and research. It reports on findings from qualitative interviews with 27 Housing First experts from the United States, Canada, and Europe. This review shows that, from the perspectives of these participants, the evolution of Housing First has been shaped by the differing contexts in which it was introduced, and by particular policy decisions. These differences may be linked to variability in perceptions of the future prospects of Housing First.

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