The Effectiveness of Housing Interventions and Housing and Service Interventions on Ending Family Homelessness: A Systematic Review Ellen L. Bassuk Center for Social Innovation, Needham, MA; The National Center on Family Homelessness American Institutes for Research, Waltham, MA; Harvard Medical School Carmela J. DeCandia The National Center on Family Homelessness American Institutes for Research, Waltham, MA Alexander Tsertsvadze Warwick Medical School, University of Warwick Molly K. Richard Center for Social Innovation, Needham, MA Family homelessness has become a growing public health problem over the last 3 decades. Despite this trend, few studies have explored the effectiveness of housing interventions and housing and service interventions. The purpose of this systematic review is to appraise and synthesize evidence on effective interventions addressing family homelessness. We searched 10 major electronic databases from 2007 to 2013. Empirical studies investigating effectiveness of housing interventions and housing and service interventions for American homeless families regardless of publication status were eligible for inclusion. Outcomes included housing status, employment, parental trauma and mental health and substance use, children’s behavioral and academic status, and family reunification. Study quality was appraised using the Effective Public Health Practice Project tool. Six studies were included in this review. Overall, there was some postintervention improvement in housing and employment, but ongoing residential and work stability were not achieved. Methodological limita- tions, poor reporting quality, and inconsistent definitions across outcomes hindered between-study comparisons. Substantial limitations in research underscore the insufficiency of our current knowl- edge base for ending homelessness. Although many families were no longer literally homeless, long-term residential stability and employment at a livable wage were not ensured. Developing and implementing evidence-based approaches for addressing homelessness are long overdue. Supplemental materials: http://dx.doi.org/10.1037/ort0000020.supp H omelessness, once viewed as transient and situational, has become a growing public health problem that has escaped ready solutions. Each year many more families, comprised primarily of single mothers with young children in tow, join the ranks of those experiencing homelessness. Almost half of these children are less than 6 years old. Families now account for 36% of the overall homeless population and 50% of the sheltered population (U.S. Department of Housing and Urban Development; HUD; 2013b). The 2013 HUD point in time count conducted by participating local Continuums of Care (CoC) used HUD’s literal definition of homelessness: families residing in emergency shelter, transitional or supportive housing, and safe havens, or families living in places not meant for human habitation such as cars, parks, and abandoned buildings. HUD reported that 222,197 family members in the United States were homeless on a given night in 2013; 138,515 of these were children under the age of 18 (HUD, 2013b). Using the newer definition of family homelessness estab- lished by the Homeless Emergency Assistance and Rapid Transi- tion to Housing (HEARTH) Act (2009) that includes precariously housed families, an estimated 1.6 million school-age children in the United States were homeless over the course of the 2011–2012 school year. These numbers represent a 10% increase over the previous school year—an historic high (National Center for Home- less Education, 2013). Ellen L. Bassuk, Center for Social Innovation, Needham, MA; The National Center on Family Homelessness American Institutes for Re- search, Waltham, MA; and Department of Psychiatry, Harvard Medical School; Carmela J. DeCandia, The National Center on Family Homeless- ness American Institutes for Research; Alexander Tsertsvadze, Warwick Evidence, Division of Health Sciences, Warwick Medical School, Univer- sity of Warwick; Molly K. Richard, Center for Social Innovation, Need- ham, MA. Correspondence concerning this article should be addressed to Ellen L. Bassuk, Center for Social Innovation, 200 Reservoir Street, Suite 202, Needham, Massachusetts 02494. E-mail: ebassuk@center4si.com This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. American Journal of Orthopsychiatry © 2014 American Orthopsychiatric Association 2014, Vol. 84, No. 5, 457– 474 http://dx.doi.org/10.1037/ort0000020 457