Burnam 1995.

Methods	Allocation: randomised. Design: single‐centre. Duration: 9 months. Setting: community, residential. Location: West Los Angeles county, Ca, USA.
Participants	Diagnosis: schizophrenia and or major affective disorder with co‐occurring substance disorder.* N = 276 (132 were included in analysis). Age: mean ˜ 37 years. Sex: 232 M, 44 F. Ethnicity: 58% white. Inclusion criteria: homeless, substance abuse within past year.
Interventions	1. Psychosocial intervention: integrated mental health and substance use treatment. Residential: educational groups, 12‐step programmes including AA or NA, discussion groups, individual counselling, case management, psychiatric consultation, ongoing medication management, general community activities. N = 67. 2. Psychosocial intervention: non‐residential: above model operating 1‐9 PM 5 days/week, more case management for basic needs. N = 144.** 3. Standard care: routine care with no special intervention but free to access other services (shelters, mental health clinics, AA groups). N = 65.
Outcomes	Leaving the study early: lost to evaluation. Unable to use Substance use: level of alcohol in previous 30 days (modified measure used). Mental state: SCL‐90 and PERI ( modified version of scales used). Homelessness: number of days living in independent housing (data skewed).
Notes	ITT analysis. * Schizophrenia, 6%; major affective disorder, 60%, both 34%. ** Only residential and control group data used. Non residential intervention did not meet a priori category. Authors kindly provided further data. Participants paid $10 for each assessment interview.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomised, no further description. Assignment to non‐residential group was set at twice that of the other groups requiring a larger sample size.
Allocation concealment (selection bias)	Unclear risk	Unclear, no details.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Clinician‐/participant‐mediated and participants and personnel not blinded. It is not possible to blind a psychosocial intervention.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Unclear if raters were independent or blind.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Lost to follow‐up: 38% (50/132) 9 months. No reasons given for dropouts.
Selective reporting (reporting bias)	Unclear risk	No protocol to compare outcomes reported. In the published articles, means and SD were not reported, but were kindly provided by the author.
Other bias	Low risk	No evidence other biases are occurring.