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Permanent supportive housing: assessing the evidence
- Authors:
- ROG Debra J., et al
- Journal article citation:
- Psychiatric Services, 65(3), 2014, pp.287-294.
- Publisher:
- American Psychiatric Association
Objectives: Permanent supportive housing provides safe, stable housing for people with mental and substance use disorders who are homeless or disabled. This article describes permanent supportive housing and reviews research. Methods: Authors reviewed individual studies and literature reviews from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. The authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results: The level of evidence for permanent supportive housing was graded as moderate. Substantial literature, including seven randomized controlled trials, demonstrated that components of the model reduced homelessness, increased housing tenure, and decreased emergency room visits and hospitalization. Consumers consistently rated this model more positively than other housing models. Methodological flaws limited the ability to draw firm conclusions. Results were stronger for studies that compared permanent supportive housing with treatment as usual or no housing rather than with other models. Conclusions: The moderate level of evidence indicates that permanent supportive housing is promising, but research is needed to clarify the model and determine the most effective elements for various subpopulations. Policy makers should consider including permanent supportive housing as a covered service for individuals with mental and substance use disorders. An evaluation component is needed to continue building its evidence base. (Publisher abstract)
Supportive housing for addicted, incarcerated homeless adults
- Authors:
- HICKERT Audrey O., TAYLOR Mary Jane
- Journal article citation:
- Journal of Social Service Research, 37(2), March 2011, pp.136-151.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Homeless populations often suffer from mental illness, substance abuse, and criminality. Housing interventions have been effective in serving homeless persons with criminal experience, substance abuse issues, and mental illness. However, previous studies have noted the difficulty of working with this population and that success can be limited. This study examined outcomes for clients of a new supportive housing intervention. The Homeless Assistance Rental Program (HARP) provided supporting housing for homeless persons who were struggling with mental illness, in jail, in criminal justice programmes, in substance abuse programmes, or aging out of foster care. The sample for the study consisted of 102 individuals who participated in HARP at some point during its first 22 months of operation. Data was collected from 4 major sources: the Housing Authority; the Substance Abuse division; jail records; and the self-sufficiency matrix completed with HARP participants by their case managers. Use of formal treatment, jail contact, and community stability were compared pre- and post-housing. Jail bookings and residential substance abuse treatment significantly declined post-housing, while clients improved in income level, access to food, and housing stability. Results from official justice and treatment system data suggest that supportive housing can lead to significant changes.
Housing scheme is putting people in the comfort zone
- Author:
- SALE Anabel Unity
- Journal article citation:
- Community Care, 11.12.08, 2008, pp.36-37.
- Publisher:
- Reed Business Information
Reports on the work of the supported housing provider Comfort Care Services. The organisation provides supported accommodation for people with mental illness, learning disabilities and substance misuse problems in Slough, Reading and Maidenhead. It has also developed vital crisis units and an innovative Move On programme which operates a structured, three-tiered approach to support that eventually leads to clients living independently.
Developing HIV service-enriched permanent housing in five cities: perspectives of social services staff
- Authors:
- SOTHERAN Jo L., PATTERSON Elizabeth K., AIDALA Angela A.
- Journal article citation:
- Journal of HIV/AIDS and Social Services, 4(4), 2005, pp.5-28.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Newer antiretroviral treatments are adding years to the lives of people with HIV. At the same time, the face of the epidemic is changing to include increasing numbers of people with other diagnoses, especially chronic substance use and/or mental illness, that compromise their ability to secure and maintain permanent housing. Social service providers are increasingly attempting to meet the need for permanent supportive housing. However, many social service providers are new to developing specialized permanent housing, and little practical guidance exists. The authors use the experience of five agencies participating in the Department of Housing and Urban Development's Housing Opportunities for People with AIDS (HOPWA) Multiple Diagnoses Initiative, in the United States to explore the potential pitfalls and solutions in developing these programs, from the point of view of providers from social service rather than housing backgrounds. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The role of occupational meaningfulness and citizenship as mediators between occupational status and recovery: a cross-sectional study among residents with co-occurring problems
- Authors:
- NESSE Linda, et al
- Journal article citation:
- Advances in Dual Diagnosis, 14(3), 2021, pp.99-118.
- Publisher:
- Emerald
Purpose: Engagement in meaningful occupations and being included as full citizens of the community, is essential in everyday life, and may be of considerable relevance for recovery and quality of life. However, persons with co-occurring substance use and mental health problems experience extensive obstacles to engagement in occupations and citizenship. The relationship between objective measures of occupational status and subjective experiences of occupational meaningfulness, citizenship and recovery, is scarcely researched in the context of co-occurring problems. As such, the purpose of this study is to examine associations between occupational status, occupational meaningfulness, citizenship and recovery and quality of life and to examine the roles of occupational meaningfulness and citizenship as possible mediators between occupational status and recovery and quality of life. Design/methodology/approach: The study used a cross-sectional design with a sample of 104 residents at supported housing sites across six Norwegian cities. Findings: Linear regression analyzes indicated that occupational status was significantly associated with the citizenship domains caring for others and community participation and with the quality of life measure positive affect. Occupational meaningfulness and citizenship were significantly associated with different domains of recovery and quality of life. Furthermore, mediation analyzes showed that the relationship between occupational status and recovery and quality of life was mediated by caring for others and community participation. Originality/value: The results suggest that emphasizing opportunities for occupational meaningfulness and citizenship in practice may have positive implications for recovery among persons with co-occurring problems. (Edited publisher abstract)
“Come together”: a thematic analysis of experiences with belonging
- Authors:
- OGUNDIPE Esther, et al
- Journal article citation:
- Advances in Dual Diagnosis, 13(3), 2020, pp.123-134.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore, describe and interpret two research questions: How do persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging? How do residential support staff experience promoting a sense of belonging for persons with co-occurring mental health and substance abuse problems, living in a supportive housing? Design/methodology/approach: Individual semi-structured interviews were conducted with five persons with co-occurring mental health and substance abuse problems living in supportive housing in a Norwegian district. In addition, one semi-structured focus group was conducted with nine residential support staff. All interviews were transcribed verbatim and analyzed using thematic analysis. Findings: Analysis resulted in three main themes: “I do not go to sleep in my pajamas”, “Do I have a choice?” and “Be kind to each other”. Research limitations/implications: More research on how inclusive practices that are commonly described in guidelines actually affect the experience of residents and residential support staff is needed. Practical implications: Practices that incorporate a communal and contextual understanding when assigning supportive housing are warranted. Originality/value: By paying attention to the components of social recovery, this paper provides a nuanced understanding of how persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging. In addition, residential support staffs’ experiences with promoting a sense of belonging for this group are explored. (Edited publisher abstract)
Integrating permanent supportive housing and co-occurring disorders treatment for individuals who are homeless
- Authors:
- SMELSON David A., et al
- Journal article citation:
- Journal of Dual Diagnosis, 12(2), 2016, pp.193-201.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objectives: This pilot study examined the feasibility and preliminary outcomes of systematically integrating permanent supportive housing and an evidence-based co-occurring disorders intervention called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking (MISSION). Methods: This single-group open pilot enrolled 107 people with co-occurring disorders experiencing chronic homelessness from two Massachusetts inner-city and rural areas. Enrolled subjects were interested in receiving permanent supportive housing along with 1 year of MISSION services. Data were collected through baseline and 6- and 12-month follow-up assessments. Results: Participants were mostly male (76.6%), Caucasian (52.3%), and unemployed (86.0%), with an average of 8.34 years of homelessness. Self-reported lifetime problems with anxiety (75.7%) and depression (76.6%) were common, as was use of alcohol (30.8%), cannabis (31.8%), and cocaine (15.9%). Almost all participants (95.3%) were placed into permanent housing, which took on average 42.6 days from enrollment. Among those placed, nearly 80% of the clients were able to retain housing through the end of the study. Overall retention was high, with 86.0% remaining in MISSION treatment until the end of the study. While there were no significant changes in rehospitalisation, service utilisation, or substance use, there were modest significant mental health symptom improvements from baseline to program completion. Conclusions: This pilot study suggests that co-occurring disorder interventions like MISSION are feasible to integrate with permanent supportive housing despite the somewhat differing philosophies, and preliminary data suggested substantial improvements in housing and modest improvements in mental health symptoms. While caution is warranted given the lack of a comparison group, these findings are consistent with other rigorous studies using MISSION among homeless individuals who did not receive permanent supportive housing. (Edited publisher abstract)
More than shelter: supported accommodation and mental health
- Author:
- BOARDMAN Jed
- Publisher:
- Centre for Mental Health
- Publication year:
- 2016
- Pagination:
- 36
- Place of publication:
- London
This report looks at evidence about the provision of supported housing for people with mental health problems in England, including those with multiple needs and substance misuse, and presents key themes for its future development. It highlights the significant links between housing and mental wellbeing, indicating that factors such as overcrowding, insufficient daylight and fear of crime all contribute to poorer mental health. The review identifies a wide range of types of housing support, including help for people to remain their own tenancies to specialist supported accommodation, hostels, crisis houses and the Housing First approach. Although the review identified limited evidence about what kinds of housing support are most effective and cost-effective, small-scale studies suggest that housing support can reduce the costs of hospital stays. When looking at the type of support people want, the literature found most people prefer help in their own homes to being in sheltered or transitional accommodation. The report calls for better provision of housing support and also argues that housing support should be funded jointly by local authorities and the NHS to ensure that services are delivered in partnership between health, housing and social care providers. (Edited publisher abstract)
Housing, home and recovery
- Author:
- JOHNSON Robin
- Journal article citation:
- Mental Health Today, December 2007, pp.27-29.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Supported housing can provide the community and peer support that many vulnerable groups need to maintain mental well-being. This article looks at the role supported housing in the development of new ways of thinking about mental health - where supported housing is not only meeting needs but also providing a community.
Supportive housing for the chronically homeless with HIV/AIDS: an effective model
- Author:
- PRADASANI P Manoj
- Journal article citation:
- Journal of HIV/AIDS and Social Services, 4(1), 2005, pp.23-38.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article examines an innovative supportive housing program for chronically homeless individuals with HIV/AIDS. A Better Place (ABP). a supportive housing program in New York City that provides housing and social services to HIV-positive individuals with multiple diagnoses (mental illness, mental retardation, developmental disability and/or chemical addictions), is offered as an example of an effective and economical model of service that aims to break the cycle of homelessness by providing comprehensive preventative care with positive long-term results. The structure and functioning of the program, along with two case summaries, are described in order to provide a service framework for practitioners engaged in this field of service. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).