Mental Health Minute: Housing Help Provides Stability

Everyone needs safe, decent, stable housing. For some of the most vulnerable people in America — people with mental illness, chronic health conditions, histories of trauma, and other struggles — a home helps them to get adequate treatment and start on the path toward recovery. But some conditions make it difficult for people to maintain a stable home without additional help

Supportive housing, a highly effective strategy that combines affordable housing with intensive coordinated services, can provide that needed assistance.

Essential Characteristics of Supportive Housing

Supportive housing is a highly effective strategy that combines affordable housing with intensive coordinated services to help people struggling with chronic physical and mental health issues maintain stable housing and receive appropriate health care.  Supportive housing features:

Service providers also help tenants address physical health, mental health, and substance use conditions, and help with other issues like applying for Social Security benefits or gaining employment.  Teams of professionals such as mental health and substance use specialists, nurses or doctors, and case managers provide care.  Services must be flexible enough to address each individual tenant’s needs, which may involve multiple service agencies working together.  These teams also try to link people to mainstream service systems like work training, if appropriate.

Building on this strong body of research, supportive housing practice is expanding to help other vulnerable people, such as homeless youth, who often have spent time in the foster care system and struggle with mental health issues and trauma, and people with developmental disabilities, who often live in segregated group homes rather than being integrated into the community.  The existing research suggests that supportive housing would be successful for such other groups, but researchers should continue to examine how supportive housing’s impact might differ for them.

People with mental illness and other severe disabilities are also more likely than others to be incarcerated or to enter long-term health care institutions like nursing homes or psychiatric hospitals, or to cycle between institutionalization and homelessness.  Many studies show that supportive housing successfully interrupts this cycle — people with histories of incarceration or institutionalization significantly reduce their use of those systems after moving into supportive housing.  One of the largest studies to date that documents these reductions, conducted in New York City, found that individuals placed in supportive housing spent, on average, 115 fewer days per person in homeless shelters, 75 fewer days in state-run psychiatric hospitals, and almost eight fewer days in prison or in jails, in the two years after entering supportive housing, compared to a similar group without supportive housing.

A majority of the evidence on behavioral health in supportive housing simply compares substance use and mental health symptoms before and after entering supportive housing (rather than using comparison groups).  These studies show consistently that those in supportive housing reduce their use of substances over time, and at least one study shows a reduction in mental health symptoms as well.   Together the available studies indicate that supportive housing works at least as well as other treatments available in the community to help people experiencing homelessness reduce their substance use and may be more effective.

The above is an excerpt from Supportive Housing Helps Vulnerable People Live and Thrive in the Community. The full article can be found here.