Transcript Housing Stability among Homeless Individuals with Serious

Housing Stability Among Homeless
Individuals with Serious Mental
Illness Participating in Housing First
Programs
Coalition on Homelessness and
Housing in Ohio
2008 Annual Conference
Context
• Evidence that permanent supportive housing
reduces homelessness of chronically homeless
people, many with psychiatric or substance abuse
issues
• Increasing popularity of approaches emphasizing
access to housing without service requirements
for “hard to serve”
• Evidence (including this study) that Housing First
may be an effective approach to meet the needs
of homeless people with SMI
Purpose of the Study
• Exploratory look at program features and client
outcomes in three Housing First programs
serving homeless individuals with serious mental
illness
Research Questions
• What are the participants’ characteristics?
• What are the features of the programs—target
population, housing options, and service
models?
• How long do the participants remain in housing?
• Why do some participants leave the program
within 12 months of placement?
What is Housing First?
• Direct, or nearly direct, placement into housing
• No requirement that participants use supportive
services
• Assertive outreach and use of a low demand
approach
• Provision of services and housing during
temporary leaves
Housing First Programs
• Downtown Emergency Services Center (DESC):
Seattle, WA
• Pathways to Housing: New York City
• Reaching Out and Engaging to Achieve Consumer
Health (REACH): San Diego, CA
Housing First Programs
Feature
DESC
Pathways
REACH
Established
1993
1992
2000
Units
306
450
250
Housing
types
Owned by DESC:
3 SRO buildings,
1 Safehaven
Scattered-site
apartments in
private buildings
SRO, Safehaven,
Independent
Living Facilities,
scattered-site
apartments
Colocation
of housing,
services
Yes—on-site staff
provide property
and case
management
No—ACT team
members visit
clients in home
No—case
managers visit
clients in home
ACT team
Modified
Yes
Modified
Data Collection
• Administrative interviews with program staff
(program features)
• Structured data collection by program staff to
track program participation and outcomes over a
12-month period
• Focus groups with program participants
(program experience and satisfaction)
Study Participants
• Chronically homeless (88%)
• Co-occurring mental illness and substance-related
disorders (69%)
• Prior living situations immediately prior to Housing
First Program entry varied:
–
–
–
–
39% streets
28% shelter
18% psychiatric hospitals
17% other or unknown
Housing Tenure
• Overall programs had similar outcomes, but
findings reveal nuances to housing stability
• 84% of participants were still housed in Housing
First program at the end of 12 months
– 43% stayers (n = 34)
– 41% intermittent stayers (n = 33)
– 16% leavers (n = 13)
Level of Housing Stability
70%
62%
60%
52%
50%
40% 40%
40%
31%
28%
30%
21%
20%
20%
8%
10%
0%
DESC
Pathways
Stayers
Intermittent
REACH
Leavers
Prior Living Situation
by Housing Stability
69%
70%
60%
50%
36%
40%
30%
29% 26% 26%
30%
23%
18%
20%
18%
15%
8%
10%
0%
0%
Stayers
Streets
Intermittent Stayers
Shelter
Psych/Jail
Leavers
Other/Unknown
Impairment from Mental Illness
and Substance Abuse
• Little change in level of impairment from mental
illness over 12 months but considerable
fluctuations for individual study participants
• No overall improvement
• Changes in level of impairment may be the result
of better clinical information over time
Issues with Methodology
• No basis for comparison with other PSH options
• Inability to track beyond 12 months
• Small sample size precluded measuring relative
impact of service v. housing features on client
outcomes
Funding
• This study was funded by the U.S. Department of
Housing and Urban Development (HUD)
• The full report may be found at:
http://www.huduser.org/Publications/pdf/hsgfirst.pdf
For More Information
• Carol Pearson, PhD
Walter R. McDonald & Associates, Inc.
[email protected]
• Paul Dornan, PhD
Office of Policy Development and Research
U.S. Department of Housing and Urban
Development (HUD)
[email protected]