In some permanent supportive housing settings, housing is not contingent upon service participation, and an individual can choose from a variety of service programs based on need and personal preference. There is, however, considerable variability in the nature and staffing of services in supportive housing programs. Transitional housing programs tend to have greater structure and have requirements for participation in work programs, treatment, and housing searches. Some single-site housing programs have onsite recreational and self-i mprovement activities, as well as onsite clinical staff to prescribe and dispense medication treatment or deliver primary care services. Some even provide two or three meals a day. In scatter-site apartment units, there may be periodic visits from a mobile mental health team or case manager to provide psychiatric treatment or arrange for access to clinic-based or offsite rehabilitation services.
Permanence of Tenancy
Transitional housing programs including safe havens are time-limited, but tenure is not rigid, and some individuals remain for months or longer until they are able to move on to permanent housing. Tenants may be required to move to more independent housing as their needs for intensive services and structure are reduced. In many permanent supportive housing programs, the residents have full rights of tenancy, with a lease (or a sublease) in their name and with the same terms and conditions as would be found in a typical lease. Housing is permanent as long as the individual is able to maintain the requirements of successful tenancy. However, in some programs, housing may be terminated for the individual’s failure to adhere to treatment goals, for illegal activity, or persistent disruptive behavior. Sometimes house rules are no different from those found in housing for people without mental illness, but supportive housing programs are known to have curfews and house rules banning smoking, alcohol, and drug use. Rule violations can be a cause for sanctions.