Impact of Permanent Supportive Housing on Behavioral Outcomes
A small-scale non-experimental study of homeless people with serious mental illness in housing-first and treatment-first programs found that the housing-first group had lower rates of both substance use and substance abuse treatment utilization compared to the treatment-first group (Padgett et al., 2011). To date, however, other studies have found no effect of permanent supportive housing on mental health status or use of alcohol and drugs (Leff et al., 2009; Padgett et al., 2006; Rosenheck et al., 2003; Tsemberis et al., 2004). More positive life changes (Nelson et al., 2015) and greater improvements in community functioning have been observed among Housing First participants in the At Home/Chez Soi Study at one year (Aubry et al., 2015b). At the end of two years, however, differences between Housing First participants and participants in usual care were not significant (Aubry et al., 2015b). In-depth analysis of the effect of permanent supportive housing on employment and family and social relationships has not yet been reported.
The most favored model of permanent supportive housing among consumers is both low-demand and free of service requirements (Tsemberis et al., 2004). Compared to other types of community housing, tenants are more satisfied with permanent supportive housing (Leff et al., 2009; Siegel et al., 2006), particularly as it relates to autonomy and economic viability (Siegel et al., 2006). Participants in the Housing First/Chez Soi study reported improved quality of life over the two-year study period (Aubry et al., 2015b), but their reports did not differ from those of participants in usual care.