Evidence from Supportive Housing
The achievement of full community integration has, however, eluded participants in the most innovative housing and service intervention efforts to date. Supportive housing studies have demonstrated impressive gains in improving housing stability and reducing homelessness for the mentally ill. Success in achieving clinical objectives, quality of life, and participation in the life of the community has, however, been insignificant. In a multi-site study of over 500 chronically homeless adults with mental illness who received supportive housing, Tsai et al. (2012) observed that, despite strong gains in housing stability one year after housing placement, many remained socially isolated and experienced limited improvements in community participation and civic involvement. Similarly, Baumgartner and Herman (2012) reported that neither critical time intervention (CTI) nor housing stability were associated with improved community integration. Yanos et al. (2012) found that, when formerly homeless mentally ill individuals living in scatter-site supportive housing were compared to residents without mental illness living in similar neighborhoods, the mentally ill individuals did not achieve the same level of community integration as their non-mentally ill counterparts. Noting that the differences in community integration found between mental health consumers and the community participants were small, both groups shared common educational and racial/ethnic characteristics and residence in poor and disadvantaged communities, any or all of which could constrain opportunities for community integration. A rehabilitative group-housing model that has embodied the values of empowerment and self-efficacy has also failed to facilitate community integration for formerly homeless people with mental illness (Ware, 1999). Peer support groups (Castelein et al., 2015) and consumer- run organizations and business enterprises (Mandiberg, 2012) offer promise for the creation of supportive environments for people with severe mental illness; their development will be followed with interest.
Serving People with Multiple Disabilities
Housing and service programs for the homeless mentally ill typically serve people with extensive histories of illness and deprivation, whose mental illness has been compounded by addictions, abject poverty, and the knocks and bruises of street and shelter living. In their effort to enable this challenging group of severely disabled individuals to achieve a modicum of housing stability, housing programs have not focused on community integration as a service objective (Baumgartner & Herman, 2012). The extent to which community integration can be achieved with this severely disabled population requires further study and evaluation.