Supportive Housing as a Foundation for Recovery: Homelessness, Co-Occurring Disorders, and Housing Laura Gillis, RN, MS HRC Project Director

HRC: Homelessness Resource Center Seeks to improve the daily lives of people affected by homelessness and who have mental health and substance use disorders and trauma histories. We seek to achieve this mission by:  Increasing awareness, knowledge of resources, and capacity to help people experiencing homelessness  Integrating and transforming homelessness service systems  Supporting the implementation of the 10-Year Plans to end homelessness  Supporting the Projects for Assistance in Transition from Homelessness (PATH)  Facilitating communication and collaboration among providers, researchers, policy makers, and consumers

HRC: Homelessness Resource Center Our work includes:  Training and technical assistance  Publications  On-line learning opportunities  Networking 

HRC: Homelessness Resource Center Funded by the Substance Abuse and Mental Health Services Administration Operated by the Institute on Homelessness and Trauma Organization of clinicians, social scientists, policy analysts, consumers and educators dedicated to using knowledge to improve the lives of vulnerable populations. Our mission is to bring theory onto the streets by applying knowledge of best practices to real world settings.

Poems, Pictures, and Other Great Stuff. (1996). Salem-Keizer Public Schools. Salem, Oregon.

Family Permanent Supportive Housing Reviewed characteristics of 13 FPSH programs - quantitative and qualitative data Profiles of program participants Progress over time on three outcomes  Housing stability  Family reunification  Self support Corporation for Supportive Housing (2006). Family Permanent Supportive Housing: preliminary research on family characteristics, program models, and outcomes.

Family Permanent Supportive Housing: Findings Characteristics of families varied substantially when compared to families in emergency shelters and transitional housing  Mothers are older, better educated, have a longer and more complex history of homelessness, and may have “special needs” such as mental health and substance use issues  Subgroup of homeless families with more intense needs – characteristics of chronically homeless

Family Permanent Supportive Housing: Findings Programs had many similarities but some significant differences  All offered case management services  Majority offered on-site service options  Services were not family focused  Intensity of services was limited, e.g. one service contact per week

Family Permanent Supportive Housing: Findings Differences in outcomes appear to be related to the control the programs exerted over residents and participants’ difficulties engaging in critical services.  High demand programs more successful at family reunification and increasing employment rates and income  Low demand programs more successful in retaining families in housing

Family Permanent Supportive Housing: Findings The relationship between a client and staff member can become the decisive factor in re-setting the direction of a client’s life.  Provides the leverage necessary to empower clients to access services  May eliminate necessity of creating stringent rules for program participation  Trusting relationships take time  Developing a sustaining relationship rarely occurs in a linear fashion

Family Permanent Supportive Housing: Recommendations Focus on active outreach and engagement Gather information about exposure to traumatic stress and add trauma informed services to all programs. Reconsider the brokered model of case management Account for the needs of the children and their impact on the family.

Family Permanent Supportive Housing: Recommendations Further research should focus on  examining the key ingredients and processes by which FPSH helps (or fails to help) families achieve residential stability, self-sufficiency, and family reunification,  developing a typology of the homeless families population (including homeless children) to better understand differential housing and service needs  determining which families do best in which FPSH programs and then comparing the outcomes of FPSH to other housing models

Limitations of Study Available data were collected by three distinct research efforts  one of which includes five separate studies  one a single study of seven different programs  one a single study of which the family programs were only one part.  each data set has a unique study design employing different data collection and sampling strategies that limit the ability to compare data across programs and to draw conclusions from these comparisons.