Supportive housing
Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives, and is an active "community services and funding" stream across the United States. It was developed by different professional academics and US governmental departments that supported housing. Supportive housing is widely believed to work well for those who face the most complex challenges—individuals and families confronted with homelessness and who also have very low incomes or serious, persistent issues that may include substance use disorders, mental health, HIV/AIDS, chronic illness, diverse disabilities or other serious challenges to stable housing.
Supportive housing in rehabilitation
Supportive housing can be coupled with such social services as job training, life skills training, alcohol and substance use disorder treatment, community support services, and case management to populations in need of assistance. Supportive housing is intended to be a pragmatic solution that helps people have better lives while reducing, to the extent feasible, the overall cost of care. As community housing, supportive housing can be developed as mixed income, scattered site housing not only through the traditional route of low income and building complexes.Supportive housing has been widely researched in the field of and psychiatric rehabilitation, based in part on housing and support principles from studies of leading community integration organizations nationally. In addition, supportive housing has been tied to national initiatives in supportive living to cross-disability transfer and to national and international efforts on developing homes of one's own. Supported housing in the field of mental health is considered to be a critical component of a community support system which may involve supported education, supported or transitional employment, case management services, clubhouses, supported recreation and involvement of family and friends often translated into psycho-educational programs.
From 2002 to 2007, an estimated 65,000 to 72,000 units of supportive housing were created in the United States. This represents about half the supply of supported housing units. Of the new units added, about half were targeted towards chronically homeless individuals, and one-fifth were for homeless families. According to the United States Department of Housing and Urban Development, the number of Permanent Supportive Housing beds in the US increased from 188,636 to 353,800 between 2007 and 2017. Although of the shelter population, the majority remain as single, adult males of minority groups, 38% were between 31 and 50 years old, and 38% had a disability; the rest were homeless families with a high concentration in the states of California, New York and Florida.
Populations served
Sponsors of supportive housing projects generally aim to serve a specific population; the characteristics of those served and the housing program range widely: However, supporters of regular housing and support services in the community suggest choice based on other personal, social, and situational factors than specific population basis.Today, important new populations for supported housing in regular neighborhoods include working families, especially those with high proportional housing costs, older adults who need intensive services to avoid nursing home placements, and people who need places to live due to the closure of the old style, institutional psychiatric care. Increasingly, supportive housing may be required as unemployment increases, for newly emerging groups such as newly legalized gay and lesbian partners, multi-generational immigrant groups in the new multicultural world, and for those adolescents aging out of their parents' homes to new community options. One of the 2000s textbooks on Supported/supportive Housing is a report on state projects in the US for older adults which includes use of the home and community-based waiver, efforts to reform more than 43 congregate residential categories in states, use of housing subsidies for low income persons, assisted living options, "comprehensive case/care management", and technical area such as "at-risk" housing and non-profit development.
Benefits of supportive housing for specific populations groups
Supportive housing proposes to be a comprehensive solution to a problem rather than a band-aid fix. While many of those who stay in the shelter system remain in or return to the system for extended periods of time, a much higher percentage of those who are placed in supportive housing remain housed on a more permanent basis. This idea is also referred to as the Housing First model, an approach to combating chronic homelessness by providing homes upfront and offering help for illnesses and addictions. The concept turns the traditional model, which typically requires sobriety, upside down.Research has shown that coupling permanent housing with supportive services is highly effective at maintaining housing stability, as well as helps improve health outcomes and decreases the use of publicly funded institutions. A review of the impact of these services found that they can improve health outcomes among chronically homeless individuals, including positive changes in self-reported mental health status, substance use, and overall well-being. In the Collaborative Initiative to Help End Chronic Homelessness, participants who had been homeless for an average of eight years were immediately placed into permanent housing. The CICH evaluation reported that 95% of those individuals were in independent housing after 12 months. A study of homeless people in New York City with serious mental illness found that providing supportive housing to the individuals directly resulted in a 60% decrease in emergency shelter use for clients, as well as decreases in the use of public medical and mental health services and city jails and state prisons. Another study in Seattle in 2009 found that moving "people with chronic alcoholism" into supportive housing resulted in a 33% decline in alcohol use for clients.
There is significant support for the contention that supportive housing also costs less than other systems where its tenant base may reside, such as jails, hospitals, mental health facilities, and even shelters. Research on the overall costs to the taxpayer of supportive housing has consistently found the costs to the taxpayer to be about the same or lower than the alternative of a chronically homeless person sleeping in a shelter. The CICH evaluation showed that average costs for healthcare and treatment were reduced by about half, which the largest decline associated with inpatient hospital care. The use of supportive housing has been shown to be cost-effective, resulting in reductions in the use of shelter, ambulance, police/jail, health care, emergency room, behavior health, and other service costs. For example, one 2016 report identified studies documenting that these services can reduce health care costs, emergency department visits, and length of stays in psychiatric hospitals. The Denver Housing First Collaborative documented that the annual cost of supportive housing for a chronically homeless individual was $13,400. However, the per-person reduction in public services recorded by the Denver Housing First Collaborative came to $15,773 per person per year, more than compensating for the annual supportive housing costs.
When paired with low-income housing, government subsidies and other revenue generating operations, supportive housing residences are claimed by their supporters to be capable of supporting themselves and even turning a profit. According to a 2007 study done by the National Alliance to End Homelessness, supportive housing helps tenants increase their incomes, work more, get arrested less, make more progress toward recovery, and become more active, valued and productive members of their communities.
Impact on neighborhoods
Supportive housing can help people facing health challenges to continue to live in the community. However, proposals for new housing projects often faced local opposition, largely based on fears regarding adverse effects on property values and crime rates, local businesses, and the quality of life in the surrounding neighborhood. A 2008 study in Toronto, Canada reported:- There is no evidence linking supportive housing to property values and crime rates
- Supportive housing tenants contribute to local businesses
- Neighbors do not think the supportive housing buildings have a negative impact
- Positive contributions of supportive housing tenants to the community
Limitations, impediments and challenges affecting the development of Supportive Housing
Financial feasibility
Some projects fail to materialize because of a real or perceived lack of government program funds, charitable grants, bank loans or a combination of such funding to pay for the cost of creating and operating financially viable supportive housing. Other organizations, however, have accessed diverse mix and match funding for highly visible community demonstrations for special population groups.Early directions for financing of housing and support services in the community included financing sources, such as housing cooperative programs, mixed income housing associations, community development block grants, loans for accessibility programs, tax exempt bonds, trust funds, housing subsidies, and low interest loans. The housing communities and institutes in the US, as early as the early 1980s, included Institute for Community Economics, McAuley Institute, Women's Institute for Housing and Economic Development, Habitat for Humanity, the Housing Technical Assistance Project of the ARCs, Local Support Corporation, University of Vermont, Creative Management Associates, Enterprise Foundation, and National Housing Coalition.
The US Department of Housing and Urban Development regularly makes available free information on housing financing and developments in the US through their website, including "Research Works" and "US Housing Market Conditions". Specific technical resources are available to providers and researchers such as on Section 8 or housing vouchers.