When we talk about housing stability, we’re referring to the state of having autonomy over living conditions. A person with housing stability has a quality, affordable home they can occupy however long they wish, under their terms. This concept relates to the Social Determinants of Health (SDOH), including mental health, which are environmental conditions that impact a person’s well-being.
People without housing stability often experience challenges to their mental health because they struggle to access the resources they need. Such people need help if they’re to lead healthy, meaningful lives. Supportive housing aims to provide that help.
Supportive housing is a housing model built for individuals with behavioral health needs or developmental disabilities. It aims to address chronic homelessness while enabling individuals to live independently and engage with their community. Supportive housing combines affordable residences with a variety of support and services, such as:
These help vulnerable individuals transition into a state of housing stability. In addition to a dependable housing situation, they have the resources to learn their rights as a tenant and manage their behavioral health to avoid relocating to inpatient facilities. These are means of self-empowerment that can help them rise above unstable conditions.
The foundational idea underpinning supportive housing is that housing stability and mental health outcomes are inextricably linked. Instability in housing can force individuals into overcrowded living conditions and eventually lead to difficulty paying rent, eviction, or homelessness. Any of these can elevate stress levels and mental health problems, so treating housing and mental health as a combined concern is more sensible and effective than addressing them separately.
It’s difficult to pinpoint permanent supportive housing examples because there’s no universal design model when it comes to this housing model. Some units are purpose-built residences. Others are units in privately owned buildings, set aside for supportive housing candidates. Still others are units on the private market but paid for with subsidies.
Supportive housing is often confused with other types of housing models, like transitional housing and group homes. But compared to supportive housing, these other models can be restrictive. They’re also transient, providing temporary housing and services only until an individual moves to a more permanent residence. As you’ll see, those characteristics don’t align with the principles of supportive housing.
Supportive housing programs target specific populations who are vulnerable to housing instability, such as:
A large proportion of supportive housing units are for individuals experiencing chronic homelessness. This is defined as being without a home for more than a year or a minimum of four times across three years. According to the Annual Homeless Assessment Report, the inventory of year-round beds for the formerly homeless in permanent supportive housing amounted to more than 370,000, accounting for 66% of all the beds in programs designed to help people leave homelessness.
Individuals with mental illness commonly face housing instability because their health introduces unpredictable variables into their lives. Often, they need support and guidance to stay true to their medication regimen, without which they may become hospitalized for mental health crises. So supportive housing for mental health does more than provide individuals with a permanent place to stay. It’s also the key to the resources they need to maintain their health.
People with substance dependence often face unique challenges on their path to recovery. Other assisted housing options aren’t helpful because of time-limited bans related to drugs, and some agencies might deny assistance on the basis of drug history. With these alternatives closed to them, people with substance dependence may experience undesirable outcomes, including relapse and homelessness. For them, supportive housing is an encouragement to continue on the recovery path.
Many people with developmental disabilities have historically lived in isolated institutions with scarce control over their lives and the services they received. They also face a serious shortage of housing options in addition to housing discrimination. Supportive housing would provide these individuals with safe and affordable living arrangements that integrate them into the community.
Half of the country provides no foster care services for individuals aged 18 and older. As soon as they become legal adults, they age out of the system and find themselves forced to navigate, alone, a series of unfamiliar environments. Poor outcomes tend to arise as a result, including unemployment, homelessness, and incarceration.
For many elderly people, supportive housing provides a more dignified alternative to assisted-living facilities like nursing homes. They have the freedom to live on their own terms while receiving essential support. Resources are available to help them stay on their medications and seek vital health services, and often there are community-based programs to facilitate activity, socialization, and engagement.
A set of key characteristics distinguishes supportive housing from other forms of assisted housing:
Supportive housing is meant to be permanent. It provides long-term housing with no designated limits on how long an individual or family can stay. While occupying the unit, they enjoy the same rights and obligations as any other tenant. The lease bears their name, no one can invade the sanctuary of their privacy, and no one can force them to leave if they haven’t violated the terms of their lease. In effect, they’ve achieved housing stability.
Affordability is one of the core tenets of housing stability. To keep conditions affordable, supportive tenants are responsible only for a portion of their rent and utilities, typically spending 30% of their income or less on rent costs. Percentage-based rent control ensures they can cover installment payments even if their income fluctuates.
Remember, the purpose of supportive housing is to help vulnerable populations achieve housing stability and lead normal lives. To that end, supportive housing systems feature lenient eligibility requirements so the people who need help can get it.
For example, consider New York City’s supportive housing system for individuals with serious mental illness. There’s just one clinical criterium: having a serious mental illness. Aside from that, candidates need to submit an application, a psychiatric evaluation, and a psychosocial assessment.
Supportive housing tenants are varied individuals, and so are the services available to them. The providers associated with supportive housing systems include:
Service coordinators can also refer tenants to external programs when necessary. For example, if a tenant needs employment training, a case manager can help establish them with a mainstream organization that specializes in that area.
The prime function of every provider, regardless of their discipline, is to keep tenants housed. Any mental health, physical health, or substance use service is a means to that end. If necessary, the service provider may intercede on a tenant’s behalf to keep them from being ejected from their supportive housing unit.
Participating in services is voluntary and is not a requirement of maintaining the lease. The services are assertive, however. That means providers offer the services persistently and encourage tenants to use them. But the tenant chooses whether to accept or deny them at any given time.
Tenants have the power to direct their own lives. They decide whether a particular housing unit is suitable for them. They can decide to move to another unit if their current unit isn’t suitable. No one dictates their day-to-day living, and they can conduct activities and receive visitors as they please.
Compare these conditions to a halfway home, which restricts certain activities and keeps residents on semi-strict schedules. Whereas a supportive housing tenant can come and go as they please, a halfway home resident would abide by a curfew that prevents them from leaving the premises at specified times of the day.
For supportive housing to succeed, tenants mustn’t live apart from the communities they enter or the services they need. Housing units are within ordinary residential neighborhoods, which promotes the normality of the living situation. Common community amenities and resources — stores, mass transit, green spaces — are within easy reach, just as they are for everyone else. And accessing support services is no hassle. Providers may visit tenants at their homes or wherever the tenants prefer. If a tenant relocates, that has no impact on service accessibility.
Supportive housing provides numerous advantages to vulnerable, housing-unstable populations while also benefiting the community at large. Namely:
Supportive housing is one of the most sustainable ways to provide affordable housing that connects individuals with their communities. In fact, supportive housing communities are just ordinary communities, so individuals can interact with people of various populations and have access to all the public amenities in the area.
In some programs, individuals rent units in buildings that are not exclusively dedicated to supportive housing, allowing them to live alongside neighbors who do not necessarily have disabilities or behavioral health needs. So tenants can feel they’re normal contributing members of society, which is what they are. That goes a long way in empowering them to take positive control of their lives.
Since services are typically provided at or near the residence, the supportive housing model increases the accessibility of those supports. Individuals don’t have to travel long distances to meet with providers. This is particularly important in areas with limited public transit infrastructure.
By offering stable housing, individuals are more likely to address their own health care needs and receive early health care interventions. What’s more, providers can link individuals with primary and specialty medical care, allowing tenants to overcome conditions that stand in the way of empowerment and housing stability. In a 2006 study done in Denver, for instance, half of all supportive housing residents experienced improved health status, while 43% had better mental health outcomes and 15% reduced their substance use.
Supportive housing has been shown to bring down health care costs by reducing the need for emergency room visits, ambulance rides, and overnight hospital stays. Affordable, stable housing can also reduce the burden on other public institutions, such as shelters and the child welfare system, as well as the risk of re-incarceration, family separation, and additional trauma.
The continued progress of the supportive housing model faces a few main challenges, such as:
NIMBY, which stands for “not in my backyard,” is the phenomenon of community opposition to certain developments in a particular area. With regard to supportive housing, NIMBYism stems from a range of misconceptions surrounding the effect that affordable housing has on the community, particularly concerning factors like crime rates, property values, race, class, and neighborhood aesthetics.
Overcoming NIMBYism requires a multifaceted, long-term approach that encompasses education and awareness of the system’s advantages. It’s important to engage the community as early as possible and share the lived experiences of community advocates. The United States Department of Housing and Urban Development (HUD) offers a NIMBY decision tree that provides a framework for advocates and agencies who are tackling these factors.
Supportive housing requires a mix of funding sources to establish or renovate a quality residence unit, operate the residence, and deliver services to tenants. Funding sources include Medicaid, government agencies, and private philanthropic organizations. However, these funding sources are competitive to obtain, shift with changes in policy and community support, and come with their own unique requirements.
To help providers evaluate and secure funding, the Corporation for Supportive Housing (CSH) has published a guide to help providers understand and take advantage of their funding options.
Providers of supportive housing are working to address the unequal distribution of housing resources across gender identity, race, and need. Minority groups continue to represent a disproportionate number of unsheltered homeless. HUD has published a CoC Race and Ethnicity Analysis Tool to help Continuum leaders identify and analyze racial disparities in people experiencing homelessness within their communities.
The problem of unequal distribution also relates to chronic homelessness. Though the supportive housing model was originally designed to address it, some systems struggle to identify individuals experiencing this particular problem. To help providers prioritize such candidates for resources, HUD established its official definition of chronic homelessness in 2015. Providers also rely on homeless management information systems to capture a client’s current living situation and track a client’s entries/exits from the system.
Despite these challenges, supportive housing is a valuable investment. The community health care cost savings aside, it allows large populations of vulnerable people to realize their potential as human beings, something that many of them have been denied because of their circumstances. It’s an indication of empathy on the part of society, and empathy is a cornerstone of healthy minds and healthy cultures.
We have decades of experience working with supportive housing providers and helping to integrate technology into their programs.
Input your search keywords and press Enter.