“Halfway Independent”: Experiences of formerly homeless adults living in permanent supportive housing

Abstract

Permanent supportive housing (PSH), which combines affordable public housing with social services, has become the dominant model in the United States for providing housing to formerly homeless people. PSH has been effective in reducing re‐entry to homelessness, yet has shown limited evidence of improving formerly homeless individuals' mental health and quality of life. This study aimed to understand the lived experiences of formerly homeless adults' adjustment to tenancy in PSH, with a focus on how living in PSH has affected their meaningful activity and social engagement. Based on a phenomenological approach, a thematic analysis was conducted using semi‐structured interviews with 17 individuals living in three PSH buildings in New York City. Results suggested that PSH was beneficial in fulfilling formerly homeless individual's basic needs and facilitating lifestyle improvements, yet many were dissatisfied with their living conditions and lacked meaningful activity, social integration, and community belongingness. These issues were found to develop in large part as a result of formerly homeless individuals' disharmonious relationships within the social context of PSH, consisting of staff members, other residents, and people in the surrounding community. The effects of the COVID‐19 pandemic and implications for PSH social services are discussed.

Variables associated with deterioration in quality of life among individuals living in permanent supportive housing in Quebec during the COVID-19 pandemic

“…Congregate PSH has been shown to reduce social isolation and to provide a more comprehensive response to resident needs compared with other models [27], while also allowing for day-to-day interactions between staff and residents [28], which increased the ability to identify emerging problems [29]. Social participation has also been linked to higher QoL [30,31]. Yet, the advantages in congregate PSH of sharing living spaces with peers, and having staff onsite, may have been offset by greater isolation from the outside world during the COVID-19 pandemic, as reported in long-term care residences for the elderly.…”

“…Yet, the advantages in congregate PSH of sharing living spaces with peers, and having staff onsite, may have been offset by greater isolation from the outside world during the COVID-19 pandemic, as reported in long-term care residences for the elderly. General regulations about prohibition related to home visits and travelling during the pandemic may also have affected equally the two PSH groups [30]. Concerning duration of residence in PSH, a recent systematic review demonstrated that PSH have sustained greater housing stability and more long-term benefits than treatment as usual but not for QoL in follow-up data up to 6 years [10].…”

“…Previous studies reported that diagnoses of MD, including SUD, were associated with lower QoL [17,33], and that these individuals were at increased risk for adverse psychosocial outcomes during the COVID-19 pandemic [34], with greater risks of experiencing deterioration in QoL as a consequence. Symptoms and suicidal thoughts related to MD were also found to be elevated in PSH residents due to decreased social engagement and meaningful activity [30], or to maladaptive lifestyle-related behaviors during the COVID-19 pandemic [35]. Contracting COVID-19 was also identified previously as associated with deterioration in QoL [4], as measures taken during the pandemic reinforced social isolation, increased the amount of time spent at home and prolonged the inability of relatives to offer support, which, in turn, exacerbated psychological distress and depression [36].…”

Bringing Lived Experience to Research on Health and Homelessness: Perspectives of Researchers and Lived Experience Partners

“…Consequently, most LEG members have previously been involved in activities—such as volunteering for research projects, speaking at conferences, or working as peer advocates in PSH programs—that are not typically pursued by most people who experience homelessness. Many individuals exiting homelessness continue to experience a lack of meaningful activity and social integration, (Harris et al, 2019 ; Hawkins & Abrams, 2007 ; Pilla & Park-Taylor, 2022 ), and it is likely that that our LEG members are more active and engaged in their community than most people who are experiencing homelessness or transitioning to housing. Furthermore, in our study, lived experience contributions were confined to the perspectives of people who had previously experienced homelessness.…”

Homelessness within the COVID-19 Pandemic in Two Nova Scotian Communities

“…The COVID-19 pandemic opened a window to comprehensively examine the diverse vulnerabilities regarding homeless individuals, including physical health (Kar et al, 2020), mental health (Martin et al, 2021), overall wellbeing (van Ruth, 2021), vaccine hesitancy (Balut et al, 2021), historical poverty and alterative affordable housing (Pilla & Park-Taylor, 2021), and social exclusions (Platt et al, 2021), with a focus on the entire life span from youth (Schwan et al, 2020) to older adults (Gombita et al, 2020). When governments worldwide released stay-athome orders to quickly respond to the COVID-19 emergency, previous housing challenges faced by homeless individuals were compounded by the public health protocols, further strengthening their vulnerabilities and related negative influence as well as reducing their coping capacities of developing mitigation strategies (Obasi & Anierobi, 2020;Wu & Karabanow, 2020).…”