Housing first: paradigm or program?

Schiff, Jeannette Waegemakers; Schiff, Rebecca

doi:10.1179/1573658x14y.0000000007

Cited by 24 publications

(28 citation statements)

References 56 publications

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“…Eriksson et al 2010; Stenberg et al 1995, 2011). This notion of a “non housing-ready” population, which is also widespread in the current debate on pathways into housing (as an argument against the “housing first” model) (Tsemberis et al 2004; Waegemakers Schiff and Schiff 2014) tends in other words to make the positive aspects of having a dwelling (or inversely, the negative aspects of losing it) conditional upon individuals ability to maintain their independent housing status. Thus, for those who are not members of the “housing-ready” population, the dwelling tends to be reduced to a mere question of bricks and mortar.…”

Section: Discussionmentioning

confidence: 99%

Evictions and short-term all-cause mortality: a 3-year follow-up study of a middle-aged Swedish population

Rojas

2016

Int J Public Health

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ObjectivesThis study sets out to explore whether being forcibly removed from one’s home is related to all-cause mortality.MethodsWith the help of unique register data covering all middle-aged persons registered at the Swedish Enforcement Authority with a case closed by an eviction during the period 2009–2011 (n = 2092), evictees’ deaths from any cause that occurred within 3 years of the date of the eviction are compared with the all-cause mortality of a random sample of the Swedish population (n = 426,117). The analysis is based on penalized maximum likelihood logistic regressions.ResultsThose who had been evicted from their homes were found to be approximately one and a half times more likely to die from any cause than those who had not been exposed to this experience (OR = 1.59), controlling for several demographic, socio-economic and health conditions prior to the date of the eviction.ConclusionsThe results provide support for the notion that the experience of losing one’s dwelling place should be treated as a major life event in its own right, just like other well-established social stressors.

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Section: Discussionmentioning

confidence: 99%

Evictions and short-term all-cause mortality: a 3-year follow-up study of a middle-aged Swedish population

Rojas

2016

Int J Public Health

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“…Although some studies have compared HF and “usual care” approaches that used the continuum of care model and reported comparable or better outcomes for HF, reviews of these studies have cited a variety of limitations, including characteristics of the samples used, selection of inclusion and exclusion criteria, measures used to assess problems, neglect of specific behaviors (e.g., assessment of heavy drinking), and retrospective data collection methods such as clinical chart reviews. 11,12 An additional concern in some of these studies was the use of unclear comparison conditions that did not define “usual care” or identify what services were offered or received. When continuum of care was identified as a comparison condition few of those programs had resources for long term housing after completion of treatment despite the fact that permanent housing is supposedly an integral component of the continuum of care approach.…”

Section: Introductionmentioning

confidence: 99%

Housing Status, Psychiatric Symptoms, and Substance Abuse Outcomes Among Sober Living House Residents Over 18 Months

Polcin

Korcha

2017

Addictive Disorders &Amp; Their Treatment

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Studies show individuals entering sober living recovery houses (SLHs) make significant, sustained improvement on measures of substance abuse problems, employment, and arrests. The current study assessed changes in housing status among SLH residents over 18 months and the relative influences of housing status and psychiatric distress on substance abuse outcomes. Two hundred forty one men and 58 women, all age 18 and older, were interviewed within their first week of entering 20 SLHs and again at 6-, 12-, and 18-month follow-up. Between entry into the SLHs and 18-month follow-up homelessness declined from 16% to 4%, marginal housing declined from 66% to 46%, and stable housing increased from 13% to 27%. Psychiatric severity was generally mild to moderate in severity, but nevertheless showed improvement over the 18-month study period. Multivariate models showed worse substance abuse outcomes for residents with higher psychiatric distress and unstable housing. Relative to persons with stable housing, those who were homeless or marginally housed had worse outcomes and those in SLHs had better outcomes. Overall, we conclude that individuals entering SLHs show improvement in housing status and psychiatric distress, both of which are associated with better substance abuse outcomes.

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“…Reviews of the research on HF indicate when homeless persons are provided free or subsidized apartments they tend to stay in those locations for extended periods of time (Kertesz, et al, 2009; 2015; Waegemakers, et al, 2014). While some studies have documented other favorable outcomes (e.g., substance abuse and mental health), reviews of the current literature have described a variety of research design limitations.…”

Section: Housing Firstmentioning

confidence: 99%

“…While some studies have documented other favorable outcomes (e.g., substance abuse and mental health), reviews of the current literature have described a variety of research design limitations. Concerns have been raised about the measures used, study procedures, sampling, and descriptions of comparison groups (Kertesz, et al, 2009; Waegemakers, et al, 2014). One factor shown to be associated with favorable outcomes is the provision of case management services (Hwang et al, 2005).…”

Section: Housing Firstmentioning

confidence: 99%

The architecture of recovery: two kinds of housing assistance for chronic homeless persons with substance use disorders

Wittman¹,

Polcin

Sheridan³

2017

DAT

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Purpose Roughly half a million persons in the United States are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. Approach We examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals. Findings We found two predominant housing models that reflect different service goals: Sober Living Houses (SLHs) and Housing First (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders and other problems. Practical Implications If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of “recovery,” roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing. Originality This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon an integrated analysis that considers how architecture and operations align with service goals.

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Housing first: paradigm or program?

Cited by 24 publications

References 56 publications

Evictions and short-term all-cause mortality: a 3-year follow-up study of a middle-aged Swedish population

Evictions and short-term all-cause mortality: a 3-year follow-up study of a middle-aged Swedish population

Housing Status, Psychiatric Symptoms, and Substance Abuse Outcomes Among Sober Living House Residents Over 18 Months

The architecture of recovery: two kinds of housing assistance for chronic homeless persons with substance use disorders

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