Evidence

Supportive housing – A successful model

Supportive housing was first developed and implemented in the US in the early 1990s. The model quickly took hold as an effective solution to ending homelessness for people with complex needs. Since that time there have been a range of studies conducted into the effectiveness of the supportive housing model, particularly in terms of reduction in use of other more expensive emergency and crisis services.

One of the most exhaustive studies to evaluate the cost-effectiveness of supportive housing was conducted as part of the New York/New York initiative. The study looked at the use of public health institutions, corrections facilities and emergency shelters by 4,679 homeless people, before and after they were housed in supportive housing. The results were then compared with those of a control group of individuals with the same characteristics of need, who were not placed in supportive housing.

The study found that:

Use of psychiatric centers decreased by 60%
Use of acute facilities in public hospitals (for both physical and mental health presentations) dropped from 8.25 days to 1.65 days per person
Use of state prisons and city jails dropped by 74% and 40% respectively
Use of emergency shelters decreased by 60%

The study found that before placement into NY/NY housing, a homeless person spent an average of four and a half months in a variety of institutional settings per year, at a cost of $40,449. After being housed, the study determined that on average, these costs were reduced to $16,282 per year per person .

A number of similar studies have been conducted across multiple states in the US since that time, with similar results. Across the board, the result of placing people who have previously experienced chronic homelessness into permanent housing with appropriate supports is a significant reduction in the use of costly emergency responses .

Just as compelling as the cost-effectiveness of supportive housing is the evidence of its success in improving the quality of life of individuals. Numerous individual case-studies are available that attest to the positive impact supportive housing has had on people’s lives . It provides people with an environment in which they are safe and secure, and where they can work toward recovery.

In addition to case-studies there is evidence on a larger scale that, overall, residents report that Supportive Housing provides them with quality housing and support that improves their health and well-being. In particular, providing housing first, and then support, as opposed to requiring evidence of sobriety or treatment compliance before housing is provided, was shown to produce significantly higher rates of retention and consumer satisfaction.

In general, retention rates for a range of supportive housing providers are high. Many providers report retention rates above 80% for periods of 3 years and more , with varying reasons for leaving, and only a small percentage as a result of eviction.

Overwhelmingly the evidence shows that Supportive Housing is effective in stably housing chronically homeless individuals with significant support needs. In both economic and human terms, the model is effective in providing long tern housing stability to people who have experienced ongoing difficulties in accessing and maintaining housing.

Who is it for?

HomeGround’s Supportive Housing is generally targeted toward people who have experienced chronic homelessness and have a range of support needs that have impacted on their ability to access appropriate services in an ongoing way.    Often this group of people will have multiple support needs, and may have been seen as ‘non-compliant’ and not ‘housing ready’. Supportive housing is intended to provide appropriate, quality, affordable housing to people first, and then provide support so that they are able to maintain housing, and in the long-term improve health, well-being and connection to the community.

Supportive Housing is not just for single people, but can be aimed at families, or specific target groups such as young people, people with disabilities, or older people. The key is in providing long term support to help people maintain housing, and work toward goals of recovery and integration into the community.

What are the outcomes?
The outcomes of supportive housing for the individual will vary as widely as the individuals themselves. For some, it will be enough that they have maintained housing and achieved a measure of stability in their lives. For others, it will open doors into employment and education, and may be the beginning of a vastly different life to what they had previously thought possible.

In general we speak of improving peoples’ well-being. This is largely determined by the residents themselves and may range from things such as long needed dental treatment; improved access to nutritional food; the opportunity to manage chronic health conditions such as diabetes or hepatitis; an environment in which to address substance use issues; opportunities for recreation and social activities with other residents; better levels of personal hygiene; learning how to be a good neighbour; getting and keeping employment; setting up a home and furnishing it – the possibilities for change are numerous. Supportive housing offers, over the long term, the opportunity for individuals to set aspirational goals and, with the right support, to achieve them.

What makes supportive housing different?

Supportive housing combines a number of service elements to create a model that is different to anything else in the current Australian service system.

The key to supportive housing is the combination of long-term tailored support and long-term quality, affordable housing. It incorporates flexible tenancy management, and has an emphasis on community integration and reduction of social isolation.

There are currently a range of crisis and transitional housing models that combine both support and accommodation in the short-term. Anecdotally, these housing models – while often being very effective in addressing short term need – disengage with people at the point where some measure of stability has been achieved. For the client group that HomeGround works with, this approach typically creates a point at which clients are at risk of re-entering the homelessness system. There are many examples of people re-entering crisis services over long periods of time – some for years – without ever achieving positive change.

Supportive housing offers ongoing housing and support to those who need help to successfully maintain housing and improve their quality of life. It is one vital part of an overall range of strategies to end homelessness in Melbourne.