The history of housing and treatment services for people with serious psychiatric disabilities: Models of residential service delivery

During the last decade, supported housing has emerged as a popular new approach to the delivery of housing and treatment services for consumers who have been homeless and experience serious psychiatric disabilities and/or substance use disorders. Supported housing offers an alternative to the residential treatment programs comprising traditional linear residential continuum of care models by offering consumers access to independent, permanent housing integrated with non-disabled members of the community, choices regarding the location of their housing from available housing stock, and the availability of a wide range of community-based treatment and support services designed to maximize independent living skills and successful community integration (Carling, 1995). To date, research on supported housing has focused almost exclusively on examining concrete aspects of consumers' experiences in supported housing (e.g., changes in psychiatric stability following receipt of housing, and factors associated with increased housing satisfaction and stability) (Baker & Douglas, 1990; Cohen & Somers, 1990; Hogan & Carling, 1992; McCarthy & Nelson, 1991; Nelson, Smith-Fowler, 1987; Nelson, Wiltshire, Hall, Peirson, & Walsh-Bowers, 1995; Rimmerman, Finn, Schnee, & Klein, 1992). Research has yet to understand tenants' experiences living in supported housing, their relationships with other supported housing participants, and their definition of home. To help fill the research gap, the goal of this dissertation study was to use a grounded theory approach to qualitative data analysis to examine consumers' experiences residing in a Shelter Plus Care (SPC) funded supported housing program in Hartford, Connecticut. Using a 43-item semi-structured qualitative interview as a guide, eight tenants receiving supported housing through the SPC program were asked to describe: (1) their experiences living in their apartments, (2) their definition of home, (3) the quality of their experiences interacting with other supported housing program participants (landlords, service providers, housing program staff), and (4) needs for a successful housing experience. Although tenants' personal experiences living in their apartments and interactions with other supported housing program participants were varied, overall tenants reported positive experiences participating in this supported housing program. Tenants' descriptions of their apartment settings and past experiences with homelessness were compared to current definitions of home. Implications of tenants' differentiation of the physical and architectural needs fulfilled by a housing environment from the subjective, intangible attributes identified as necessary to have a home were discussed. These results are followed by recommendations for service providers and housing program planners working with tenants and landlords participating in supported housing.

Publication Date: 
2005