With the 2023 National Conference on Ending Homelessness approaching, I am excited to discuss the findings of a research project that I have been involved with. This project is a 2-year qualitative and quantitative study of a permanent supportive housing program in London, Ontario. The findings of this study provide key insights into the experienced value of permanent supportive housing and the current policy challenges that limit the development of new supportive housing stock. 

This blog will provide an overview of the project and its key findings.


Permanent Supportive Housing (PSH) is characterized by two core features:

  1. Housing that is deeply affordable
  2. Accessible supports that include housing stability and health services 

The implementation of a PSH program in London, Ontario developed by Indwell, created an opportunity to evaluate the impact of a new service that blended housing with embedded health and housing stability supports – a service that was new for the City of London. A team of researchers, led by Abram Oudshoorn from Western University took advantage of this opportunity by completing a 2-year study on this topic using a community-based participatory action research design. The design of the study allowed for a deeper exploration of what supportive housing means to the people who live in it. While the in-depth interviews with staff and program administrators conducted as part of the study, provided insights into the development and operation of permanent supportive housing.


The results of the study provided a deeper understanding of people’s journeys into housing stability. Tenants described the elements of PSH that assisted their housing stability and independence and three general themes emerged. 

1. People have available supports as required.

The proximity and nature of the support provided by the PSH were both cited by participants as important to their well-being. In terms of proximity, onsite support was identified as valuable as it promoted early access. 

“I'm glad that there are people around here that I can just phone or talk to…that help me with basically anything I need or assist me the best they can to help me. So it’s better than where I was when I was in an apartment and if there was an issue or something that I needed help with, you know, I was on my own and I had to ask my family, oh, what do you think, or what is this, or whatever. And you know, if they didn’t know, then I was literally on my own.” –Karen

2. The housing they live in matches their income. 

Participants also identified that affordability matched with the quality of housing in terms of aesthetics and functioning was important.

“The day I first moved in here, big apartment, it was my dream home because I never had an apartment like the one I got right now in my entire life. That’s the best one I had so far. And Indwell is very – it’s a beautiful building and a wonderful building, it’s a nice layout.” –Laura

3.  There is a sense of community that creates a sense of belonging and stability while maintaining independence.  

The final concept that was important to participants was that they felt as if PSH provided them with a community. There are opportunities for engagement with neighbours, however, this does not impact independence. Social connections are not dependent on a congregate setting which is an important feature of PSH as having one’s own space is essential for personal development.

“Living at Indwell is teaching me to do things and is teaching me how to get along with better people, be better people and trust people and let people do and say what they want.” –Goj

Phase 3 of the study utilized both the Gains SS and the Community Integration Scale (CIS) to examine behavioural change and a sense of community belonging among participants. The Gains SS measures participant changes in behaviours over time. Our study found that there were substantive positive changes in all four domains of the tool across two time periods. Whereas the Community Integration Scale measures both physical and psychological interactions. We found that participants demonstrated a significant increase in participation in social events. Meanwhile, changes in the perception of belonging were not significant. 

Finally, key informant interviews with staff and administrators pointed to several challenges with expanded scaling and replication of supportive housing in the current policy environment. 

“Interestingly enough, it took ten years of solid work, until 2016, to convince any health planner, policy/decision maker that investment in supportive housing construction and development was worthwhile.”  - Thomas, Indwell leader.

Based on our findings, one of the key recommendations made was to include permanent supportive housing development in the National Housing Strategy with a corresponding funding mechanism.

Key Takeaways:

  • Permanent supportive housing is an important element of systems that promote the principles of Housing First and ending homelessness.
  • People who otherwise struggle to leave homelessness or institutionalization can find housing stability in PSH where supports is readily available. There is deep affordability in PSH, and this model creates opportunities for belonging and developing a community while maintaining independence.
  • The current policy environment does not support the rapid replication of PSH at a rate that can meet the need.


This post is part of our #CAEH23 blog series which highlights research on preventing and ending homelessness that is being presented at the 2023 National Conference on Ending Homelessness, November 8-10 in Halifax, NS. Learn more about the authors’ work through their presentation in the Models and Obstacles: Promising Directions for Preventing and Ending Homelessness session on Thursday, November 9th at 10:30am