SUPPORTIVE HOUSING:
The Most Effective and Integrated Housing for
People with Mental Disabilities1
Introduction
People with mental disabilities can successfully live in the community like
everyone else, as envisioned by the Americans with Disabilities Act. Supportive
housing makes this possible. Supportive housing gives them their own apartment
or home while making available a wide variety of services to support recovery,
engagement in community life and successful tenancy.
A growing body of evidence confirms that supportive housing works for people
with mental disabilities, including those with the most severe impairments.
Indeed, these individuals may benefit the most from supportive housing.
Supportive housing gets much higher marks than less integrated alternatives;
research confirms that people with disabilities vastly prefer living in their own
apartment or home instead of in group homes or buildings housing primarily
people with disabilities. Moreover, supportive housing is less costly than other
forms of government-financed housing for people with disabilities. Studies have
shown that it leads to more housing stability, improvement in mental health
symptoms, reduced hospitalization and increased satisfaction with quality of life,
including for participants with significant impairments, when compared to other
types of housing for people with mental disabilities.2 Supportive housing has
been endorsed by the federal government, including the U.S. Department of
Housing and Urban Development,3 the Surgeon General,4 the U.S. Department
of Health and Human Services5 and the National Council on Disability.6
The Basic Principles of Supportive Housing
Three basic principles guide supportive housing.7 First, supportive housing gives
participants immediate, permanent housing in their own apartments or homes.
Unlike most other housing for people with disabilities, there is no limit on how
long the person can stay in the residence, and temporary absences do not lead
to disenrollment. Treatment compliance or sobriety is not a requirement for
receiving or remaining in housing.8 Supportive housing participants have the
same rights and responsibilities as any other tenant. They may lose their unit, for example, for disruptive behavior or drug use. Supportive housing staff, however,
try to avoid this situation by providing supports and the accommodations
necessary to help ensure successful tenancy.
Supportive housing provides housing first, allowing participants the opportunity to
focus on recovery next. Adequate, stable housing is a prerequisite for improved
functioning for people with mental disabilities and a powerful motivator for people
to seek and sustain treatment.9 Studies find that providing immediate, permanent
housing leads to more long-term housing stability when compared to housing
conditioned on treatment.10
Second, individuals in supportive housing have access to a comprehensive array
of services and supports, from crisis mental health services to cooking tutors.11
Services are provided as needed to ensure successful tenancy and to support
the person’s recovery and engagement in community life. Services and supports
are provided in the home and other natural settings, allowing individuals to learn
and practice skills in the actual environment where they will be using them.12
Services are available whenever people need them, including after working hours
and on weekends when necessary. Service providers are highly flexible and
supports are highly individualized. A creative “whatever it takes” approach is
pursued. No “program” attendance is required and services are increased,
tapered or discontinued as decided by the individual in consultation with the
provider. As a result, individuals “buy in” to the treatment plan—the most
important predictor of plan success.13
Available services and supports include mental health and substance abuse
treatment and independent living services, including help in learning how to
maintain a home and manage money as well as training in the social skills
necessary to get along with others in the community. Medication management,
crisis intervention and case management are also available. Peer-support
services are especially effective in securing good results.14 For individuals who
are unable to do certain tasks, such as cooking and cleaning on their own,
personal care and/or home-care services are provided until no longer needed.
Assertive Community Treatment (ACT) teams serve the clients with the greatest
challenges, including individuals with serious mental illnesses who have coexisting
problems such as homelessness, substance abuse or involvement with
the judicial system.15 ACT teams are interdisciplinary and mobile, typically
including a social worker, psychiatrist, substance abuse counselor, nurse,
vocational counselor and housing specialist. They develop individualized
treatment plans with their clients and provide services around-the-clock in
consumers’ homes and in the community. Among the services ACT teams may
provide are: case management, initial and ongoing assessment, psychiatric
services, rehabilitation services, employment and housing assistance, family
support and education, substance abuse services, and other supports critical to
an individual’s ability to live successfully in the community.  Excerpt from BAZELON CENTER FOR MENTAL HEALTH

Each blog I submit, I try to leave the reader with a picture of supported housing, and how important it is to the community. When we include ourselves in the life of others, we not only gain friendships, we give back to what God so freely gave to us. lifenewfmind

New FoundMinds…Birthing a new way of thinking, living, and sustaining life.

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