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Assessing the Evidence Base Series
Published Online: 15 October 2014

Permanent Supportive Housing: Assessing the Evidence

Debra J. Rog, Ph.D., Tina Marshall, Ph.D., Richard H. Dougherty, Ph.D., Preethy George, Ph.D., Allen S. Daniels, Ed.D., Sushmita Shoma Ghose, Ph.D., and Miriam E. Delphin-Rittmon, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 65, Number 3
https://doi.org/10.1176/appi.ps.201300261
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Abstract

Permanent supportive housing for individuals with mental illness and substance abuse is predicated on the simple idea that housing has an impact on health and should be part of the treatment and recovery process. Service providers offer ongoing support and collaborate with property managers to preserve tenancy and help individuals resolve crisis situations and other issues. This comprehensive literature review (1995–2012) found substantial research evidence demonstrating that this approach has been successful, but more rigorous studies are needed to clarify which components of the model are most effective and for which subpopulations.

Abstract

Objectives

Permanent supportive housing provides safe, stable housing for people with mental and substance use disorders who are homeless or disabled. This article describes permanent supportive housing and reviews research.

Methods

Authors reviewed individual studies and literature reviews from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. The authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness.

Results

The level of evidence for permanent supportive housing was graded as moderate. Substantial literature, including seven randomized controlled trials, demonstrated that components of the model reduced homelessness, increased housing tenure, and decreased emergency room visits and hospitalization. Consumers consistently rated this model more positively than other housing models. Methodological flaws limited the ability to draw firm conclusions. Results were stronger for studies that compared permanent supportive housing with treatment as usual or no housing rather than with other models.

Conclusions

The moderate level of evidence indicates that permanent supportive housing is promising, but research is needed to clarify the model and determine the most effective elements for various subpopulations. Policy makers should consider including permanent supportive housing as a covered service for individuals with mental and substance use disorders. An evaluation component is needed to continue building its evidence base.

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Information & Authors

Information

Published In

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Cover: Young Girl Playing, by Jessie Willcox Smith, 1902. Watercolor and charcoal on board. © Copyright 2014 National Museum of American Illustration™, Newport, Rhode Island. Photo courtesy of Archives of the American Illustrators Gallery™, New York.

Psychiatric Services
Volume 65 • Number 3 • March 2014
Pages: 287 - 294
PubMed: 24343350

History

Published in print: March 2014
Published online: 15 October 2014

Authors

Details

Debra J. Rog, Ph.D.
Dr. Rog, Dr. Marshall, Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Dougherty is with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
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Tina Marshall, Ph.D.
Dr. Rog, Dr. Marshall, Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Dougherty is with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
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Richard H. Dougherty, Ph.D.
Dr. Rog, Dr. Marshall, Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Dougherty is with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
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Preethy George, Ph.D.
Dr. Rog, Dr. Marshall, Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Dougherty is with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
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Allen S. Daniels, Ed.D.
Dr. Rog, Dr. Marshall, Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Dougherty is with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
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Sushmita Shoma Ghose, Ph.D.
Dr. Rog, Dr. Marshall, Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Dougherty is with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
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Miriam E. Delphin-Rittmon, Ph.D.
Dr. Rog, Dr. Marshall, Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Dougherty is with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
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