Supportive Services

The supportive services provided in supportive housing are what distinguish supportive housing from other types of affordable housing. To the extent possible, the supportive services available in a supportive housing project should be customized with the needs of the tenants in mind. Supportive housing support services are intended to help ensure housing stability and to maximize each tenant’s ability to live independently. Depending upon the supportive housing model in use, supportive services may be provided on-site within the supportive housing development, off-site at a central community location, or provided through a mobile team of multidisciplinary service providers that visit tenants in their homes. Additionally, services should be designed and delivered to promote integration of residents into their communities to the greatest extent possible and appropriate.

What are the primary types of services offered in supportive housing?
The examples of services below are not intended to be a comprehensive list. Please visit Developing the “Support” in Supportive Housing for a more detailed description of each category.

Case Management
This is the most widely used form of services in supportive housing. The case manager does not provide every service a tenant needs but helps broker relationships between the tenant and the service providers. Case management can include new tenant orientation, assistance with accessing child care, community building activities and transportation to help the tenant access services in the community.

Mental Health Services
This category of services focuses on assisting a tenant in improving their mental health status. Services under this category may include psychosocial assessment, individual or group counseling, support groups and peer mentoring.

Alcohol and Substance Abuse Services
This category of services is designed to assist tenants in addressing their abuse of substances. Services may include relapse prevention and recovery planning, individual or group counseling, harm reduction services and inpatient rehabilitation.

Independent Living Skills
Tenants in supportive housing may need assistance in acquiring or regaining skills that allow them to maximize their independence. This may include assistance with rent payment and budgeting, conflict resolution, training in cooking/meal preparation, training in personal hygiene and self-care, and training in housekeeping and apartment safety.

Vocational Services
These services are designed to assist a tenant in accessing employment or improving their employment situation. Services may include vocational counseling, job placement and supported employment.

Health/Medical Services
This category of services helps to ensure that a tenant is addressing their physical health needs. This is particularly important as persons experiencing homelessness often have serious unaddressed health needs. Services may include routine medical care, medication management and nutrition counseling.

Peer Support Services
For adults, peer support services are those that are provided by someone who is on their own recovery journey and has received training in how to be helpful to others who participate in mental health services. For children, peer services are called "family-to-family" services. Peer Support Specialists can help people find interesting or fun things to do, advocate for themselves, make friends, get a job, find better housing and learn skills to live well in the community 

Social Activities
Social activities can be a great way to build community within supportive housing. Some activities can be provided by housing and service providers and others can be tenant-led. In addition to helping to create a positive milieu within a building, these types of activities help to engage people who might otherwise isolate in their apartments.

 

What are the primary approaches to providing supportive housing?
In structuring the services within a supportive housing project, there are several approaches that can be utilized in order to improve outcomes for tenants and promote housing stability.

Housing First
Housing first is a philosophy that homelessness can be most efficiently ended by providing someone with access to safe, decent and affordable housing. Although an individual experiencing homelessness may benefit from supportive services such as mental health or substance abuse counseling, participation in these services is not a prerequisite to access housing or a condition of maintaining it. In fact, the stability provided by a housing unit facilitates the ability of a tenant to participate in these services. Research has shown that even when participation in services is not required as a condition of tenancy in supportive housing, tenants still participate at high rates[i]. The housing first philosophy focuses on simplifying the process of accessing housing through streamlining the application process and removing unnecessary documentation or site visits. It also ensures that supportive housing tenants are not subject to conditions of tenancy that exceed the normal conditions under which any leaseholder would be subject, including participation in treatment or other services. Research has demonstrated that this approach is effective in promoting housing stability, particularly among people who have been homeless for long periods of time and have serious psychiatric disabilities, substance use disorders and/or other disabilities.[ii]

Harm Reduction
Similar to Housing First, the Harm Reduction philosophy prioritizes housing stability among persons who have experienced homelessness and who may be facing disabilities. Although recovery from mental health and substance abuse disorders is always the goal, harm reduction acknowledges that persons may be at different places along the continuum of behavior change. Harm reduction focuses on meeting tenants where they are at and assisting them to set and achieve goals for themselves. In this process a trusting relationship is established with the provider. This relationship has been proven to be a key to many individual change processes. Services focus on helping tenants stay housed by assisting with the management of problems that interfere with their ability to meet the obligations of tenancy, such as paying rent. Tenants are also encouraged to explore obstacles toward their goals in an open and non-judgmental atmosphere where they can contemplate costs and benefits of receiving services addressing their special needs, so that staff does not alienate tenants or cause them to begin a dishonest game of hiding their drug use, psychiatric symptoms, etc. Like any other tenant, tenants receiving services using this philosophy must still pay rent and comply with the terms of their lease.

Consumer-Driven Program Design
In designing supportive housing in general and particularly the services to be provided, it is important that potential tenants (often called consumers) have an ongoing opportunity to provide input. Consumer participation is a tool for empowerment through which persons who have experience with homelessness can both “develop management skills…and the ability to make decisions that affect their own lives.”[iii] Organizations can also benefit through the involvement of persons experiencing homelessness. Involving the persons served by a particular policy or program in its development and evaluation can lead toward programs which are more “user-friendly,” responsive and effective.[iv] When tenants are empowered to govern their living community, they are also more likely to respect property and treat neighbors with respect.

 

Go to the next section for a glossary of supportive housing terms.

Go back to the PHA Toolkit Homepage.

 


[i] http://www.csh.org/wp-content/uploads/2011/11/VoluntaryServicesFAQFINAL.pdf

[ii] http://www.csh.org/wp-content/uploads/2011/11/HousingFirstFAQFINAL.pdf

[iii] Buck, D., Rochon, D., Davidson, H., McCurdy, S. (2004). Involving homeless persons in the leadership of a health care organization. Qualitative Health Research, 14(4), 513-525.

[iv] Glasser, N. (1998). Giving voice to homeless people in policy, practice, and research. 1998 National Symposium on Homelessness Research. Retrieved on February 24, 2005 from http://aspe.hhs.gov/homeless/symposium/5-CONSUMR.htm