Supportive housing best practices in a mid‐sized US urban community

Abstract

Purpose -Housing First has been upheld as an evidence-based best practice for transitioning homeless individuals into permanent housing in a maximally cost-effective and humane manner. However, there is much variance in the implementation and structure of Housing First programming in the USA. This paper aims to focus on a collaborative, interdisciplinary Housing First effort to house and provide case management and ancillary services to chronically homeless individuals in The City of San Mateo, California.Design/methodology/approach -The paper is a case study in which the philosophy, structure, and impact of San Mateo's outreach and housing team are discussed. To explore the project's impact, data concerning arrests and other criminal justice contacts, as well as health costs associated with these clients, both prior to and post housing and services, were collected and analyzed. These are corroborated with qualitative data on client outcomes.Findings -After participants received housing and wrap-around supportive services provided through the collaboration of police, local stakeholders, and non-profits, the cost of medical care and criminal justice interventions were dramatically reduced. While challenges such as the availability of housing units remain, the findings of this study strongly support the interdisciplinary outreach team as a model for Housing First programming.Research limitations/implications -This is an in-depth study, derived from a particularly innovative project; and therefore the sample size is limited by the size of the project.Originality/value -The originality of this study lies in its analysis of a Housing First model which incorporates an interdisciplinary outreach team designed to provide highly individualized care for clients. The San Mateo permanent supportive housing pilot project is itself unique in that it incorporates a Homeless Outreach Team (HOT) comprised of the police, other government entities, local stakeholders, and other non-profits engaged with homelessness.

Outcomes Associated with Providing Secure, Stable, and Permanent Housing for People Who Have Been Homeless: An International Scoping Review

“…Several research teams found savings across the justice system with fewer prison days and police contacts (Basu et al 2012;Chalmers McLaughlin 2011;Goering et al 2014;Greenberg et al 2013;Larimer et al 2009;West et al 2014). Greenberg et al (2013) found that prior to housing, monthly health costs averaged $US195.93 per person per month, and one year after moving into permanent housing, these costs had dropped 85 percent to $US28.98 per month. There were reductions in mental health costs (Chalmers McLaughlin 2011;Goering et al 2014).…”

“…Reduced criminal reconvictions following stable housing Somers et al (2013) Association between recent incarceration and insecure housing Geller and Curtis (2011) Fewer jail bookings Clifasefi, Malone, and Collins (2013) Less criminal activity/reduced offending DeSilva, Manworren, and Targonski (2011); Srebnik, Connor, and Sylla (2013) Fewer prison days/reduced incarceration Basu et al (2012); Bean, Shafer, and Glennon (2013); Hanratty (2011); Kerman et al (2018); Larimer et al (2009); Srebnik, Connor, and Sylla (2013); Tsai, Mares, and Rosenheck (2010) Reduced police contact/arrests Goering et al (2014); Greenberg et al (2013) violence. Other notable research gaps were older people more generally, refugees, recent migrants, veterans, Indigenous people, and those with a disability.…”

“…(2016);Mares and Rosenheck (2010);Larimer et al (2009);Greenberg et al (2013);Srebnik, Connor, and Sylla (2013); Chalmers McLaughlin (2011); Goering et al (2014); Basu et al (2012) Reduced community service costs Chalmers McLaughlin (2011) Reduced justice costs/prison days/police contact West et al (2014); Chalmers McLaughlin (2011); Goering et al (2014); Basu et al (2012); Larimer et al (2009); Greenberg et al (2013) Reduced mental health costs Chalmers McLaughlin (2011); Goering et al (2014); Latimer et al (2019) Table 5. Service Use Outcomes.…”

Empowering Features and Outcomes of Homeless Interventions: A Systematic Review and Narrative Synthesis

“…As shown in Table 3, two studies of flexible, individualized, and strengths-based interventions described a positive relationship with participants' relational outcomes, and these referred to HF interventions (Bean et al, 2013;Greenberg et al, 2013). One described project H3, and after 12 months, HF participants had significantly greater social quality of life compared to baseline (Bean et al, 2013).…”

“…One described project H3, and after 12 months, HF participants had significantly greater social quality of life compared to baseline (Bean et al, 2013). Greenberg et al (2013) examined HF participants' outcomes over time and reported that after 12 months, 87.5% of HF services users strengthened their connections with family and friends, compared to 12.5% at baseline. However, in both studies the sample sizes were small (< 40), and the absence of detail about participants' characteristics made it difficult to rule out attrition bias or other confounding influences.…”