The Role of Recovery Housing: Prioritizing Choice in Homeless Services

Abstract

Housing options for people exiting homelessness and seeking recovery from substance use disorders are limited. Policies tend to favor low-demand models such as housing first and permanent supportive housing that do not require abstinence, but offer immediate housing placement based on consumer choice and separate housing from clinical services. While these models have proven effective in promoting housing retention, especially among individuals with a primary diagnosis of mental illness, evidence to support positive outcomes related to people with a primary or co-occurring substance use disorder are mixed. Recovery housing models provide abstinence-focused environments and integrated peer support embedded within a recovery framework. Various models exist along a continuum from fully peer-run to clinically staffed residences. However, this continuum is typically separate from the homeless services system, and many barriers to integration persist. Recent national dialogues have begun to explore opportunities to integrate housing and substance use recovery approaches to meet the needs of people who need both types of support. This perspective paper argues that recovery housing is essential for supporting some homeless individuals and families. Within a comprehensive continuum based on choice, both recovery housing and low-demand models can support housing retention, reduce homelessness, promote recovery, and foster self-determination.

Problems and service needs among ex-offenders with HIV risk behaviors entering sober living recovery homes

“…Moreover, both housing status and housing stability predicted a variety of problem areas controlling for demographic factors. These findings support the growing contention in the broader literature on homelessness that consumer perceptions about housing choices should be considered when providing housing assistance (Paquette & Pannella Winn, 2016; Pannella Winn & Paquette, 2016). …”

Housing Status, Psychiatric Symptoms, and Substance Abuse Outcomes Among Sober Living House Residents Over 18 Months

“…The study findings reported here support recommendations made by Paquette and Winn, 17,18 who suggest a better approach to co-occurring problems of substance abuse problems among persons who are homeless or unstably housed would be to provide funding for a broader based system of choices that includes HF, SLHs, and other housing options. The availability of these distinct housing options would provide greater responsivity to individuals.…”

“…It has been argued that a significant limitation in current homeless services is the failure to fund different housing options that would present choices to consumers. 17,18 While the U.S. Department of Housing and Urban Development provides funding or some types of housing programs (e.g., HF), it does not provide funds for others (e.g., SLHs and other types of recovery residences).…”

“…17,18 Studies that have been conducted of SLHs and OHs where significant proportions of the residents were homeless at entry have shown favorable outcomes. For example, in a study of 53 residents of OHs in St. Louis half were found to have a history of homelessness.…”

Integrating Housing and Recovery Support Services: Introduction to the Special Section

“…The article by Paquette and Winn (2016) summarizes system-level barriers to integrating recovery housing (i.e., abstinence-based living environments that promote recovery from addiction) and homelessness services. They highlight key differences between recovery housing, which presumes abstinence, and “housing first” approaches, in which neither abstinence nor service use is a precondition to housing, and offer recommendations for research, policy, and practice to better integrate recovery housing into homelessness service continuums.…”