Volume 3 Number 7
July/August 2006

In this Issue
Outcomes of Permanent Housing Programs for the Homeless
Fair Housing: What the Public Knows and Supports
Exploring Subprime Mortgage Lending and Alternative Financial Services
Does Owning a Manufactured Home Make Sense?
In the next issue of ResearchWorks

Outcomes of Permanent Housing Programs for the Homeless

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According to the U.S. Department of Health and Human Services, over 600,000 adults are homeless in an average week. Since the passage of the Stewart B. McKinney Homeless Assistance Act of 1990, however, the problem of chronic homelessness has been systematically attacked on many fronts. Permanent housing, in which there’s no limit on length-of-stay, is a significant component of HUD’s overall effort to combat homelessness. Combined with supportive services, permanent housing offers homeless people - especially those with disabilities - a chance to live independently and safely in their own homes.

Yet despite what the term permanence implies, about 12 percent of participants in these HUD-funded programs left permanent housing in 2004 within the first six months of residence and twentyfive percent left within two years. This has prompted questions regarding the real meaning of ‘permanent housing’ and about what happens to the ‘leavers.’ The following statistics on the paths taken by the leavers suggest that many of them moved on to potentially positive living situations:

Permanent housing, combined with supportive services, can help homeless individuals live independently and safely.

• 23% -> market-rate rentals
• 29% -> subsidized rentals
• 1%  -> homeownership
• 20% -> moved in with family or friends
• 10% -> jail, prison, psychiatric hospital, or inpatient alcohol or drug treatment
• 3%  -> transitional housing
• 3%  -> emergency shelters
• 1%  -> back to the street
• 10% -> unknown

Permanent Housing for the Mentally Ill in Philadelphia

Searching for greater insight into what these statistics mean in terms of policymaking, HUD sponsored an analysis of outcomes for a unique group that participated in Philadelphia’s permanent housing program. Analysts reviewed the tenure of 943 mentally ill individuals, previously counted among the chronically homeless with disabilities, who resided in permanent housing sometime between January 1, 2001 and June 15, 2004. A research team interviewed 100 participants who left permanent housing between February 2003 and December 2004, as well as a matched sample of ‘stayers’ who were living in permanent housing as of January 2005. The researchers also interviewed service providers.

The individuals making up the Philadelphia sample were scattered across 28 different programs in five areas of the city. Most lived in diverse neighborhoods where supportive services could be easily accessed. Notably, more than half of the residents interviewed did not view their living arrangements as permanent. Rather, they had intentions of ultimately living elsewhere. And indeed, the incidence of leaving permanent housing was about 30 percent within the first 18 months of residence and 50 percent after 30 months.

Differing circumstances of leaving were reported among those who departed permanent housing. Sixty-one percent were voluntary leavers, while 39 percent left involuntarily at the request of the housing provider or program staff. Most who chose to leave permanent housing were seeking to improve their living situation. They seemed to have the necessary skills to live independently and to reintegrate with the community. Perhaps most importantly, they were able to tap into financial resources (housing subsidies, social security, food stamps) that reduced their living expenses, as well as to maintain appropriate treatment for their illness. This is consistent with recent research showing that unconditional assurance of a roof over one’s head often reduces stress, freeing the individual to constructively get on with the business of living. According to Judith Samuels of the Nathan S. Kline Institute for Psychiatric Research, “Housed individuals feel empowered to control their lives and start making better choices.”

In retrospect, leavers of permanent housing who left involuntarily, or who went on to less favorable situations, had higher risk profiles than those leaving of their own accord. As a group, their illnesses were more severe. They functioned less effectively, had a greater rate of substance abuse, and required a higher level of supportive services. Inpatient and emergency psychiatric services were required at a relatively higher rate, suggesting that the illnesses of these individuals may have worsened.

Involuntary leavers of permanent housing often have higher risk profiles and require more supportive services.

The reviewers of the Philadelphia program concluded that, while permanent housing programs belong in the arsenal used to combat chronic homelessness, there is much more that can be done to improve these programs’ outcomes. Among the more promising would be detection of early warning signs related to unfavorable departures — especially at the point of entry into permanent housing — to allow for timely application of preventive measures. Effective tools are needed to ensure an initial assessment and ongoing monitoring of risk that will steer residents to appropriate supportive services. Such tools can lead to a better use of resources and increase the likelihood of positive outcomes for residents.

This analysis is reported in a new HUD publication titled Predicting Staying In or Leaving Permanent Supportive Housing That Serves Homeless People with Serious Mental Illness. It can be downloaded at no cost from the HUD USER website at http://www.huduser.org/publications/homeless/permhsgstudy.html or ordered in print for a nominal fee by calling 800.245.2691, option 1. For additional HUD publications on homelessness, see http://www.huduser.org/publications/povsoc.html.