Understanding the critical ingredients for facilitating consumer change in housing first programming: a case study approach
Open accessAbstract
Housing First is a form of permanent supportive housing for chronically homeless consumers with mental health and substance abuse issues. In light of the model's growing popularity and wide diffusion, researchers and policy makers have identified a need to better understand its critical ingredients and the processes through which they affect consumer outcomes. Researchers used a bottom-up approach to understand the critical ingredients of Housing First within community-based programs. Interviews and focus groups were conducted with 60 informants (staff and consumers) across 4 "successful" Housing First programs. Qualitative analysis demonstrated six program ingredients to be essential: (1) a low-threshold admissions policy, (2) harm reduction, (3) eviction prevention, (4) reduced service requirements, (5) separation of housing and services, and (6) consumer education.
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Housing First helped tenants get housing, whereas harm reduction was the 'tool' to keep people housed.
“helped tenants get housing, whereas harm reduction was the 'tool' to keep people housed”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Watson et al. (2012)
The Results (Harm reduction) call harm reduction the “tool” used to keep consumers housed. But they identify low-threshold admissions policies, not Housing First as a whole, as the mechanism that helped consumers gain access to housing; a staff member describes Housing First as the encompassing philosophy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredTwo studies explored tenants' experiences of harm reduction in Housing First.
“Two studies explored tenants' experiences of harm reduction in Housing First (Collins et al., 2012b; Watson et al., 2012), with two other articles investigated multiple stakeholder groups' perspectives on smoking cessation in relation to harm reduction policies (Alizaga et al., 2020; Peterson et al., 2020).”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Watson et al., 2012
Four studies found that Housing First's harm reduction philosophy fostered improved working relationships, as service users were not fearful of losing their housing if they disclosed substance use, allowing them to discuss the topic more freely with case managers.
“Four studies found that Housing First's harm reduction philosophy fostered improved working relationships, as service users were not fearful of losing their housing if they disclosed substance use, allowing them to discuss the topic more freely with case managers (Andvig et al., 2018; Henwood et al., 2013; Watson et al., 2012; Tiderington et al., 2013).”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Watson et al., 2012
A harm reduction philosophy was found to reduce stress and fear of judgment for Housing First tenants, as their housing was not dependent on sobriety.
“A harm reduction philosophy was found to reduce stress and fear of judgment for Housing First tenants, as their housing was not dependent on sobriety (Watson et al., 2012).”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Watson et al., 2012
Provision of education on harm reduction could help tenants 'attach to their choices and help them to feel positively about their achievements'.
“Provision of education on harm reduction could help tenants 'attach to their choices and help them to feel positively about their achievements”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Watson et al. (2012)
HF tenants perceived that harm reduction reduced stress, fear, and judgment related to losing their housing due to substance use; in turn, this improved relationships between case managers and tenants.
“HF tenants perceived that harm reduction reduced stress, fear, and judgment related to losing their housing due to substance use; in turn, this improved relationships between case managers and tenants”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Watson et al. (2012)
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- Authors
- Watson, D. P., Wagner, D. E., & Rivers, M.
- Affiliations
- Indiana University Indianapolis (US)
- Loyola University Chicago (US)
- Corresponding author
- Watson, Dennis P.
- Venue
- The Journal of Behavioral Health Services & Research
- Published
- 2013-02-01
- Volume
- 40
- Issue
- 2
- Pages
- 169-179
- ISSN
- 1094-3412 (ISSN-L)
- 1556-3308
- PMC
- PMC3642235
- OpenAlex
- W2105384481
- Cited by
- 82
- References
- 34
- Citations by year
- 2025: 5 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 5 · 2017: 41 · 2016: 4 · 2015: 4 · 2014: 5 · 2013: 1 · 2012: 2
- FWCI
- 8.45
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- The Journal of Behavioral Health Services & Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- National Institute on Drug Abuse (R36DA027770)
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- Housing First, permanent supportive housing, chronic homelessness, mental health, substance abuse, consumer change, harm reduction, eviction prevention, consumer education, community-based programs
- MeSH terms
- Mental Disorders, Female, Ill-Housed Persons, Humans, Male, Public Housing, Social Support, Social Welfare, Midwestern United States, Focus Groups, Substance-Related Disorders, Organizational Case Studies, Qualitative Research
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