Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing
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This article assesses the impact of public investment in supportive housing for homeless persons with severe mental disabilities. Data on 4,679 people placed in such housing in New York City between 1989 and 1997 were merged with data on the utilization of public shelters, public and private hospitals, and correctional facilities. A series of matched controls who were homeless but not placed in housing were similarly tracked. Regression results reveal that persons placed in supportive housing experience marked reductions in shelter use, hospitalizations, length of stay per hospitalization, and time incarcerated. Before placement, homeless people with severe mental illness used about $40,451 per person per year in services (1999 dollars). Placement was associated with a reduction in services use of $16,281 per housing unit per year. Annual unit costs are estimated at $17,277, for a net cost of $995 per unit per year over the first two years.
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Supportive housing initiatives specific to people leaving prison have been shown to be effective in reducing reincarceration.
“Supportive housing initiatives specific to people leaving prison have been shown to be effective in reducing reincarceration (14).”
From Behavioral Health and Social Correlates of Reincarceration Among Hispanic, Native American, and White Rural Women (2013) · cites this paper as [14]
The Outpatient services section reports fewer people jailed and fewer incarceration days after supportive-housing placement. But the initiative studied housed homeless people with severe mental illness, not specifically people leaving prison; the reported outcome is incarceration after placement, not a measured reincarceration rate for prison leavers. (LLM, conf=0.88)
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Self-citationKresky-Wolff, M., Larson, M. J., O'Brien, R., & McGraw, S. (2010) · Journal of Behavioral Health Services & Research · doi:10.1007/s11414-009-9206-y · Cited by 49 · see citing works
Rethinking Homelessness Prevention among Persons with Serious Mental Illness
Montgomery, A., Metraux, S., & Culhane, D. (2013) · Social Issues and Policy Review · doi:10.1111/j.1751-2409.2012.01043.x · Cited by 49 · see citing works
Self-citationPOLICIES TO REDUCE AND PREVENT HOMELESSNESS: WHAT WE KNOW AND GAPS IN THE RESEARCH
Evans, W. N., Phillips, D. C., & Ruffini, K. (2021) · Journal of Policy Analysis and Management · doi:10.1002/pam.22283 · Cited by 51 · see citing works
Milby, J. B., Schumacher, J. E., Wallace, D., Vuchinich, R. E., Mennemeyer, S. T., & Kertesz, S. G. (2009) · American Journal of Public Health · doi:10.2105/ajph.2008.152975 · Cited by 50 · see citing works
Aging in place within permanent supportive housing
Henwood, B. F., Katz, M. L., & Gilmer, T. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4120 · Cited by 46 · see citing works
“, 2012) and consistent with basic human rights (United Nations, 1976), PSH has been found to be cost effective with people with complex health and social needs (Culhane et al., 2002; Metraux et al., 2003; Culhane, 2008).”
BackgroundCollaborative Initiative to Help End Chronic Homelessness: Introduction
Rickards, L. D., McGraw, S. A., Araki, L., Casey, R. J., High, C. W., Hombs, M. E., & Raysor, R. S. (2009) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-009-9175-1 · Cited by 47 · see citing works
“Cumulatively, the reliance on the use of emergency departments as the safety net for medical care, the excess of acute and chronic conditions that result from delayed or inadequate care, and the longer stays per hospital admission result in disproportionately high medical service costs for facilities providing care to…”
BackgroundInfluentialGender differences in response to homelessness services
Rich, A. R., & Clark, C. (2005) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2004.05.003 · Cited by 45 · see citing works
Smelson, D. A., Zaykowski, H., Guevermont, N., Siegfriedt, J., Sawh, L., Modzelewski, D., Tsemberis, S. J., & Kane, V. R. (2016) · Journal of Dual Diagnosis · doi:10.1080/15504263.2016.1174010 · Cited by 44 · see citing works
Nicholls, C. M., & Atherton, I. (2011) · Housing Studies · doi:10.1080/02673037.2011.581907 · Cited by 44 · see citing works
Evaluation of Housing for Health Permanent Supportive Housing Program
Hunter, S., Harvey, M., Briscombe, B., & Cefalu, M. (2017) · RAND Corporation eBooks · doi:10.7249/rr1694 · Cited by 42 · see citing works
Russolillo, A., Patterson, M., McCandless, L. C., Moniruzzaman, A., & Somers, J. M. (2014) · International Journal of Housing Policy · doi:10.1080/14616718.2014.884881 · Cited by 43 · see citing works
“Specifically, reductions in hospitalisation, ED use, as well as increased housing stability and cost offsets have been reported (Culhane et al., 2002; Desilva, Manworren, & Targonski, 2011; Hanrahan, Luchins, Savage, & Goldman, 2001; Kessell, Bhatia, Bamberger, & Kushel, 2006; Mares & Rosenheck, 2011; Parker, 2010).”
BackgroundMethodMoving from Fact to Policy: Housing is HIV Prevention and Health Care
Shubert, V., & Bernstine, N. (2007) · Aids and Behavior · doi:10.1007/s10461-007-9305-9 · Cited by 41 · see citing works
“strated that supportive housing for persons with chronic health care needs substantially reduces utilization of costly emergency and inpatient health care services (Bendixen 2006; Wilkins 2006; Culhane et al. 2002; Culhane 2006).”
BackgroundResultA cost analysis of San Diego County's REACH program for homeless persons
Gilmer, T. P., Manning, W. G., & Ettner, S. L. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.4.445 · Cited by 54 · see citing works
Hamilton, Z. K., Kigerl, A. C., & Hays, Z. (2013) · Justice Quarterly · doi:10.1080/07418825.2012.761720 · Cited by 43 · see citing works
“Costs of Housing Services The potential financial costs and benefits of housing interventions have also been considered as a part of an evaluation’s impact (Culhane et al., 2002).”
BackgroundFarrell, A., Britner, P. A., Guzzardo, M. T., & Goodrich, S. A. (2010) · doi:10.1016/j.childyouth.2009.06.012 · Cited by 37
Removing barriers to work: Building economic security for people with psychiatric disabilities
Morrow, M., Wasik, A., Cohen, M., & Perry, K.-M. E. (2009) · Critical Social Policy · doi:10.1177/0261018309341904 · Cited by 30 · see citing works
Stanhope, V., Marcus, S., & Solomon, P. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.2.183 · Cited by 36 · see citing works
Housing First: Lessons from the United States and Challenges for Australia
Kertesz, S. G., & Johnson, G. (2017) · Australian Economic Review · doi:10.1111/1467-8462.12217 · Cited by 41 · see citing works
The Impact of Homelessness and Incarceration on Women’s Health
Ahmed, R. A., Angel, C., Martell, R., Pyne, D., & Keenan, L. (2015) · Journal of Correctional Health Care · doi:10.1177/1078345815618884 · Cited by 31 · see citing works
- Authors
- Culhane, D. P., Metraux, S., & Hadley, T.
- Affiliations
- University of Pennsylvania (US)
- Venue
- Housing Policy Debate
- Publisher
- Informa UK Limited
- Published
- 2002-01
- Volume
- 13
- Issue
- 1
- Pages
- 107-163
- ISSN
- 1051-1482 (ISSN-L)
- 2152-050X
- OpenAlex
- W2118672011
- Cited by
- 515
- References
- 0
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 16 · 2023: 10 · 2022: 12 · 2021: 30 · 2020: 32 · 2019: 23 · 2018: 20 · 2017: 54 · 2016: 21 · 2015: 30 · 2014: 26 · 2013: 30 · 2012: 33
- FWCI
- 34.04
- Type
- journal article
- Language
- en
- Open access
- green
- repository.upenn.edu
- Locations
- Housing Policy Debate (publishedVersion)
- Scholarly Commons (University of Pennsylvania) (submittedVersion)
- ScholarlyCommons (University of Pennsylvania) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Social Sciences › Urban Studies › Urban and Rural Development Challenges
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- homeless people, severe mental illness, supported housing, public service utilization, shelter use, hospitalization, incarceration, cost-benefit analysis, public investment, New York City
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