Combination of two evidence-based practices shows promise in addressing chronic homelessnes

The combination of two evidence-based practices—supported employment and permanent supportive housing—shows promise in addressing chronic homelessness among adults with serious mental illness. Research reported in the March issue of Psychiatric Services, a journal of the American Psychiatric Association, found good housing and employment outcomes in a demonstration project with this very difficult-to-reach group.

The research was part of a 2003 federal initiative that funded five demonstration projects to combine these practices through ambitious interagency cooperation agreements. Researcher Martha R. Burt, Ph.D., with the Urban Institute, compared data for clients of the demonstration project called LA’s HOPE—Los Angeles’ Homeless Opportunity Providing Employment—with that of clients of similar homeless programs in Los Angeles who received services through an ongoing state-funded homeless assistance program.

LA’s HOPE clients fared better in both housing and employment. They were many times more likely to achieve permanent supportive housing than the comparison group, and they moved into it more quickly. LA’s HOPE clients were more than twice as likely to have found work (57% versus 22%). In addition, more than one in four of the LA’s HOPE clients found competitive jobs.

LA’s HOPE program provided a range of housing and employment supports. In contrast to common practice, LA’s HOPE operated on a “housing first” basis, moving people into housing first, even people with active substance abuse issues and uncontrolled mental illnesses, and then working on those issues. Most other programs require clients to be drug-free and have stabilized psychiatric symptoms before providing housing.

The program also had case managers specifically supporting employment-related activities and resources available for classes, work clothing, uniforms, and other job-related needs.

The LA’s HOPE demonstration project was a collaboration of four public agencies: the City of Los Angeles Community Development Department; the Los Angeles County Department of Mental Health; the Housing Authority of the City of Los Angeles; and the VA Medical Center.

This research, Burt notes, “adds to the substantial separate literatures on the effectiveness of supported employment and permanent supportive housing by showing what the two can do together” and it helps to dispel a common misperception that people with serious mental illnesses can work only in sheltered workshops and set-aside jobs and can live only in group homes.