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Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed.
Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
Contents
- The National Academies of SCIENCES • ENGINEERING • MEDICINE
- COMMITTEE ON AN EVAULATION OF PERMANENT SUPPORTIVE HOUSING PROGRAM FOR HOMELESS INDIVIDUALS
- Preface
- Abbreviations and Acronyms
- Summary
- 1. Introduction
- 2. Addressing Homelessness in the United States
- 3. Evidence of Effect of Permanent Supportive Housing on Health
- 4. Cost-Effectiveness of Permanent Supportive Housing
- 5. Effect of Individual and Program Characteristics on Outcomes in Permanent Supportive Housing
- 6. Impact of Permanent Supportive Housing on Families and Youth
- 7. Program and Policy Barriers to Permanent Supportive Housing
- 8. Research Gaps
- HARMONIZATION OF PSH DEFINITIONS AND PROGRAM CHARACTERISTICS
- UNDERSTANDING WHO BENEFITS MOST FROM PSH
- IMPROVING THE QUALITY OF EVIDENCE EXAMINING PSH AND HEALTH
- APPLYING NEW TOOLS TO INTEGRATE AND LEARN FROM DATA SYSTEMS
- BUILDING UNIVERSITY-AGENCY PARTNERSHIPS FOR BETTER DATA AND ANALYSIS
- TESTING INNOVATIONS IN PAYMENT MODELS TO SUPPORT HOUSING AND SERVICES
- CONCLUSIONS
- 9. Conclusions and Recommendations
- References
- APPENDIXES
- Appendix A. Committee on an Evaluation of Permanent Supportive Housing Programs for Homeless Individuals: Biographical Information
- Appendix B. The History of Homelessness in the United States
- Appendix C. Counting the Number of Individuals Experiencing Homelessness
- Appendix D. Examples of Homeless Service Programs in Denver and San Jose
- Appendix E. Studies of Effectiveness of Permanent Supportive Housing
Suggested citation:
National Academies of Sciences, Engineering, and Medicine. 2018. Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes Among People Experiencing Chronic Homelessness. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25133.
- NLM CatalogRelated NLM Catalog Entries
- Investigating the Comparative Effectiveness of Place-Based and Scatter-Site Permanent Supportive Housing for People Experiencing Homelessness During the COVID-19 Pandemic: Protocols for a Mixed Methods, Prospective Longitudinal Study.[JMIR Res Protoc. 2023]Investigating the Comparative Effectiveness of Place-Based and Scatter-Site Permanent Supportive Housing for People Experiencing Homelessness During the COVID-19 Pandemic: Protocols for a Mixed Methods, Prospective Longitudinal Study.Henwood BF, Kuhn R, Padwa H, Ijadi-Maghsoodi R, Corletto G, Lawton A, Chien J, Bluthenthal R, Cousineau MR, Chinchilla M, et al. JMIR Res Protoc. 2023 Apr 28; 12:e46782. Epub 2023 Apr 28.
- Review Permanent Supportive Housing for Those Experiencing Chronic Homelessness with High Health or Social Support Needs: A Scoping Review.[J Health Care Poor Underserved...]Review Permanent Supportive Housing for Those Experiencing Chronic Homelessness with High Health or Social Support Needs: A Scoping Review.Porchak E, Oudshoorn A, Modanloo S, Gilliland J, McLean S, Thuemler N, Ariba O, Rolfe S. J Health Care Poor Underserved. 2023; 34(4):1178-1209.
- Permanent supportive housing: addressing homelessness and health disparities?[Am J Public Health. 2013]Permanent supportive housing: addressing homelessness and health disparities?Henwood BF, Cabassa LJ, Craig CM, Padgett DK. Am J Public Health. 2013 Dec; 103 Suppl 2(Suppl 2):S188-92. Epub 2013 Oct 22.
- Everyday discrimination among formerly homeless persons in permanent supportive housing.[J Soc Distress Homeless. 2019]Everyday discrimination among formerly homeless persons in permanent supportive housing.Wenzel SL, Rhoades H, LaMotte-Kerr W, Duan L. J Soc Distress Homeless. 2019; 28(2):169-175. Epub 2019 Jun 15.
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- Permanent Supportive HousingPermanent Supportive Housing
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