Effectiveness of the supportive housing model for the homeless population with severe mental illness in the United States

Homeless persons diagnosed with severe mental illness represent approximately a quarter of the homeless population in the United States. The risk of deteriorating health is increased the longer a person with severe mental illness remains on the streets. Supportive Housing Model (SHM) was introduced in the early 1990’s to address this public health concern. SHM intended to provide affordable permanent housing, with added support provided by case managers, social workers, and various treatment providers to assist residents in accessing services to help lengthen their time away from homelessness. This thesis is a critical literature of peer reviewed articles in PUBMED, Social Work Abstracts, Social Sciences Abstracts and PsyCritiques of randomized controlled trials published between the years 1990 and 2014 in the United States. Systematic and meta-analyses reviews were identified and included, to gain an additional perspective on the effectiveness of the SHM when applied to homeless persons with severe mental illness in the United States.\ud The adaptation of the SHM with the homeless population diagnosed with severe mental illness does favor improved housing retention, based on the findings of the review. Additionally, consumers have a strong preference for the SHM, even though lifetime substance abuse and minority status are strong predictors of reducing the number of days away from homelessness. The intensity level of the case management services may favorably alter the housing retention rates for homeless persons with severe mental illness, substance use disorder or both, which may result in additional costs as intensity level is heightened. Future policy decisions for the SHM may need to consider the effects of mental illness, substance abuse, declining incomes, housing affordability, availability of units, intensity level of case management services, and the identification of continuous funding streams to effectively address this public health concern. The low number of randomized controlled trials identified in this literature review limits the conclusions