Should I Stay or Should I Go? Intention to Leave Permanent Supportive Housing Among Residents Who Have Been Housed for One Year

Background: Permanent Supportive Housing (PSH) has been identified by the federal government as an effective solution for chronic homelessness, but the need for housing far surpasses the availability of affordable housing units. Previous research has proven extremely useful in getting people off of the streets, into housing, and keeping them housed. However, due to the lack of available housing, it is necessary to examine the nature of housing exits further to understand how to increase the impact of supportive housing by facilitating sustainable exits. Inquiry into exists from supportive housing may increase housing sustainability over time, yet is currently lacking. The purpose of this study is to examine influences on intention to leave PSH among residents who have been housed for one year.

Methods: Data come from 383 chronically homeless individuals that moved into 26 Permanent Supportive Housing agencies in Los Angeles from August 2014 to January 2016. Data was collected 12 months post move-in via structured interviews in agency-based settings. All responses were based on self-report. Separate Multivariate Logistic Regressions stratified by gender assessed a yes/no response of intention to remain in current PSH for the next year. A socio-ecological framework was used to explore associations of demographic characteristics, mental health, substance use, social and service engagement, and environment with intention to leave housing.

Results: For both men (OR=0.62, CI=0.46-0.83) and women (OR=0.30, CI=0.16-0.56) there was a negative relationship between satisfaction with apartment and wanting to leave, but satisfaction with neighborhood was only statistically significant for men (OR=0.69, 95% CI=0.51-0.93). In terms of service engagement, women who were dissatisfied with services were 2.3 times more likely to want to leave housing (OR=2.25, 95% CI=1.04-4.91). Women who engaged in outpatient services were 78% less likely to want to leave (OR=0.22, 95% CI=0.05-0.94), and women who were employed in the last 12 months were 16.8 times more likely to want to leave housing (OR=16.77, 95% CI=2.42-116.19). Likewise, women who exhibited signs of psychological distress were 89% less likely to want to leave housing (OR=0.11, 95% CI=0.02-0.75). Whereas, men show no significant association between service engagement, social engagement, or mental health and intention to leave.

Discussion: For men, significant associations only emerged regarding environment, whereas for women significance was found regarding environment, and service engagement, social engagement, and mental health, indicating that men and women may have different experiences within PSH environments. Despite not engaging in services at drastically different rates, supportive services may differ in utility for men and women. These data indicate that substance use and mental health experiences are not contributing to the desire to leave housing in a manner that could potentially be considered adverse. Further identifying residents who may be capable of transition from PSH appears to be a next step in research and practice to support sustainable exits from supportive housing as “moving on,” and a practical next step for the policy agenda of maximizing the impact of PSH nationwide.