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Permanent supportive housing (PSH) is an evidence-based approach that combines subsidized housing and supportive services to effectively end homelessness for individuals with significant barriers to housing stability (e.g., mental illness, substance abuse, chronic health conditions). However, the demand for PSH continues to exceed supply. To address this supply gap and increase access to PSH for those in need of intensive, embedded supports, communities have started employing “Moving On” initiatives (MOIs). These initiatives provide transitional support to stable PSH residents who are interested in exiting PSH for mainstream affordable housing without embedded services. While MOIs are a potentially promising way to open up PSH units, they also risk exiting PSH residents back into homelessness. PSH providers could mediate moving on outcomes depending on whether and how they promote resident exits from PSH. However, research regarding providers’ perspectives on these exits is limited. Drawing on diffusion theory, which helps explain how innovations are communicated and adopted within social systems over time, this study explores how providers view PSH exits and the conditions influencing their views and practices related to moving on. Understanding providers’ perspectives in this area is essential to inform better policy and practice.
Methods
In-depth, semi-structured qualitative interviews were conducted virtually with a theoretical sample of nineteen direct practice PSH providers from two geographic regions in the U.S. The semi-structured interview guide was constructed from sensitizing concepts from the literature and previous research. A modified grounded theory analysis was utilized to analyze the data for this study, with constant comparative analysis employed at every stage (Corbin & Strauss, 2015).
Results
The data show that organizational support and prior experience with residents moving on shape providers’ broad perceptions of residents’ capacities to move on, either as relatively limited to select individuals or universally attainable. These perceptions were associated with gate-keeping and recovery-oriented approaches to practice, which ultimately informed provider’s self-identified role as either following residents’ efforts or leading residents towards moving on. Overall, system-level support and resources are needed for providers to effectively foster moving on among PSH residents. Further leadership and social pressure to adopt a moving on mindset may lead more providers to promote independence and autonomy among individuals with histories of homelessness.
Conclusions and Implications
This study identifies modifiable barriers at the individual, organizational, and system levels to promoting successful exits from PSH. Thus, it has important implications for the homelessness service system and its ability to increase PSH capacity, as well as recovery-oriented, client-centered social work practice. It also elevates the voices of frontline providers, a valuable resource for informing successful shifts in policy and social work practice.