Health Service Use after Moving on from Permanent Supportive Housing

Background and Purpose: As the demand for permanent supportive housing (PSH) outstrips supply in many localities, some communities are using Moving On Initiatives (MOIs) to transition tenants out of PSH and into mainstream housing. While MOIs have shown positive outcomes in housing retention and quality of life, less is known about movers’ health service use after leaving PSH. This paper uses data from the New York City MOI to answer these research question: 1) To what extent do participants use physical and mental health services at baseline, 12-months move, and 24-months post move? 2) Are there discernible patterns in how participants use physical and mental health services over time? 3) Is there a relationship between service use patterns and physical and mental health status?

Methods: This article uses survey data collected from program participants (N=41) at baseline, 12-months post move, and 24-months post move to explore mental and physical health service use patterns and their association with mental and physical health status. Participants were mostly women (58.5%), Black/African American (75.0%), and had completed at least a high school education (66.7%). The average age was 49.59 years. Health status was measured with the Medical Outcomes Study Short Form Survey Instrument. An exploratory analysis approach, informed by small N clinical evaluation research, was used to identify service use pattern groups; bivariate analyses were used to explore relationships between groups and health status.

Results: Mental and physical health service utilization patterns varied among movers with a slight but nonsignificant decline in utilization at 12 and 24 months and low overall use of acute mental health services across all three time points. The most common mental health service used across all time points was outpatient group/individual care. Three mental health service use patterns emerged: 1) service use at all time points (n=17), 2) inconsistent service use across time points (n=13), and 3) no service use at any time point (n=11). Significant group differences in mental health were found at baseline and 12 months, with scores highest for those in the no service use group. The most common physical health service used across time points was outpatient specialty/primary care. Two physical health service use patterns emerged: 1) service use at all three time points (n=33) and 2) inconsistent service use across time points (n=8). Significant group differences were found in mental health at 12 months and 24 months, with the inconsistent service use group having lower mental health scores.

Conclusions and Implications: Over time, physical and mental health service use declined slightly but not significantly for movers in this MOI. Additionally, mental health status was higher for those not using any mental health services and for those consistently using physical health services. These findings support those of previous MOI evaluations in suggesting that moving on from PSH is generally not disruptive to movers’ overall well-being. As such, housing policymakers and service providers have reason for cautious optimism regarding the effectiveness of MOIs in supporting PSH tenant exits to mainstream housing without embedded supports.