Supportive housing for the chronically mentally ill. Matching clients with community environments

The need for permanent housing for the chronically mentally ill has received a great deal of attention over the last several years. One response to the problem has been the development of supportive housing, that is, non-facility-based permanent homes with placement based on clients' functional capabilities and preferences. However, little research has focused on assessing the match between clients and environmental requirements. This study begins to identify the social and clinical characteristics of clients that contribute to selection into different types of housing environments. Ninety-one clients were sampled from the supportive housing services of a major provider in two New England states. Logistic regression was used to estimate the probability that clients will be placed into apartments vs. other, more restricted settings, based on their clinical and social characteristics. Findings show that the primary determinants of placement were clinical severity, early family history, and adequacy of family support. The less severely ill and better functioning the client, the more likely that he or she was placed in an apartment. This was mitigated, however, by the availability and adequacy of family support. In addition, clients with early family disruptions were also less likely to be placed in apartments. Findings are discussed in light of their implications for providing permanent housing placements for chronically mentally ill persons and for factors in future research to evaluate the success of placement.