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Perceived Coercion to Treatment and Housing Satisfaction in Housing-First and Supportive Housing Programs

Ms. Robbins and Dr. Callahan are affiliated with Policy Research Associates, Inc., 345 Delaware Ave., Delmar, NY 12054 (e-mail: probbins{at}prainc.com). Dr. Monahan is with the University of Virginia School of Law, Charlottesville.

OBJECTIVES: This study of five housing programs across the United States examined whether the type of program—housing first or supportive housing—is related to an explicit requirement that residents adhere to mental health and substance abuse treatment, to residents' subjective perceptions that treatment adherence was being coerced, and to residents' housing satisfaction. METHODS: Interviews were conducted with 136 residents of housing programs at five sites. RESULTS: Results showed that compared with residents in supportive housing programs, those in housing-first programs were significantly less likely to report that mental health treatment adherence was an explicit requirement of obtaining housing and less likely to report that mental health and substance abuse treatment was a requirement of retaining housing. There was no difference between the programs in residents' satisfaction with their housing. CONCLUSIONS: Housing-first programs achieved a level of client satisfaction comparable to that of supportive housing programs while apparently staying consistent with their guiding "no coerced treatment" philosophy.

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