The Impact of Supportive Housing for Homeless People with Severe Mental Illness
A research team from the Center for Mental Health Policy and Services Research, University of Pennsylvania, has published the most comprehensive study to date on the effects of homelessness and service-enriched housing on mentally ill individuals’ use of publicly funded services.
Five years in the making, the study measures for the first time the full extent of homeless mentally ill individuals’ dependence on an array of publicly funded emergency service systems. The study also ascertains the degree to which this dependence is reduced by placement into service-enriched housing. And by comparing precise measurements of the cost of the service use to that of the housing, the study has determined exactly how much the public saves by placing homeless mentally ill people into service-enriched housing, and how little this housing ultimately costs.
The study tracked 4,679 homeless people with psychiatric disabilities who were placed into service-enriched housing created by the 1990 New York/New York Agreement to House Homeless Mentally Ill Individuals, a joint initiative between New York City and New York State that created and continues to maintain 3,615 units of affordable housing supported with clinical and social services.
The researchers first examined these individuals’ use of emergency shelters, psychiatric hospitals, medical services, prisons and jails in the two years before and in the two years after they were placed into the housing. They then compared their service use in these two time periods to the service use of control groups of homeless individuals with similar characteristics who had not been placed into NY/NY housing. Collaborating with eight different government agencies, the researchers were able to establish the cost of each type of service use, as well as the cost of constructing, operating and providing services in NY/NY housing. The researchers completed the study by comparing these costs and savings to determine the true cost to the public of providing service-enriched housing to homeless mentally ill individuals.
Key Findings
The study found that:
- A homeless mentally ill person in New York City uses an average of $40,449 of publicly funded services over the course of a year.*
- Once placed into service-enriched housing, a homeless mentally ill individual reduces his or her use of publicly funded services by an average of $12,145 per year.
- Accounting for the natural turnover that occurs as some of the residents move out of service-enriched housing, these service reduction savings translate into $16,282 per year for each unit of housing constructed.
- The reduction in service use pays for 95% of the costs of building, operating and providing services in supportive housing, and 90% of the costs of all types of service-enriched housing in New York City.
Closely examining these service reductions in detail, the study also found that:
- $14,413 of the service reduction savings resulted from a 33% decrease in the use of medical and mental health services directly attributable to serviceenriched housing.
- Much of these savings resulted from NY/NY residents’ experiencing fewer and shorter hospitalizations in state psychiatric centers, with the average individual’s hospital use declining 49% for every housing unit constructed.
- On average, shelter use decreased by over 60%, saving an additional $3,779 a year for each housing unit constructed.
- The cost of supportive housing, the most common model of NY/NY housing, was considerably less than that of other models created by the initiative, requiring an annual outlay of just $995 per unit.
* All figures are stated in 1999 dollars.
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