Core Characteristics and Nuances of PSH

Core Characteristics and Nuances of Permanent Supportive Housing

The following description is derived from Standards for Quality Support Housing Guide, Supportive Housing Quality Toolkit, and Housing First in Permanent Supportive Housing.

• PSH is not time-limited. Participants live in permanent housing, and there is no assumption that participants will “graduate” or “move on” from the housing program.
  
  
• Housing is affordable to tenants, even tenants with little or no income.
  
  
• PSH can be scattered site (tenant based) or single site (project based). Where possible, participants are given choices about where they live.
  
  
• Tenants who live in PSH sign a standard lease (or sub-lease) and have standard tenancy rights and responsibilities (which means they can get evicted from PSH). The lease should be identical to a non-PSH lease.
  
  
• Supportive services are provided to the tenant household, both to help them keep their housing and to help improve their quality of life. 
  
  
  • Ideally, services are voluntary. 
    
    
  • Services might include: case management, medical, mental health, or substance use treatment, peer support, parenting skills, education, vocational and employment services, money management services, and life skills training and advocacy.  
    
    
  • Services could be provided either directly by the housing provider, or by an external organization. In some circumstances, the tenant’s case manager might connect them to a “mainstream” service (like Medicaid).
    
    
• PSH, when most similar to Housing First, has the following characteristics:
  
  
  • PSH is low-barrier. Applicants are not blocked from entering a PSH program because they use drugs or alcohol, have a criminal record, or have previously been evicted.
    
    
  • Voluntary service use. 
    
    
  • Tenants in PSH are integrated in the community by living among non-PSH neighbors, using services in their community, and having standard leases that allow visitors. 
    

• In a high-fidelity PSH programs, services are commonly delivered using one of the following methods:

• • ACT (assertive community treatment) is a community-based approach to providing services to people with severe mental illness. The goal of ACT is to help patients flourish in their community after leaving inpatient treatment. An ACT team is composed of professionals who can provide almost all the services a patient needs to remain stable in a community setting (healthcare, mental healthcare, substance use treatment, employment supports), without having to refer the patient to other providers.

• • Similar to ACT is intensive case management (ICM), which is a type of case management that was developed by combining principles of ACT and case management. ICM serves similar populations to ACT, and the terms are sometimes used interchangeably, but ICM often doesn't have all the elements that an ACT program would.