People with severe mental illness have a wide range of needs that cannot be met through a single kind of housing or support service delivery. Rather, they require a range of housing options, from group supportive housing to independent “mainstream” living with flexible supports.
There have been three approaches to the provision of housing for people with serious mental illness: custodial housing, supportive housing and supported housing.
Custodial or residential approaches to housing provide room and board, 24-hour supervision, basic assistance with activities of daily living (bathing, dressing, etc.) and medication supervision. Despite the emerging body of literature which supports approaches that emphasize normal housing, consumer choice and control and promote community integration, Ontario continues to fund large numbers of custodial beds concentrated in the Homes for Special Care, Habitat, Approved Homes and Domiciliary Hostel programs.
Referred to as “alternative housing,” both supportive and supported housing focus on rehabilitation and community integration. They are generally operated by non-profit agencies and staff and are composed of individuals trained in social work or psychiatric rehabilitation.
In supportive housing, housing and support are linked, with staff members providing various levels of support within the residences. This type of housing usually features group home settings but can sometimes include low-support self-contained apartments.
In supported housing, housing and support are separate functions. There are no staff members on-site. Support services are provided from outside the home, usually in the form of case management. Supported housing usually consists of independent apartments, housing co-operatives or other government-funded social housing for people with low incomes.
Evidence demonstrates that the features inherent in the supported housing model, such as social support, good housing quality, privacy, a small number of residents and resident control, contribute to overall satisfaction and emotional well-being.