Transitions to Housing for Boston's Chronically Homeless: a Qualitative Exploration

Abstract

Purpose: Addressing chronic homelessness is a major social priority in many urban areas across America. As many municipalities begin to invest in access to permanent supportive housing (PSH), there remains gaps in the literature about the experience of transitioning to housing for chronically homeless individuals. Investigators hoped that the findings from this study could better inform the practices of homeless health care organizations in Boston and across the country. Methods: This study utilized qualitative focus groups of both consumers and providers of a homeless health care organization in Boston to better understand the nature of transitions to housing for chronically homeless individuals. All focus groups were recorded and transcribed by the primary investigator, and themes were elicited using principles of grounded theory. Results: Four major categories of themes were developed, including positive and negative experiences of transitioning to housing, and barriers to and facilitators of successful transitions to housing. Within these categories, major themes include feelings of control associated with housing, coupled with social isolation and exacerbation of underlying depression. Shame and lack of capacity to coordinate services served as major barriers to successful transitions, while many participants identified comprehensive wrap-around services and peer support as critical for transitions. Conclusions: Moving to housing has benefits for individuals but can also worsen feelings of isolation, depression, and shame. Social support services were identified as a critical intervention, but must be resourced properly to have necessary impact. Organizations serving chronically homeless and newly-housed individuals may consider interventions such as awareness campaigns, focused counseling, and directed outreach teams, that focus on improving transitions to housing.