Facilitating Exit From Encampments: Combining Low-Barrier Transitional Housing with Stabilizing Treatment for Substance Related Problems

Authors
Miriam Komaromy, Andrea Stone, Alicia Peterson, Jacqueline Gott, Rob Koenig, Jessica L. Taylor
Peer-Reviewed Article
October 2023
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Headline

Transitional housing, combined with co-located substance use disorder (SUD) care, facilitates access to permanent housing and increases engagement in SUD treatment.

Context

Supportive housing models that adopt a “housing first” approach — where access to housing is not dependent on sobriety or treatment — have been shown to be cost-effective and are linked to improved health and housing outcomes. This study analyzed a housing-first collaboration among Boston Medical Center, the City of Boston, and several community-based organizations that established a 60-bed transitional housing facility, staffed by harm reduction specialists and case managers, with a co-located SUD clinic to serve individuals living in nearby tent encampments.

Findings

Among 100 people who received transitional housing during the program’s first 12 months, 25 transitioned to permanent supportive housing or other long-term housing placement. Of the 90 individuals eligible for evaluation (which excluded those who had been residents for less than three months or who had become incarcerated), 94% either remained in the transitional housing facility, moved to permanent housing, or moved to a residential SUD program. Additionally, 59% of residents accessed services in the co-located SUD clinic. Among both walk-in patients and residents seen in the clinic, 88% of those newly initiated on methadone were successfully linked to ongoing methadone treatment with an opioid treatment provider. The article also highlights implementation details, including staffing models and facility descriptions.

Takeaways

Combining transitional housing with a harm reduction approach, as well as low-barrier access to SUD treatment, can support people who are homeless transition to permanent housing. Government officials and health systems in cities facing homelessness crises should consider opportunities for collaboration that involve establishing this or similar models to help address the needs of people who are street homeless.

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