Narratives of people with serious mental illness in Housing First: a qualitative analysis of factors contributing to housing instability and housing stability

Abstract

ABSTRACT There has been little previous research that has examined factors related to housing stability and instability among Housing First (HF) tenants. Qualitative research was used to determine themes related to housing stability and instability for people with mental illness participating in a HF program implemented in five Canadian cities. Data were gathered for all participants who completed qualitative interviews at baseline and an 18-month follow-up. At the 18-month follow-up interviews, those who were stably housed (n = 110) were significantly more likely to report positive life changes than those who were unstably housed (n = 75). Among a sub-sample of these participants, in-depth narratives were compared for stably housed (n = 25) and unstably housed (n = 21) tenants. Challenges to achieving housing stability included substance use and continued exposure to substance-using networks, evictions/multiple housing losses, incarceration and/or involvement with the legal system, and neighborhood location of housing. Themes promoting housing stability were having positive relationships with the HF program staff and program, achieving greater community integration, and making progress towards recovery. Recommendations for promoting housing stability were provided.