BEST PRACTICES

Note that all attributes listed below are embodied in the Fletcher Group model.

Supported Housing

Stability—Studies show that stable housing during and after treatment significantly decreases the risk of relapse. (Didenko and Pankratz, 2007)

Services—Ideally, recovery housing should offer services such as mental health treatment, physical health care, education, employment training, peer support, and instruction in daily life skills and money management skills.

Engagement—Recovery housing programs may include worker outreach and engagement, a variety of flexible treatment options, and services that help people reintegrate into their communities.

Four Characteristics Of An Ideal Program

Communication—Program and agency personnel should interact regularly and frequently with clients.

Coordination—Clients should be linked with a wide range of existing services, including health and mental health care, housing, and social services without having to seek them themselves.

Targeted Approach—Programs should aggressively seek out the homeless, rather than wait for them to appear.

Resources—Resources should include reasonable funding, paid employees, and peer support specialists as well as volunteers and donated goods and facilities.

Seven Attributes Of Successful Treatment

Trust—Trust in the personnel and programs they’re introduced to helps overcome any fear they may have and help them commit fully.

Continuity—Familiar faces increase the client’s willingness to cooperate and commit. Repeated changes in personnel and schedule disruptions can increase the client’s wariness and distrust. Ideally, clients should be referred for specialized services by the same personnel they encountered when arriving on-site.

Dignity—Clients should always be treated with respect and dignity.

Empathy—Treatment should be trauma-informed with personnel willing to “walk in the client’s shoes.” What may seem at first glance to be illogical behavior may in fact be reasonable, or least understandable. Always consider the client’s extreme environment and their perceived need to simply survive moment-to-moment in duress.

Holistic—Programs should always take into consideration the client’s social environment and recognize the direct or indirect relationship between that environment and the client’s illness. Other elements of a “Holistic Approach” should include the nature and level of the individual’s entitlement benefits and where they are currently finding shelter and food.

One-Stop Shopping—A wide variety of mental health and vocational guidance services should be provided in a single location.

Coordination of Service—Effective teams will include a wide range of personnel, from physicians, nurses and physician’s assistants to nurse practitioners, peer support specialists, and social workers. When volunteers are used, they should be carefully and properly supervised. Social workers should be adept at helping clients follow through with well-designed treatment plans.

A Wide Range of Services

Ideally, services offered to the homeless should include the following:

  • Outreach to people where they are, including the streets
  • General medical assessment and treatment for chronic and acute illnesses
  • Specific screening, treatment, and follow-up for health problems such as high blood pressure
  • Ancillary services (dentistry, podiatry, optometry, and specialized diets)
  • Access to mental health care and substance abuse services, including access to specialized housing
  • Referral and access to convalescent care as well as long-term medical and nursing care for catastrophic illness
  • Gynecological services
  • Prenatal care
  • Educational services, primarily with regard to family planning and the prevention of sexually transmitted diseases, including the free distribution of condoms as part of AIDS education efforts