Recovering from chronic homelessness, mental illness, or long-term substance use can pose unique barriers to a person seeking permanent housing and stability. The physical and mental stress of homelessness often leave people with debilitating conditions that require significant treatment, and adjusting to living inside can be an especially difficult challenge for people who may have spent months or years simply trying to survive the constant threat of encampment sweeps, incarceration, and arrest. Supportive housing provides the services that people need as they exit homelessness and increases the likelihood that they are able to sustain both housing and self-defined recovery.

The rationale behind supportive housing is simple: co-located, long-term, low-barrier resources ensure that people who have experienced chronic homelessness, mental illness, or substance use disorder—or, often, all three—can receive the support they need to thrive while remaining stably housed. Supportive housing surrounds a person with the tools they need to recover from behavioral health conditions and traumatic life experiences in community. Enhanced case management helps residents organize appointments and maintain access to necessities like clothing and food.

The exact nature of supportive housing can vary significantly. The Housing First model emphasizes that housing is the first step to recovery and does not require abstinence as a precondition of housing. With roots in the theories of both harm reduction and recovery capital, this evidence-based model demonstrates that people who are housed are more likely to experience positive health outcomes, avoid hospitalization, and maintain housing long-term. Housing First programs are also cost-effective, reducing overall costs spent on health care, incarceration, and shelters. This model is ideal for a person who is exiting homelessness and seeking long-term care and housing but is not ready to or interested in abstaining from substance use. Housing First is not a “housing only” model; it acknowledges the complexity of recovery and provides support regardless of a person’s current or previous substance use.

Recovery housing models are also a form of supportive housing and are better suited for people who seek to abstain from substance use as they move into permanent housing. Recovery residences are not at odds with the Housing First model; rather, when implemented properly, they provide another option along the recovery continuum for people who are prepared to embark on abstinence-based recovery. Recovery residences provide the same supportive housing supports but may also emphasize aspects of recovery like support groups and progress toward specific, individually defined goals. When integrated into a supportive housing continuum that centers individuals’ agency and choice, recovery residences can support long-term housing stability and positive change.

California must continue to invest in supportive housing in order to address the ongoing homelessness crisis and improve health among people who use substances. Evidence-based models, including recovery residences integrated into the Housing First continuum, provide the stability and foundation for a person to thrive.