Kerman Nick, Kidd Sean A, Aubry Tim, Henwood Benjamin F, Marshall Carrie Anne, Oudshoorn Abe, Sirotich Frank, Sylvestre John, Stergiopoulos Vicky
Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Community Ment Health J. 2025 Aug 16. doi: 10.1007/s10597-025-01505-5.
High-risk issues, such as overdose, suicidality, hoarding, violence, property damage, and apartment takeovers, are known challenges in supportive housing and Housing First programs. However, the effects of these incidents on residents, service providers, and programs have been minimally studied. The objective of this mixed-methods study was to understand what service providers perceived as the impacts of various high-risk issues in supportive housing and Housing First programs, with an emphasis on housing tenure. This descriptive study used an exploratory sequential mixed-methods design, with unequal weighting (QUAL→quan). In-depth interviews were held with 32 service providers working in supportive housing and Housing First programs, followed by an online survey of 202 additional service providers across Canada. In the qualitative dataset, high-risk issues were identified as having three types of potentially harmful impacts: [1] "we have to evict certain people sometimes" (residents' housing stability); [2] "we're exposed to these traumas as well" (service providers' mental health); and [3] "we're losing our stock, basically" (organizational relationships with landlords and access to housing units). Convergence was generally found in the quantitative findings, with high-risk issues affecting other individuals and property being perceived as more likely to cause housing loss. Service providers working in scattered-site programs reported that hoarding, overdose, and apartment takeovers were significantly more likely to cause housing loss than did participants of single-site programs. Overall, study findings underscore how high-risk issues, particularly those affecting others and property, can be potential housing trajectory-altering events and that this is further shaped by housing and support models.
诸如药物过量、自杀倾向、囤积行为、暴力、财产破坏以及强占公寓等高危问题，是支持性住房和“住房第一”项目中公认的挑战。然而，这些事件对居民、服务提供者和项目的影响却鲜有研究。这项混合方法研究的目的是了解服务提供者认为各种高危问题在支持性住房和“住房第一”项目中会产生何种影响，重点是住房保有期。这项描述性研究采用了探索性序列混合方法设计，权重不等（质性→量化）。对32名在支持性住房和“住房第一”项目中工作的服务提供者进行了深入访谈，随后对加拿大各地另外202名服务提供者进行了在线调查。在定性数据集中，高危问题被确定为具有三种潜在的有害影响：[1]“我们有时不得不驱逐某些人”（居民的住房稳定性）；[2]“我们也会接触到这些创伤”（服务提供者的心理健康）；以及[3]“基本上我们正在失去我们的房源”（与房东的组织关系以及住房单元的获取）。在定量研究结果中通常发现了趋同现象，影响他人和财产的高危问题被认为更有可能导致住房丧失。在分散式项目中工作的服务提供者报告称，囤积行为、药物过量和强占公寓比单站点项目的参与者更有可能导致住房丧失。总体而言，研究结果强调了高危问题，尤其是那些影响他人和财产的问题，如何可能成为改变住房轨迹的潜在事件，而且这还会受到住房和支持模式的进一步影响。
