A study published in the Journal of the American Medical Association (JAMA) Network Open finds that a Housing First model of service delivery for survivors of intimate partner violence may be more effective than traditional approaches at improving housing stability. Intimate partner violence (IPV) – defined as “violence, abuse, and controlling behavior committed by a partner or former partner” that can have long-term consequences for those subjected to it – has been identified as a major contributing factor to housing instability and homelessness, particularly for women.
Housing First is an innovative, evidence-based model of providing stable housing to individuals who are at risk of or experiencing homelessness. While traditional approaches often require individuals to meet certain qualifications (e.g., maintaining sobriety) before they are eligible for housing assistance, Housing First ensures individuals are stably and safely housed first so they can derive greater benefit from supportive services like counseling or substance use treatment that empower them to thrive in a community setting. Domestic Violence Housing First (DVHF) tailors this model to the unique needs of IPV survivors. Instead of requiring survivors to complete prerequisites like leaving their abuser or obtaining a protective order before receiving assistance, advocates work collaboratively with survivors to secure safe, stable housing before all else. This may include the use of “flexible funding” to pay rent or relocation costs and address other immediate financial needs that contribute to housing instability (e.g., transportation expenses). Other supportive services are then provided at a pace with which the survivor is comfortable, and for as long as they feel services are needed.
The study’s authors sought to determine whether a DVHF approach resulted in better outcomes for survivors of IPV than a more traditional approach to service delivery (i.e., one prioritizing “support groups, counseling, legal advocacy, and referrals”). From July 2017 to 2021, staff from five domestic violence (DV) services organizations based in Washington State referred all clients experiencing housing instability or homelessness to the study. Due to ethical concerns, the researchers decided not to randomly assign participants to receive services through either the DVHF or traditional approach. Instead, participants were provided services organically, based on the DV services providers’ available capacity and resources at the time of referral.
Each of the 344 participants was interviewed at the beginning of the study and again every six months for two years, resulting in a total of five interviews per participant. In each session, the researchers administered five validated screening questionnaires to assess the participant’s current level of housing instability, abuse (including “physical, emotional, and sexual abuse, as well as stalking and harassment”), depression, anxiety, and post-traumatic stress disorder (PTSD). The researchers then evaluated participants’ scores on the screening questionnaires over time and between the two treatment groups (DVHF versus traditional approach), accounting for key characteristics that could bias the results. These characteristics included whether the participant was parenting children, lived with their abuser, identified as a member of a racial/ethnic minority group, reported challenges with substance abuse, or resided in a rural area.
The researchers found that all five indicators (housing instability, abuse, depression, anxiety, and PTSD) improved over the two-year period regardless of whether clients received services via DVHF or the traditional approach, which “speaks to the value of DV services overall.” However, participants who received services via DVHF experienced significantly greater improvement in all five indicators than those who were served through a traditional approach, particularly in terms of housing stability. The authors note that, “it is promising that DVHF resulted in relatively rapid improvements for survivors…and that these positive changes were maintained across 12, 18, and 24 months.” However, they emphasized that because the participants overwhelmingly self-identified as female (97.1%) and heterosexual (86.9%), the results may not be fully representative of the experiences of LGBTQ+ survivors of IPV. Furthermore, the effectiveness of DVHF may vary in states with different laws and policies than Washington.
The study further corroborates a growing body of evidence that the Housing First model and its derivatives (like DVHF) are effective strategies to end homelessness and increase housing stability. However, greater funding is needed to ensure social services providers have the resources, staff, and training required to successfully implement the components of Housing First – namely, the ability to work collaboratively and intensively with clients in a trauma-informed manner, as well as to provide flexible funding for housing and secondary financial needs that prevent clients from remaining safely and stably housed.
Read the article at: https://bit.ly/3qi7GnE