Introducing the
SAMHSA ToolKIT on
Permanent
Supportive Housing
Anne Cory
Corporation for Supportive Housing
MHSA Small County TA Call 8/18/10
www.csh.org
SAMHSA’s KIT (Knowledge
Informing Transformation)
This KIT is part of a series of Evidence-Based
Practices KITs created by the Center for Mental
Health Services, Substance Abuse and Mental
Health Services Administration, U.S. Department
of Health and Human Services
http://mentalhealth.samhsa.gov/cmhs/Community
Support/toolkits/housing/
2
SAMHSA’s KIT (Knowledge
Informing Transformation)

3
Two philosophical tenets steer these KITs:
– Consumers and families have a right to
information about effective treatments and, in
areas where EBPs exist, they have a right to
access effective services.
– Mental health services should have the goal
of helping people achieve their personal
recovery goals; develop resilience; and live,
work, learn, and participate in the
community.
SAMHSA’s KIT (Knowledge
Informing Transformation)
Each KIT provides the EBP’s practice philosophy,
beliefs, and values that guide the following:
• Clinical judgments;
• Specific treatment components;
• Structured service-delivery components; and
• Evaluation components.
KITs outline the essential components of each EBP and
give you suggestions collected from those who have
successfully implemented them within mental health
systems and agencies.
4
SAMHSA’s KIT (Knowledge
Informing Transformation)

5
The KITs are primarily geared toward five
critical groups of stakeholders:
– Public mental health authorities;
– Agency administrators and program leaders;
– Clinical supervisors and direct service
practitioners;
– Consumers of mental health services; and
– Family members and other supporters.
SAMHSA’s KIT (Knowledge
Informing Transformation)

The Permanent Supportive Housing KIT has 8
booklets:
– How to Use the Evidence-Based Practices
KITs
– Getting Started with Evidence-Based Practices
– Building Your Program
– Training Frontline Staff
– Evaluating Your Program
– The Evidence
– Tools for Tenants
– Using Multimedia to Introduce Your EBP
6
How to Use the EvidenceBased Practices KITs




7
Provides background on the Evidence-Based
Practices KITS
Definition of terms
Overview of this KIT
While many mental health agencies provide
excellent services, the opportunity to integrate the
best that science has to offer into the service
delivery system has compelled many agencies
to implement EBPs.
Getting Started with
Evidence-Based Practices



8
Getting Started with Evidence-Based Practices gives
you an overview of the activities that are generally
involved in implementing evidence-based practices
(EBPs) and tells you how to make EBPs culturally
competent. This booklet addresses EBPs generally
rather than the specific practice of Permanent
Supportive Housing and is particularly relevant to the
following:
Mental health authorities; and
Agency staff who develop and manage EBP
programs.
Building Your Program




9
Building Your Program is intended to help
mental health authorities, agency administrators,
and Permanent Supportive Housing program
leaders think through and develop the structure
of Permanent Supportive Housing programs.
Understanding Permanent Supportive Housing
Tips for Mental Health Authorities
Tips for Agency Administrators and Program
Leaders
Building Your Program

10
Additionally, Building Your Program includes
more detailed sections on the following topics:
– Sources of Funding;
– Local and State Housing Plans;
– Evaluating a Housing Market; and
– Phases of Housing Development.
Building Your Program






11
Appendix A: Case Study—Housing Support Teams
Appendix B: Sample Job Description—Housing
Support Team Housing Specialist
Appendix C: Case Study—Washington, D.C.
Appendix D: Case Study—Allegheny County,
Pennsylvania
Appendix E: State Housing Agencies
Appendix F: Memorandum of Understanding
Between a Public Housing Agency and a Mental
Health Authority
Training Frontline Staff

12
This workbook will help program leaders teach
their staff members about the principles,
processes, and skills necessary to deliver
effective Permanent Supportive Housing.
– The basic elements of Permanent Supportive
Housing;
– The theory behind the Permanent Supportive
Housing model;
– The core processes that programs follow; and
– The types of services that program staff
provide.
Evaluating Your Program


13
Evaluating Your Program shows how to evaluate
the effectiveness of your Supportive Housing
program and ensure its fidelity to the model
presented in this KIT. It includes the following:
– A Fidelity Scale;
– The General Organizational Index; and
– Scoresheets for the scale and the index.
You will also find instructions for conducting
assessments and tips on how to use the data to
improve your program.
Evaluating Your Program

14
Key stakeholders who are implementing
Permanent Supportive Housing programs may
find themselves asking two questions:
– Does the Permanent Supportive Housing
program, as implemented, follow the basic
principles and elements of the Permanent
Supportive Housing model?
– Has Permanent Supportive Housing
achieved the expected results?
Evaluating Your Program


15
To answer the first question, collect process
measures (by using the Fidelity Scale and
General Organizational Index), which capture
how services are provided.
To answer the second question, collect
outcome measures, which capture the
program’s results.
Using Multimedia to Introduce
Your EBP



16
Using Multimedia is a collection of educational tools
to help you introduce Permanent Supportive
Housing to a variety of groups including the
following:
Mental health authorities; Community members;
Consumers; Families and other supporters; and
Housing providers.
These materials can be used during inservice
training meetings and for community presentations
to educate other stakeholder groups.
Tools for Tenants








17
Tool 1: What Is Permanent Supportive
Housing?
Tool 2: How Can You Afford a Place of Your
Own?
Tool 3: Your Housing Preferences
Tool 4: What Is a Lease?
Tool 5: Your Support Needs
Tool 6: Being a Good Tenant
Tool 7: Time to Move On?
Tool 8: Fair Housing Is Your Right!
Statement of Principle

18
Federal law requires public mental health
systems to provide services in integrated
community settings, and Permanent
Supportive Housing is a proven approach for
doing so. It presents an alternative to hospitals,
shelters, and other settings that segregate
people by disability, such as nursing homes,
board and care homes, and other residential
care facilities, in which residency is tied to
receiving the particular services the facility
offered.
More Statement of Principle



19
Living in custodial settings often causes people
to withdraw from community life and to lose
daily living and interpersonal skills.
Institutionalization often causes people to lose
contact with family and friends and lose a sense
of community.
Institutionalization carries a social stigma;
having a history of institutionalization can
increase the chances that someone
will experience overt discrimination.
Why We Do This Work


20
Having a place to call home is necessary
for adequate psychological health. It is
very difficult for people with psychiatric
disabilities to stabilize their psychiatric
condition or begin to move toward
recovery without having a place to call
home.
A home is a universal human need.
PSH Systemwide Approach


21
Support for Permanent Supportive Housing
as a Systemwide Approach
Permanent Supportive Housing is an effective
approach that can be adopted system-wide,
rather than as a selective approach available
only to a select few. It is now recognized that
people with serious mental illnesses and other
disabilities have the right to be full members of
the community, and Permanent Supportive
Housing has been shown to support that goal.
Support for PSH


22
In 2005, the National Association of State
Mental Health Program Directors revised its
Position Statement on Housing and Supports for
Individuals with Mental Illness. This new
statement, a dramatic call to action, reaffirms
the commitment of state mental health
authorities to Permanent Supportive Housing.
This position statement calls for the following:
Support for PSH
The development and sustainability of decent, safe, and
affordable housing;
The availability of flexible and individualized, quality
housing services and supports;
Housing policies that do not tie the status of mental
health treatment to acquiring and protecting housing;
A more active and determined effort of the federal
government to protect and bolster federal housing
policies and programs; and
Leadership by state mental health authorities in the
housing arena, especially in housing development.
23
For more information
contact CSH
anne.cory@csh.org
www.csh.org