Article

The paradigm shift in residential services: From the linear continuum to supported housing approaches.

Psychosocial Rehabilitation Journal 03/1990; DOI: 10.1037/h0099479

ABSTRACT Describes a paradigm shift, beginning in the 1950s and reaching its zenith in the 1970s, toward supported housing models and deinstitutionalization of the mentally ill. The linear residential continuum model formed the basis for residential treatment and the provision of specialized environments that prepared patients/clients for life in the community. A supported housing paradigm shifts the primary role of the service recipient from patient to community and shifts the locus of control from staff to client. Other elements of the shift include an emphasis on (1) social integration rather than homogeneous grouping by disability and (2) the most facilitative environment and best functioning rather than the least restrictive environment and independence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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    • "Thus, the system can contribute to chronic homelessness for many individuals who then join the " institutional circuit " and rotate through repeated stays in costly acute care services, such as emergency rooms, hospitals, shelters, and jails (Hopper, Jost, Hay, Welber, & Haugland, 1997). Traditional programs have been criticized for undermining choice and autonomy , putting strict limits on tenancy rights, such as requiring treatment and sobriety as a condition for continued tenure, and for sustaining social segregation of individuals with psychiatric disabilities by placing them in residences solely dedicated to housing this population (Allen, 1996; Carling, 1993; Ridgway & Zipple, 1990; Shinn & Tsemberis, 1998). From these critiques, the PHF model was born. "
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    • "This graduated model essentially tied housing to services, as the type of housing was dependent upon sobriety and engagement in treatment, and the rejection of or failure to adhere to these requirements was often what drove people back onto the streets. However, in the 1990s the supported housing model emerged, articulated by consumer advocates , which instead called for housing that fostered community integration, honored consumer choice, and gave people immediate access to permanent independent scatter-site housing (Ridgeway & Zipple, 1990). "
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