Tove Harnett

This study introduces the concept of Collective Permanent Supportive Housing (CPSH), tailored for older adults with histories of homelessness and long-term substance use. CPSH offers residents individual apartments and secure tenures, using a harm reduction approach. The study, being designed to identify the benefits and risks of CPSH, was based on (i) a quantitative dataset with a national survey with responses from 148 of the 290 local authorities in Sweden, and (ii) a qualitative dataset with interviews with 43 residents, 10 case workers, and 25 staff members at five CPSH facilities and telephone interviews with managers at 17 facilities. The analysis identified four enabling environments: permanent housing, an accepting environment, support with ordinary life, and social relations, that enhanced survival, well-being, dignity, and the opportunity for a relatively normal life. Three risk environments were also identified: accumulating problems, creation of total institutions, and the risk of being unable to move on due to lock-in effects. This study shows that CPSH provides much-needed stability and improved wellbeing, in relation to residents’ humiliating experiences in the past; however residents are treated as being at an ‘end station’, with very few possibilities to access other forms of housing.