From struggling to survive to a life based on values and choices: first-person experiences of participating in a Norwegian Housing First project
Keywords:Housing First Model, dual diagnosis, recovery, empowerment, person-centredness
Introduction: Persons with concurrent substance-abuse and mental-health problems often lack permanent housing, and have a poorer quality of life and lower levels of functioning than persons who primarily have mental-health problems. A Housing First project (HF) began during the autumn of 2013 in a Norwegian city. The target group was persons who were struggling with substance-abuse and mental-health problems and who lacked housing. The HF model has a holistic health and social approach to help this group to establish themselves and to be able to remain in their own homes.
Aim: Little is known about how the HF model works in Norway. The aim of this study was to explore, describe, and interpret clients’ experiences of partaking in this HF project.
Method: The qualitative research interview was used as the method for the generation of data. Twelve participants were interviewed, and a phenomenological hermeneutic method was used to analyse the data.
Results: The structured analysis revealed two themes, and the comprehensive understanding centred around these two interwoven themes: having an available professional companion and taking the lead in your own life.Discussion: This study shows that people with a dual diagnosis can begin to recover and obtain a better quality of life if they receive appropriate housing, support, and services of their choice on their own terms. The study confirms the importance of the participants’ active participation, control, and choice in planning and formulating specific services. The results show that if a person wishes and dares to change his or her life, then decisive conditions are having one’s own home, meeting professionals who inspire trust, and having one’s personal preferences and needs recognized.
Antony, W.A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11-23.
Atherton, I. & McNaughton Nicholls, C. (2008). ‘Housing First’ as a means of addressing multiple needs and homelessness, European Journal of Homelessness, 2, 289-303.
Barker, P. & Buchanan-Barker, P. (2009). Getting personal: being human in mental health care. In: P. Barker (Ed.). Psychiatric and Mental Health Nursing. The Craft of Caring. London: Hodder Arnold.
Bonney, S., & Stickley, T. (2008). Recovery and mental health: a review of the British literature. J Psychiatr Ment Health Nurs, 15(2), 140-153. doi: 10.1111/j.1365-2850.2007.01185.
Borg, M., Sells, D., Topor, A., Mezzina, R., Marin, I. & Davidson, L. (2005). What makes a house a home: the role of material resources in recovery form severe mental illness. American Journal of Psychiatric Rehabilitation, 8(3), 243-256.
Busch-Geertsema, V. (2014). Housing First Europe. Results of a European Social Experimentation Project. European Journal of Homelessness, 8(1), 13-28.
Chen, S-P., Krupa, T., Lysaght, R., McCay, E. & Piat, M. (2013). The development of recovery competencies for in-patient mental health providers working with people with serious mental illness. Administration and Policy in Mental Health and Mental Health Services Research, 40(2), 96-116.
Denhov, A. & Topor, A. (2012). The components of helping relationships with professionals in psychiatry: Users’ perspective. International Journal of Social Psychiatry, 58(4), 417-424.
Drake, R.E. & Whitley, R. (2014). Recovery and severe mental illness; description and analysis. La revue canadienne de psychiatrie, 59(5), 236-242.
Erikson, B.G & Hummelvoll, J.K. (2012). To live as mentally disabled in the risk society. Journal of Psychiatric and Mental Health Nursing, 19(11), 594-602.
Gilmer, T.P., Stefancic, A., Ettner, S.L., Manning, W.G. & Tsemberis, S. (2010). Effect of Full-Service Partnerships on Homelessness, Use and Costs of Mental Health Services, and Quality of Life Among Adults With Serious Mental Illness. Arch Gen Psychiatry, 67(6), 645-652.
Gordon, S.E., Ellis, P.M., Siegert, R.J. & Walkey, F.H. (2014). Core dimensions of recovery: a psychometric analysis. Administration and Policy in Mental Health and Mental Health Services Research, 41(4), 535-542.
Hipolito, M.M., Carpenter-Song, E. & Whitley, R. (2011). Meanings of recovery from the perspective of people with dual diagnosis. Journal of Dual Diagnosis, 7(3), 141-149.
Honneth, A. (2008). Kamp om anerkjennelse: Om de sosiale konfliktenes moralske grammatikk.(The struggle for recognition: the moral grammar of social conflicts). Oslo: Pax Forlag.
Hummelvoll, J.K. (2006). Verdiundersøkende samtaler i lokalsamfunnsbasert psykisk helsearbeid. (Dialogues on basic values in community mental health care). Tidsskrift for psykisk helsearbeid, 3(2), 116-129.
Kertesz, S.G., Crouch, K., Milby. J.B., Cusimano, R.E. & Schumacher, J.E. (2009). Housing First for Homeless Persons with Active Addiction: Are we Overreaching? The Milbank Quarterly, 87(2), 495-534.
Kvale, S. & Brinkman, S. (2011). Interview. Introduction til et håndverk. (Interview. Introduction to a craft). København: Hans Reizel.
Leamy, M., Bird, V., LeBoutillier, C., Williams, J. & Slade, M. (2011). Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445-452.
Lindseth, A. & Norberg, A. (2004). A phenomenological hermeneutical method for researching lived experience. Scandinavian Journal of Caring Sciences, 18(2), 145-153.
Mares, A.S. & Rosenheck, R.A. (2010). Twelve month client outcomes and service use in a multi site project for chronical homeless adults. Journal of Behavioral Health Services & Research, 37(2), 167-183.
Mezzina, R., Davidson, L., Borg, M., Marin, L., Topor, A. & Sells, D. (2006). The social nature of recovery. Discussion and implications for practice. American Journal of Psychiatric rehabilitation, 9(1), 63-80.
National Registry of Evidence-Based Programs and Practices (2010, Nov 18). NREPP: Pathways’ housing first program. Retrieved from http://nrepp.samhsa.gov/ViewIntervention.aspx?id=155
Ness, O., Borg, M. & Davidson, L. (2014). Facilitators and barriers in dual recovery: a literature review of first-person perspectives. Advances in Dual Diagnosis, 7(3), 107-117.
Nooe, R.M. & Patterson, D.A. (2010) The ecology of homelessness. Journal of Psychiatric Behavior in the Social Environment, 20(2), 105-152.
Norwegian Board of Health Supervision (2000). Personer med samtidig alvorlig psykisk lidelse og omfattende rusmisbruk. (Persons with severe psychological illness and extensive drug abuse). IK-2727, Oslo.
Norwegian Directorate of Health (2012) Nasjonal Faglig Retningslinje for Utredning, Behandling og Oppfølging av Personer med Samtidige Lidelser. (National Guidelines for Assessment, Treatment and Follow up of People with Both Mental Health Problems and Addiction Problems). Oslo: Norwegian Directorate of Health.
Official Norwegian Reports (2011:15) Rom for alle. En sosial boligpolitikk for framtiden. (Room for everyone. A social housing policy for the future). Oslo: Ministry of Local Government and Modernisation.
Padgett, D.K. (2007). There’s no place like (a) home: Ontological security among persons with serious mental
illness in the United States. Social Science & Medicine, 64(9), 1925-36.
Padgett, D.K., Gulcur, L. & Tsemberis, S. (2006). Housing first services for people who are homeless with co-occurring serious mental illness and substance abuse. Research on Social Work Practice, 16(1), 74-83.
Patterson, M., Moniruzzaman, A., Palepu, A., Zabkiewicz, D., Frankish, C.J., Krausz, M. & Somers, J. (2013). Housing First improves subjective quality of life among homeless adults with mental illness: 12 month findings from a randomized controlled trial in Vancouver, British Columbia. Social Psychiatry and Psychiatric Epidemiology, 48(8), 1245-1259. DOI 10.1007/s00127-013-0719-6
Pearson, C.L., Montgomery, A.E. & Locke, G. (2009). Housing stability among homeless individuals with serious mental illness participating in housing first programs. Journal of Community Psychology, 37(3), 404-417.
Pleace, N. (2011). The Ambiguities, Limits and Risks of Housing First from a European Perspective. European Journal of Homelessness, 5(2), 113-127.
Ricoeur, P. (1976). Interpretation theory: Discourse and the surplus of meaning. Fort Worth: Texas Christian University Press.
Skatvedt, A. & Edland-Gryt, M. (2012). Øyeblikksomsorg – et verktøy for bedring. Evaluering av 24SJU – et lavterskeltilbud til personer med dårlig psykisk helse og rusmiddelproblemer. (Emergency care – a tool for recovery. Evaluation of 24SEVEN – low threshold services for persons with poor mental health and drug related problems). Sirus rapport nr. 4. Oslo: Statens institutt for rusmiddelforskning.
Slade, M. (2012). Everyday solutions for everyday problems: how mental health systems can support recovery. Psychiatric Services, 63(7), 702-704.
Slade, M., Leamy, M., Bacon, F., Janosik, M., LeBoutillier, C., Williams, J. & Bird, V. (2012). International differences in understanding recovery: a systematic review. Epidemiology and Psychiatric Sciences, 21(4), 353-364.
Snertingdal, M.I. (2014). Housing First i Norge – en kartlegging. (Housing First in Norway - a mapping). Fafao-rapport 2014:52.
Topor, A., Borg, M., Di Girolamo, S. & Davidson, L. (2011). Not just an individual journey: social aspects of recovery. International Journal of Social Psychiatry, 57(1), 90-99.
Tsai, J., Bond, G.R., Salyers, M.P., Godfrey, J.L. & Davis, K.E. (2010). Housing preferences and choices among adults with mental illness and substance use disorders: a qualitative study. Community Mental Health Journal, 46(4), 381-388.
Tsemberis, S. (2010). Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction. Center City, MN: Hazelden.
Tsemberis, S., Gulcur, L. & Nakae, M. (2004). Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis. American Journal of Public Health, 94(4), 651-656.
Tsemberis, S., Kent, D. & Respress, C. (2012). Housing Stability and Recovery Among Chronically Homeless Persons With Co-Occuring Disorders in Washington, DC. American Journal of Public Health, 102(1), 13-16.
Watson, D.P. (2012). From structural chaos to a model of consumer support: Understanding the roles of structure and agency in mental health recovery for the formerly homeless. Journal of Forensic Psychology Practice, 12(4), 325-348. http://dx.doi.org/10.1080/15228932.2012.695656
White papers 30 (2011-2012). Se meg! En helhetlig rusmiddelpolitikk, alkohol-narkotika-doping.. (See me! An overall drug policy: alcohol-drug-doping). Oslo: Ministry of Health and Care Services.
Williams, C. & Tufford, L. (2012). Professional competencies for promoting recovery in mental illness. Psychiatry, 75(2), 190- 201.
How to Cite
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).