The challenges of transitioning indoors: A qualitative analysis of early death in supportive housing

The Housing First (HF) model of ending homelessness is based upon principles of human rights and client choice. It prioritizes the most vulnerable people for rapid placement in permanent supportive housing units, without sobriety or treatment requirements. Very little research has been done on the difficulties of transitioning into this independent living environment. Moreover, preliminary quantitative research suggests that mortality during the first year of housing is higher than subsequent years. The following study is a qualitative exploration of what contributes to mortality in housing, particularly in the years immediately following move-in. The research questions were: (1) How do on-site service providers in a San Francisco Housing First program explain early mortality in supportive housing? and (2) What do on-site providers perceive as the major challenges that new residents face when transitioning indoors that could lead to unexpected early mortality?