Abstract

Objective: Despite increasing efforts to improve housing stability, research has largely defined housing stability in a narrow sense and heavily relied on objective measures, such as housing types and housing duration. The present study constructed a conceptual framework for a subjective housing stability definition from the perspectives of individuals with co-occurring mental health and substance use disorders and their behavioral health service providers. Methods: Following the principles of grounded theory, we collected and analyzed qualitative data through semistructured interviews with 24 individuals with serious mental illness and substance use problems and three focus groups with 22 behavioral health service providers. Results: We developed a conceptual framework with two domains of subjective housing stability: functional stability and experiential stability. The functional stability domain includes four theoretical concepts: meeting basic needs, housing quality, housing affordability, and housing permanence. The experiential stability domain includes four theoretical concepts: autonomy and independence, connectedness, safety, and supportiveness. Conclusions: The conceptual framework can inform future research, practices, and policies to move beyond focusing on merely providing housing to consider the diverse and underlying needs in improving housing stability and well-being among those experiencing or at risk of housing instability.

摘要

目标：尽管人们越来越多地努力改善住房稳定性，但研究大多对狭义的住房稳定性进行了定义，并且严重依赖于客观指标，例如住房类型和住房期限。本研究从同时存在心理健康和药物滥用障碍的个体及其行为健康服务提供者的角度构建了主观住房稳定性定义的概念框架。方法：遵循扎根理论的原则，我们通过对 24 名患有严重精神疾病和药物滥用问题的个人以及由 22 名行为健康服务提供者组成的三个焦点小组进行半结构化访谈，收集并分析了定性数据。结果：我们开发了一个包含主观住房稳定性两个领域的概念框架：功能稳定性和体验稳定性。功能稳定性领域包括四个理论概念：满足基本需求、住房质量、住房负担能力和住房持久性。体验稳定性领域包括四个理论概念：自主性和独立性、连通性、安全性和支持性。结论：概念框架可以为未来的研究、实践和政策提供信息，使其超越仅仅关注提供住房，而考虑改善经历住房不稳定或面临住房不稳定风险的人们的住房稳定性和福祉的多样化和潜在需求。