Bringing Recovery Housing to Scale in Ohio: Lessons Learned

ABSTRACT

Objective: States across the country are recognizing recovery housing, an abstinence-based living environment promoting recovery from alcohol and other drugs, as an important yet underrepresented choice within their housing and treatment continuums. However, strategies for bringing recovery housing to scale are not well known. Building upon broader quality improvement efforts in Ohio, this paper aims to identify barriers and facilitators to expanding recovery housing in Ohio by understanding the perspectives of relevant stakeholders. Methods: We conducted 6 recovery housing program site visits; 24 semi-structured key informant interviews with state and national researchers, policy makers, and stakeholder groups; and 16 focus groups with administrators and staff, residents, and local stakeholders including housing developers, advocates, and county and city policy makers (n = 113). Focus groups were disaggregated by stakeholder membership and guided by separate interview protocols. Transcripts were coded and analyzed to identify primary themes. Results: Most participants across stakeholder groups expressed a need to increase recovery housing supports within the state. Two facilitators and three barriers emerged as primary themes from the qualitative analysis. Facilitators included (1) the ability of recovery housing programs to identify, connect, and collaborate with other recovery housing programs and service systems, an approach that increased a program's ability to refer, accept new clients, learn about programmatic and financial supports, and advocate for a space within the services continuum, and (2) support from legislators and other local stakeholders to include recovery housing as a viable and necessary option. Barriers included (1) variations in recovery housing definitions, language, and understanding that limited recovery housing providers’ ability to connect with one another and be eligible for different streams of support, (2) availability of funds and ability to access them, and (3) restrictions in federal, state, and local regulations and codes. Conclusions: Although recovery housing is limited and has not been integrated into many housing and treatment continuums, there is growing consensus about its importance for various subpopulations. Developing consistent definitions, program models, funding streams, networks of recovery housing providers, and collaborations among recovery-oriented systems of care will reduce misperceptions and enhance the likelihood that recovery housing will be expanded.

KEYWORDS:

• Recovery housing
• recovery residences
• sober housing
• substance use disorders
• addiction
• recovery
• recovery-oriented systems of care

Acknowledgments

The authors would like to thank all the residents, staff, administrators, policymakers, and other key stakeholders who participated in these interviews and focus groups. The authors also wish to thank the quality improvement project team, Neil Greene, Lisa Sepahi, and Kate Thom. Finally this work could not have happened without the vision, leadership, and contributions of Lori Criss, Associate Director of the Ohio Council of Behavioral Health & Family Services Providers.

Disclosures

Ms. Pannella Winn and Ms. Paquette report no conflicts of interest related to this manuscript and no additional compensation for professional services.

Funding

This quality improvement effort was supported by funding from the Ohio Department of Mental Health and Addiction Services

Notes

¹ As of November 2015, states with NARR affiliates include California, Connecticut, Florida, Georgia, Illinois, Indiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia.