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In this study, we used ethnographic methods and a risk environment framework to consider how contextual factors produce or reduce risk for substance use with a sample of 27 adults who recently moved into permanent supportive housing (PSH). Most apparent was how the social and physical environments interacted, because most participants focused on how having an apartment had dramatically changed their lives and how they interact with others. Specific themes that emerged that also involved economic and policy environments included the following: isolation versus social engagement; becoming one's own caseworker; and engaging in identity work. This study underscores the scarcity yet importance of research that examines the multiple types of environment in which PSH is situated, and suggests that a better understanding of how these environments interact to produce or reduce risk is needed to develop optimal interventions and support services.

Understanding Risk Environments in Permanent Supportive Housing for Formerly Homeless Adults