New Publication Explores Mental Health Among Residents in Substance Use Recovery Housing

CHPPR researchers have published a new study on the mental health challenges and opportunities faced by residents in substance use recovery housing. The results of this study provide key insights into how researchers and providers can better support mental health in recovery residence environments.

“We know that mental health issues and substance use occur together pretty often,” said Hannah Stewart, Graduate Research Assistant and lead author of the publication. “We decided to explore the topic in more depth, to find out how mental health concerns are intertwined with the hard work that goes into recovery from substance use.”

The publication, “And Now that I Feel Safe…I’m Coming Out of Fight or Flight”: A Qualitative Exploration of Challenges and Opportunities for Residents’ Mental Health in Substance Use Recovery Housing, was published in the Community Mental Health Journal earlier this year. The study is part of Project HOMES, an ongoing research project led by J. Michael Wilkerson, PhD and Sheryl McCurdy, PhD, which works with local community partners throughout Texas to operate and evaluate 15 no-cost, Medically Assisted Recovery (MAR)-friendly recovery residences in the state. Although MAR is a proven and effective treatment for people in recovery from opioid use, most recovery residences require their residents to abstain from all substances. The innovative approach of Project HOMES allows residents to benefit from both MAR and the safe environment of recovery housing at the same time.

"Since research into recovery housing is relatively new, mental health within the space really hasn’t been studied,” said Stewart. “The literature that existed previously was mostly quantitative, dealing with the reduction of symptoms when in the home, but not how or why that happened. If we better understand this, we can replicate it, and develop best practices to do it well.”

To explore how mental health affects residents’ experiences in recovery housing, researchers conducted interviews with 92 current and former residents from Project HOMES residences. Many participants noted that the group home environment exacerbated their anxiety and paranoia, particularly when there was high turnover. Even so, residents overwhelmingly believed that recovery housing was an overall benefit to their mental health. Peer support and understanding from people with similar shared experiences were among the benefits identified. They also described the houses as safe, stigma-free spaces where they finally had the time and opportunity to unpack and address their mental health while transitioning back to normal life.

“People definitely struggle when moving into a group living situation,” said Stewart. “The close living and lack of privacy can be really stressful and exacerbate existing issues. But they also found it helpful to be around people who have gone through the same struggles, who understand their experiences. They support each other in ways many of them had never experienced at any other time in their life. That peer support is critical for both their mental health and their recovery.”

The insights gained from this study will inform the continuing work of Project HOMES. With a better understanding of the relationship between the residents’ mental health and recovery, the team is better situated to provide recovery housing residents and staff with the appropriate support.

“This paper was focused on the experiences of mental health along the journey, but HOMES as a whole is specifically focused on medication-assisted recovery,” said Stewart. “That crossover of medication-assisted recovery and mental health is understudied from both the public health and clinical directions, so that’s what I’m most interested in looking at next.”

Project HOMES is funded through the Texas Targeted Opioid Response (TTOR) initiative operated by the Texas Health and Human Services Commission (HHSC). Learn more about Project HOMES and other research initiatives on the CoLab team’s website.