Safe Havens

Safe havens are a form of small-scale supportive transitional housing designed to assist chronically homeless people (generally no more than fifteen to thirty clients) suffering from severe mental illness and substance addictions. Housing men and women separately, safe havens offer an alternative for people who have met conventional shelters and programs with so-called resistance or noncompliance. By reducing expectations that might be objectionable—such as potentially intrusive intake procedures, program participation requirements, and curfews—safe havens serve individuals who often are unable or unwilling to make use of more mainstream options. Such relaxed expectations make for a low-demand setting.

Few safe havens have been documented in the scholarly literature. Research on safe havens has been limited by their founding principles; these grant both support and privacy for residents, who often deeply distrust conventional shelters and institutions. But two notable examples are featured in the literature, both for chronically homeless women.

Dennis Culhane (1992) studied a low-demand respite for twenty-four women developed by a group of nuns, the Sisters of Mercy, and Catholic Social Services in Philadelphia. Those in the target population had not been using existing social and health services, nor were they using prescription drugs to modify and control their behavior. This project, Women of Hope, reportedly had great success in helping chronically homeless mentally ill women make the transition from street life. At first, many women used the facility primarily as a drop-in (or short-term “respite” from the street). Over time, many made more permanent moves. Between 1985 and 1991, approximately 120 women were brought in off the street.

A key element of Women of Hope's approach was to impose no expectations for treatment or medication. Staff advised women about their options but believed that if they were forced to take medications, the women would return to the streets. Women were able to come and go as they pleased, and they were told that a bed would be held for them for two weeks after last contact. A number of them were unable to sleep in beds after many years on the street; some slept on the floor or in chairs. If any woman was deemed dangerous, admission to a psychiatric facility would be facilitated. Older women generally moved on to nursing homes; however, staff held no expectation that all women would eventually move on. Ten years after the facility opened, management of the project changed, and participation in treatment and programming is now mandatory.

Dennis Culhane's article is but one of several written in the early 1990s that focused on the safe [Page 488]haven model in the United States. In another paper, Frank Lipton (1993, 3–4) attempted to describe the parameters of a safe haven.