Recovery housing in Scotland: international literature review

1. Introduction

The level of harms from alcohol and drugs in Scotland are high in comparison to the rest of the UK and Europe, and causes avoidable damage to people's lives, families, and communities. Tackling the high level of drug related deaths in Scotland is a priority for the Scottish Government. In January 2021, Nicola Sturgeon, in her role as First Minister, made a statement to Parliament which set out a National Mission to reduce drug deaths through improvements to treatment, recovery and other support services.

The Residential Rehabilitation Development Working Group (RRDWG) was established in April 2021 as a successor to the Residential Rehabilitation Working Group (RRWG). Its role is to advise Scottish Ministers and the wider drug and alcohol sector on implementing the recommendations made by the RRWG in December 2020. These recommendations were published in a suite of reports that provided insight into the pathways into, through and out of residential rehabilitation in Scotland. A specific “need to ensure robust exit planning and continuity of care for those leaving residential rehabilitation” was outlined as a recommendation for future work. This report aims to address this by reviewing the Scottish, UK and international academic and grey literature on recovery housing as a potentially important service for people leaving residential rehabilitation. In doing so, this report responds to the recommendation by the RRWG to better understanding the “local community-based resources […] and other recovery initiatives” that operate alongside residential rehabilitation (recommendation 6b). It also contributes to better understanding the diversity of residential treatment interventions across Scotland (recommendation 7a).

Recovery housing, as part of structured aftercare following a period of residential rehabilitation treatment, has been put forward as a potential avenue for meeting early recovery needs that can be incorporated into the continuity of care for people in recovery. Although a clear definition of recovery housing is lacking^[1], ^[2], it is generally accepted that it is a shared-living, substance-free living environment, centred on peer support to promote sustained recovery and independent living. Recovery housing therefore acts as a bridge between structured residential rehabilitation treatment and independent living. Recovery housing is one continuity of care service that can run alongside, and independently, of residential rehabilitation.

This report reviews the evidence from the Scottish, wider UK and international literature base pertaining to various aspects of recovery housing. Specifically, this report sets out to address the following research questions:

• What is meant by recovery housing: is there a definition and what are the key principles?
• What are the key recovery housing models/types and how are they similar and/or different?
• What evidence is there on the influence of recovery housing on resident outcomes?
• What challenges are associated with recovery housing?