Recovery housing in Scotland: international literature review

4. Conclusion

Recovery housing is an umbrella term for substance-free, safe living environments for people in recovery. There are different levels of recovery housing, which differ in their extent of structure, support, and staffing. However, across levels, recovery houses always centre on facilitating peer support between residents and providing access to recovery support services. It is not a formal treatment for problem substance use - people often go to recovery housing following a stay in a residential rehabilitation, although for some houses this is not always a requirement. Recovery housing therefore offers support and structure to people as they transition back to living more independently, and no longer require the high level of support and structure from a residential rehabilitation service. Recovery housing services generally follow the key principles of the social model of recovery, including mutual-help, experiential knowledge, non-hierarchical relationships, and involvement in a recovery community. Finally, building resident’s recovery capital for sustained recovery is a key aim of recovery housing.

The positive longitudinal evidence on residents of recovery houses suggests that this model of continued care may be an effective option for people in recovery wanting a substance-free living environment. Improvements in various areas were observed from international and limited UK evidence including higher rates of abstinence and lowered reports of substance use; positive employment outcomes; reduced involvement in the criminal justice system; improvements to personal social support and skills; improved psychological measures; and community benefits. Longer stays in recovery housing were found to improve these positive outcomes. Recovery housing was also described as useful to sub-populations of the recovery population that face unique challenges; however, attention was also drawn to additional support needs for certain groups.

4.1 Further areas for investigation

This review identified several areas that would benefit from further exploration:

• There is a lack of UK and Scotland-based research on recovery housing in general. Further research on longitudinal resident’s outcomes; acceptability; and lived experience would be useful.
• How to best maintain residency in the first three months of a new resident joining a recovery house, which has been shown to be a vulnerable period for premature leave. Qualitative and lived experience research may be best suited to this area of research, where residents that have stayed for prolonged periods or left prematurely can discuss barriers or facilitators.
• Research demonstrated a wide range of knowledge levels on recovery housing, whereby those who had higher levels were more supportive of recovery housing^[118]. The current knowledge levels of key Scottish stakeholders (including residential rehabilitation providers and other recovery service providers, people experiencing substance use problems, policy makers and colleagues) is unknown. Research to gauge this knowledge level would be useful to know the degree of knowledge dissemination required.