Impact of Trauma-Informed Design on Health and Well-Being of People Formerly Experiencing Homelessness in Permanent Supportive Housing

When individuals transition from homelessness into housing, their new home should serve as a place of healing and dignity. This paper presents empirical evidence on the impact of trauma-informed design (TID), an approach to designing affordable housing that supports the health and well-being of people with lived experience of homelessness. The study used a mixed-methods, quasi-experimental design across five permanent supportive housing (PSH) sites—three with TID features and two without. Residents completed surveys at two timepoints, and both the residents and the staff participated in semi-structured interviews. The quantitative results revealed a complex pattern: while some aspects of relationships and self-awareness improved at TID sites, measures of psychological safety and compassion declined. Additionally, conflict, psychological aggression, physical aggression, and mild violence increased over the same period. Qualitative findings highlight that safety is a nuanced, context-dependent experience that exists along a spectrum. The residents at the TID sites described opportunities to experience higher levels of safety. Together, the quantitative and qualitative data paint a complex picture of life in PSH. A key finding is that safety, conflict, and relationships are interwoven, evolving over time as the residents adapt to their environment.