Complex recovery: Understanding the lives of formerly homeless adults with complex needs

Objective: This report examines mental health recovery in a population neglected in the literature–formerly homeless adults with serious mental illness and co-occurring substance abuse. The term ‘complex recovery’ is used to examine the onset and impact of various types of adversity over the life course. Method: Burawoy's extended case method was conducted on in-depth interviews with 74 formerly homeless adults living in housing programs in New York City. Data included verbatim transcripts, interviewer feedback forms, and case summaries. Results: Seven themes emerged: the longstanding influence of poverty, childhood hardship, social support and network depletion, substance abuse and recovery, unequal impact of gender differences, experiences of incarceration and fragmented service system. Structural as well as individual factors were found to comprise complex recovery. Conclusions: Complex recovery, which situates mental health recovery amidst homelessness and other forms of adversity, has implications for policies and practices designed to assist this vulnerable population.