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The evolution of housing approaches for people with serious mental illness is described and analyzed. A distinction is made between three different approaches to housing:(a) custodial,(b) supportive, and (c) supported. Research evidence is reviewed that suggests the promise of supported housing, but more research is needed that compares supported housing with different supportive housing approaches. It is argued that the current move to a supported housing approach represents a fundamental shift or transformative change in mental health policy and practice. Strategies to facilitate this shift are discussed.