Between Care and Autonomy: Applying the Capability Framework to Supported Living

Abstract

Background: In the Netherlands, policy under the Social Support Act emphasizes self-reliance as a key outcome for individuals with psychological or psychosocial challenges residing in supported housing. However, it is unclear how this policy aim aligns with aspirations and recovery processes toward well-being of those affected. Methods: This qualitative study explored the perspectives of clients in supported housing transitioning to less intensive care, alongside professionals and municipal officials. Guided by the capability approach, the research examined what participants defined as meaningful goals, what they perceive as enabling factors in their recovery, and how these perspectives relate to the policy emphasis on self-reliance. Nineteen participants were recruited through purposive and snowball sampling, including current and former clients, care professionals, and municipal representatives. Data were collected via semi-structured, in-depth interviews and analysed thematically using both inductive and deductive methods. Results: Findings show that while self-reliance is considered a valuable stepping stone, it is often viewed by participants as a starting point rather than an endpoint. Clients, in particular, emphasized aspirations beyond independence, such as forming meaningful relationships, developing a positive identity, and contributing to society. Recovery was described not only in terms of reduced care dependency but as a broader process of self-actualization. Professionals and municipal officials acknowledged this wider view to some extent but noted that policy goals and tools fall short in capturing these broader outcomes. Discussion: This study suggests that policies promoting self-reliance should be reframed through a capabilities lens, emphasizing individual autonomy, valued goals, and diverse forms of participation. Policy tools should function as flexible, co-designed capability menus rather than prescriptive checklists. Supporting well-being requires not just reducing support needs but enabling people to live lives they have reason to value.