A longitudinal analysis of peer-delivered permanent supportive housing: Impact of housing on mental and overall health in an ethnically diverse population.

Abstract

Permanent supportive housing (PSH) is an evidence-based health intervention for persons experiencing homelessness, but the impact of individual mechanisms within this intervention on health requires further research. This study examines the longitudinal impact of the mechanism of supportive housing within a peer-delivered PSH model on overall health and mental health (as measured by psychological distress and self-report of bothersome symptoms) outcomes in an ethnically diverse population. The 237 participants in the study included persons who were homeless or at risk of homelessness and who also had been diagnosed with a serious mental illness. Sixty-one percent of all participants received supportive housing. All 3 outcomes were significantly associated with quality of life indicators, recovery, and social connectedness. In addition, overall health was significantly associated with employment, age, and psychological distress. Psychological distress was associated with gender, type of housing, and history of violence or trauma. Experiencing bothersome symptoms was associated with drug use, history of violence or trauma, and psychological distress. Longitudinal models of these 3 outcomes showed that supportive housing was significantly associated with good to excellent health 6 months after baseline (odds ratio = 3.11, 95% confidence interval [1.12, 8.66]). The models also demonstrated that the supportive housing and comparison groups experienced decreased psychological distress after baseline. The results of this study demonstrate the importance of supportive housing within the context of PSH, particularly for the overall health of participants, and the positive overall impact of PSH on mental health in a diverse population. (PsycINFO Database Record

Provision of peer support at the intersection of homelessness and problem substance use services: a systematic ‘state of the art’ review

“…There were two other papers looking specifically at IPS -a qualitative study looking into the experiences of peer providers and recipients and their opinion of what makes IPS effective in homelessness recovery [34]; and a mixed methods Qsort study investigating the opinions of experts on what makes peer support effective with people who are homeless [35]. The remaining studies included: a quantitative pilot intervention of peer-led support for homeless youth [79]; a feasibility study of involving vendors of The Big Issue (a magazine sold by individuals who are homeless or at risk of homelessness that provides them with opportunities to earn an income) to become peer educators for people who are homeless to reduce drug related harms [55]; a study protocol for peer-led intervention for people who are experiencing homelessness and problem substance use [81]; a report from an independent evaluation of the Homeless Health Peer Advocacy Service programme on the impact on client's health, cost, and impact on the peers themselves [27]; a commentary on the need for more safe/supervised consumption sites and other overdose prevention interventions across a range of housing sites to minimise overdose risk [83]; a longitudinal evaluation of a Housing First peer support model [36]; an evaluation of the effects of peer delivered permanent supportive housing on health and mental health of an ethnically diverse population [51]; an evaluation of a group intensive peer support model of case management in a supported housing programme for homeless veterans [67], and four studies relating to smoking cessation peer interventions in poly-substance using individuals experiencing homelessness ( [47,48,54,80]).…”

Life in company dormitories and a career change are associated with anxiety over lack of privacy among radiation decontamination workers in Fukushima Prefecture, Japan

“…However, the association between anxiety over lack of privacy and the specific type of worker housing, such as company dormitories, has yet to be clarified. Company dormitories have never been studied as a factor related to health, although past studies examining the relationship between housing type and mental health have investigated the ownership status of the house ( tenure housing or not) [12][13][14] , the building type (high-rise or low-rise accommodations) 15,16) , the form of housing (detached house or apartment) 17,18) , the size of the residence (small, medium, or large) 19) , or property ownership (public housing or private housing) 20) as factors affecting mental health. Therefore, it is essential to add new information regarding the association between different housing types, such as company dormitories, and anxiety over lack of privacy.…”

Homelessness

“…Symptoms of mental illness can create psychological distress, which is negatively associated with quality of life in homeless populations (Stewart and Townley 2019;. Higher psychological distress is also associated with lower overall health (Crisanti et al 2017), poorer relationships with families (Bonin et al 2017), and lower housing stability . With regard to the prevalence of particular mental illnesses, the general public may assume that schizophrenia predominates among people who are homeless, possibly because people who are homeless and who have schizophrenia sometimes act out in noticeable ways; however, depression-related disorders probably have a similar or possibly higher prevalence among people who are homeless (Breakey et al 1989;Vázquez et al 1997).…”

“…(B) Untreated alcohol and other substance use disorders, though far from universal among people who are homeless, do tend to occur at elevated rates among this population (Fazel et al 2008), and this too can reduce quality of life. Substance use can be associated with many negative outcomes, such as mental health symptoms (Crisanti et al 2017), risky sexual behavior (Castaños-Cervantes and Vélez-Agosto 2018), parent-child separation (Shinn et al 2017), and reduced housing stability . Again, the causal relationship is complex; substance use can cause homelessness, but in other cases, substance use may be a response to the hopelessness associated with homelessness.…”

“…Early death tends to accompany homelessness, possibly in part due to these untreated medical conditions and possibly also because of the physical stress caused by homelessness (Hibbs et al 1994;Hwang 2000). Also, people who have experienced homelessness tend to report more (G) childhood trauma and victimization than do others (O'Connor and Fitzpatrick 2017), and trauma and victimization are associated with lower quality of life (Crisanti et al 2017;Kidd et al 2017;O'Connor and Fitzpatrick 2017). Thus, homelessness tends to reduce quality of life, but possibly equally importantly, homelessness tends to co-occur, sometimes for complex reasons, with a host of other factors that reduce quality of life.…”