An observational study of effectiveness in community residential facilities

Lora, Antonio; Contartese, Antonio; Franco, Maurizio; Maglio, Maria Crocina Lo; Molteni, Emanuela; Pallavicini, Alessandra; Rasi, Elena; Rossini, M.; Violanti, Elisabetta; Lanzara, Dino

doi:10.1017/s1121189x00003468

Cited by 5 publications

(7 citation statements)

References 13 publications

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“…For this group of papers, service types ranged from intensive congregate residential care settings, with 24 h staffing [ 76 , 78 – 80 , 87 , 89 , 93 , 95 ], to less intensively supported accommodation, including group homes and supervised individual apartments (e.g. staffed 9 am-5 pm daily) [ 74 , 78 , 81 , 82 , 90 , 92 – 94 ], to individual tenancies with outreach support (staff based off-site) [ 75 , 81 , 83 , 87 , 88 , 90 , 96 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nine papers assessed changes in symptoms over time (two high quality [ 94 , 95 ] and seven moderate quality studies [ 74 , 76 , 80 , 82 , 84 , 86 , 88 ]. There was mixed evidence for an association between supported accommodation and symptoms in general SMI populations.…”

Section: Resultsmentioning

confidence: 99%

“…There was mixed evidence for an association between supported accommodation and symptoms in general SMI populations. Although some moderate quality papers demonstrated significant improvements in symptoms over time [ 82 , 84 , 95 ], a number, including a single high quality study, reported no change [ 86 , 94 ], or a worsening of symptoms [ 74 , 80 ] amongst this group. In examining change over time, one moderate quality study showed a significant improvement in symptoms for a small sub-group of participants who had been discharged from a residential facility, but no change for those participants who had remained in place [ 76 ].…”

Section: Resultsmentioning

confidence: 99%

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Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes

McPherson¹,

Krotofil²,

Killaspy³

2018

BMC Psychiatry

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BackgroundPost-deinstitutionalisation, mental health supported accommodation services have been implemented widely. The available research evidence is heterogeneous in nature and resistant to synthesis attempts, leaving researchers and policy makers with no clear summary what works and for whom. In this context, we undertook a comprehensive systematic review of quantitative studies in order to synthesise the current evidence on mental health and psychosocial outcomes for individuals residing in mental health supported accommodation services.MethodsUsing a combination of electronic database searches, hand searches, forward-backward snowballing and article recommendations from an expert panel, 115 papers were identified for review. Data extraction and quality assessments were conducted, and 33 articles were excluded due to low quality, leaving 82 papers in the final review. Variation in terminology and service characteristics made the comparison of service models unfeasible. As such, findings were presented according to the following sub-groups: ‘Homeless’, ‘Deinstitutionalisation’ and ‘General Severe Mental Illness (SMI)’.ResultsResults were mixed, reflecting the heterogeneity of the supported accommodation literature, in terms of research quality, experimental design, population, service types and outcomes assessed. There is some evidence that supported accommodation is effective across a range of psychosocial outcomes. The most robust evidence supports the effectiveness of the permanent supported accommodation model for homeless SMI in generating improvements in housing retention and stability, and appropriate use of clinical services over time, and for other forms of supported accommodation for deinstitutionalised populations in reducing hospitalisation rates and improving appropriate service use. The evidence base for general SMI populations is less developed, and requires further research.ConclusionsA lack of high-quality experimental studies, definitional inconsistency and poor reporting continue to stymie our ability to identify effective supported accommodation models and practices. The authors recommend improved reporting standards and the prioritisation of experimental studies that compare outcomes across different service models.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1725-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes

McPherson¹,

Krotofil²,

Killaspy³

2018

BMC Psychiatry

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“…While structural and organizational aspects of RFs are well described, less attention has been paid to the description of the factors related to a successful conclusion of residential treatments [30]. For instance, even in the face of data showing the effectiveness of residential structures, in both the clinical and psychosocial rehabilitation, treatment goals are often not clear, or at least not well explicated [5,6,24]. Initially, the low rate of discharge could be explained by the presence of many patients from mental hospitals, but now the percentages of these patients is of little relevance.…”

Section: Discussionmentioning

confidence: 99%

“…However, no indication on the specificity of rehabilitation and internal factors to the facilities emerged [24]. One reason for the low rate of discharge is that long-term facilities usually host severely ill and chronic patients that have, indeed, relevant difficulties living in the community, because of chronic clinical problems.…”

Section: Current Situation and Issues Raisedmentioning

confidence: 99%

Residential Care in Italy: Critical Issues and Future Perspectives

Ghio

Favaretto²,

Rocca

et al. 2016

International Journal of Mental Health

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As a result of law 180/78, a community-based model of mental health care was developed and the first nonhospital residential facilities were implemented, following specific principles that had been formulated for therapeutic communities in Italy. Taking into account the new national guidelines in this field, the purpose of this article is to describe the development over the years of residential facility care in Italy, to address the critical issues that have emerged, and to outline the future developments. The main critical issues that have emerged are: the gradually increasing of the number of facilities from 2000 to present, the low rate of discharge with the consequent risk of institutionalisation, the high variability of resources and interventions provided by facilities, the low adherence to national guidelines, and the poor differentiation of levels of intensity of care offered. In relation to this critical data, a national plan of recommendations was set up by the Ministry of Health in 2013. The aim was to promote a move from the logic of long-term stays to that of individualized and project-based care pathways and to distinguish residential facilities based on the level of rehabilitation intervention and intensity of assistance offered. The new plan should promote an improvement of the quality of care of residential facilities; however, more efforts should be addressed to the understanding of what are the factors related to a successful conclusion of residential treatments.

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Italian social psychiatry research: What gets published in peer reviewed journals?

Galeazzi

Priebe²

2007

Epidemiol Psichiatr Soc

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Aims -To explore the current state of Italian social psychiatry research as evidenced by original papers published in peer-reviewed journals 2004-2006. Methods -Electronic databases and hand searches of leading peer-reviewed journals were used to identify original research papers published in 2004-2006, addressing a social psychiatric issue, having at least one Italian author, and reporting data from Italian samples. Results -A total of 174 papers were identified. A substantial proportion reported findings of international collaborative research. Quantitative methods dominated, with 86 papers on cross-sectional surveys. Only 18 papers showed results of intervention trials with pre and post measures. Most common target group were psychiatric patients in community mental health services which featured in 93 papers. Conclusions -There is a critical mass of Italian social psychiatry research, dominated by a few research centres and with considerable amount of international collaboration. The findings of this survey might reflect the relative shortage of national funding for social psychiatry research. Declaration of Interest: None.

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An observational study of effectiveness in community residential facilities

Abstract: Outcome assessment is feasible in residential facilities, following a multiaxial and multifactorial model. We need to clarify the goals of residential care, focussing on active components of the residential treatment.

Cited by 5 publications

References 13 publications

Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes

Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes

Residential Care in Italy: Critical Issues and Future Perspectives

Italian social psychiatry research: What gets published in peer reviewed journals?

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