Use of mental health services by formerly homeless adults residing in group and independent housing

Abstract

When homeless mentally ill adults are provided permanent housing and accessible mental health treatment and specialized social services, they are likely to avoid unstable housing patterns, which are associated with higher use of inpatient services.

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

“…Projects adhering to this model included, among others, HF [ 13 , 17 , 18 , 26 , 27 , 31 – 33 , 36 , 37 , 40 , 41 ], Pathways to Housing [ 34 , 44 ], At Home/Chez Soi [ 42 ], and projects using Section 8 housing certificates [ 39 ]. The principles of permanent supported housing are implemented in various forms; accommodation types include group homes [ 24 , 35 , 43 ], individual apartments [ 24 , 35 , 38 , 43 ], community residences (residences in buildings with single or shared rooms, or studio apartments, and common dining, meeting, and services space) [ 21 ]. The permanent supported housing projects also varied according to intensity and nature of support (including intensive case management, assertive community treatment and different levels of on-site staff support), level of integration between housing and mental health service providers, fidelity to the principle of separation between housing and treatment, and restrictions around sobriety [ 9 ].…”

“…The permanent supported housing projects also varied according to intensity and nature of support (including intensive case management, assertive community treatment and different levels of on-site staff support), level of integration between housing and mental health service providers, fidelity to the principle of separation between housing and treatment, and restrictions around sobriety [ 9 ]. Traditional housing available to homeless populations with SMI, such as homeless shelters [ 29 ], nursing homes [ 20 ], board and care homes [ 28 ] and residential care facilities [ 35 ] were used as comparison conditions in some studies.…”

“…In total, 19 studies of supported accommodation for homeless populations assessed housing stability as an outcome, comprising 7 high quality [ 8 , 18 , 19 , 21 – 23 , 44 ] and 12 moderate quality studies [ 9 , 25 , 26 , 30 – 35 , 37 , 39 , 42 ]. Supported accommodation appears to be effective in promoting housing retention for homeless adults with mental illness; high quality studies consistently reported high rates of housing retention, with 37 to 84% of participants still housed at follow-up (6 months to 5 years) [ 19 , 21 , 23 , 44 , 45 ].…”

What Works? Toward a New Classification System for Mental Health Supported Accommodation Services: The Simple Taxonomy for Supported Accommodation (STAX-SA)

“…Non-English language papers were excluded to ensure faithful application of the taxonomies. The final pool consisted of 132 service descriptions across 101 papers (quantitative: 95 service descriptions across 72 papers; qualitative: 37 service descriptions across 29 papers) [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,…”

“…This may be particularly pertinent to the supported accommodation sector where local pressures have resulted in unique service models. For example, one service model, the evolving consumer household [46], was unable to be categorized by the STAX-SA; this model provides permanent, shared, community housing to a group of service users, where staff, who are based on-site, gradually reduce their presence over time. It should be acknowledged, however, that examples such as these are relatively rare in the literature and, as described previously, the majority of service descriptions that could not be classified by the STAX-SA were due to insufficient information, as opposed to unique configurations across the four domains.…”