Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization

Rudoler, David; Oliveira, Claire de; Jacob, Binu; Hopkins, Melonie; Kurdyak, Paul

doi:10.1177/0706743717752881

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…Enfacing the number of persons in need of supported housing, economic considerations [26], and most of all the users' preferences [27], our main results implicate important considerations regarding mental health care policy and access to housing services for persons with a severe mental illness. As there appeared overall positive psychosocial and clinical outcomes regardless of the supported housing type, one can conclude that supported accommodation per se appears to be an effective rehabilitative care approach (compare to [1]).…”

Section: Discussionmentioning

confidence: 83%

“…All in all, the present findings seem to support the expansion of supported housing programs and ensuring the availability of affordable housing for people with mental health problems. This would not only be a reasonable future perspective under financial aspects [26,29,30], but also by taking the users' needs and wishes even more into account: a recent review and meta-analysis on the choice of housing in people with mental disorders revealed that 84% of the persons with severe mental illness preferred to live under more independent housing settings [27]. The importance of user preferences should not be underestimated, because studies have shown the positive effects of choice on psychosocial outcomes in mental health supported housing [31,32].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of supported housing versus residential care in severe mental illness: a multicenter, quasi-experimental study

Dehn

Beblo

Richter

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose Up to now there are only few studies and no RCT comparing efficacy or effectiveness of supported housing (SH) versus residential care (RC) in severe mental illness (SMI) without homelessness. Here we present an observational follow-up study in SMI subjects, who entered SH or RC, to compare clinical and functional outcomes 2 years later. Methods In this prospective study in more than 30 locations throughout a German federal state, we included SMI subjects, who entered SH (n = 153) or RC (n = 104). About one quarter suffered from each substance use, psychotic, affective, or other disorders. To avoid sampling bias, we used the propensity score matching method to establish a quasi-experimental design. Outcome measures were social functioning (SFS), the number of psychiatric hospitalisations, psychopathology (SCL-9-K), and quality of life (MANSA). Apart from descriptive methods we analysed primarily using repeated-measures ANOVAS. Results Our analyses revealed significant effects of time for all outcomes in both study groups. However, there were not any group differences of outcome measures, i.e., not any significant effects of group or interactional effects of group x time. Moreover, these results hold true for intent-to-treat and per-protocol sample analyses. Conclusion The results show, that SH and RC for non-homeless people with SMI achieve the same clinical and psychosocial outcomes across a 2-year period. Taking into account the users’ preferences, the present findings should give reason to ensure the availability of affordable housing and to support the expansion of supported housing approaches.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Effectiveness of supported housing versus residential care in severe mental illness: a multicenter, quasi-experimental study

Dehn

Beblo

Richter

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

View full text Add to dashboard Cite

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Housing for vulnerable populations—identifying system cost implications: an analytic literature review

Kongats

Paulden

Pabayo

et al. 2023

Health Promotion International

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We explored how investments in housing for vulnerable populations (including those experiencing homelessness) are described as leading to cost containment for the health, justice, and social service systems; the nature of any costs and benefits; and variations by housing type and over time. A structured search of peer-reviewed academic research focused on the core concepts of economic benefit, public housing programs, and vulnerable populations. Findings from 42 articles reporting on cost containment specific to health, justice, and social service systems at the municipal, regional, and/or state/provincial level were synthesized. Most of the studies focused on supportive housing interventions, targeted adults (mainly men) experiencing chronic homelessness in the USA, and reported results over 1–5 years. Approximately half of the articles reported on the costs required to house vulnerable populations. About half reported on funding sources, which is critical information for leadership decisions in cost containment for supportive housing. Most of the studies assessing program cost or cost-effectiveness reported a reduction in service costs and/or greater cost-effectiveness. Studies mostly reported impacts on health services, with hospital/inpatient care and emergency service use typically decreasing across the intervention types. All the studies that assessed cost impacts on the justice system reported a decrease in expenditures. Housing vulnerable populations was also found to decrease shelter service use and engagement with the foster care/welfare systems. Housing interventions may offer cost-savings in the short- and medium-term, with a limited evidence base also demonstrating long term benefit.

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Characteristics of patients with mental illness and persistent high-cost status: a population-based analysis

Oliveira¹,

Mason²,

Kurdyak³

2020

CMAJ

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Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization

Abstract: This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.

Cited by 5 publications

References 19 publications

Effectiveness of supported housing versus residential care in severe mental illness: a multicenter, quasi-experimental study

Effectiveness of supported housing versus residential care in severe mental illness: a multicenter, quasi-experimental study

Housing for vulnerable populations—identifying system cost implications: an analytic literature review

Characteristics of patients with mental illness and persistent high-cost status: a population-based analysis

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