Maslow and Mental Health Recovery: A Comparative Study of Homeless Programs for Adults with Serious Mental Illness

Abstract

This mixed-methods study uses Maslow’s hierarchy as a theoretical lens to investigate the experiences of 63 newly enrolled clients of housing first and traditional programs for adults with serious mental illness who have experienced homelessness. Quantitative findings suggests that identifying self-actualization goals is associated with not having one’s basic needs met rather than from the fulfillment of basic needs. Qualitative findings suggest a more complex relationship between basic needs, goal setting, and the meaning of self-actualization. Transforming mental health care into a recovery-oriented system will require further consideration of person-centered care planning as well as the impact of limited resources especially for those living in poverty.

Service user experiences of specialist mental health supported accommodation: A systematic review of qualitative studies and narrative synthesis

“…The expected length of stay and emphasis on “move‐on” within a service had significant impact on individuals’ recovery (Browne et al., ; Bryant, Craik, & Mckay, ; Chesters et al., ; Chopra & Herrman, ; Dorvil, Morin, Beaulieu, & Robert, ; Goering, Sylph, Foster, Boyles, & Babiak, ; Henwood, Derejko, Couture, & Padgett, ; Kirkpatrick & Byrne, ; Kowlessar & Corbett, ; Newton, Rosen, Tennant, & Hobbs, ; Piat, Ricard, Sabetti, & Beauvais, ; Rønning & Bjørkly, ). In permanent housing, “move‐on” was experienced as gaining independence, accessing resources, learning new skills and achieving goals (Kirkpatrick & Byrne, ), whereas in time‐limited accommodation, “move‐on” also meant the physical process of moving to more independent accommodation and was associated with disruption and upheaval (Browne et al., ; Henwood et al., ; Piat et al., ), stress (Goering et al., ), uncertainty (Chopra & Herrman, ) and the experience of loss (Newton et al., ). Frequent moves between settings sometimes led to a loss of connection with the local community and staff and compromised continuity of care (Chopra & Herrman, ).…”

“…Restrictiveness of the environment was strongly dependent on the intensity of staff support and service ethos, with recovery orientated services being generally less restrictive. Restrictions could manifest in rigid practices such as curfews, set meal times, bed times, locking the fridge or other communal facilities, strict visiting rules or not providing service users with keys or free access to come and go through the front door (Forchuk, Nelson, et al., ; Goering et al., ; Henwood et al., ; Nelson, Hall, & Walsh‐Bowers, ). Unsurprisingly, service users preferred less restrictive settings (Carpenter‐Song et al., ).…”

“…Loneliness was exacerbated by lack of family support (Chopra & Herrman, ; Forchuk, Nelson, et al., ; Forchuk, Ward‐Griffin, et al., ; Koch & Kralik, ). However, being in supported accommodation sometimes created an opportunity to re‐establish family relationships (Henwood et al., ; Kirst et al., ; Nelson et al., ). A stable housing environment provided a safe space for family interactions and alleviated the shame associated with homelessness (Kirkpatrick & Byrne, ; Nelson et al., ).…”

In their own words: Content analysis of pathways to recovery among individuals with the lived experience of homelessness and alcohol use disorders

“…Ultimately, fulfilling basic needs can facilitate recovery, whereas recovery is very difficult to achieve when people’s basic needs are not consistently met. (Henwood, Derejko, Couture, & Padgett, 2015) Further, participants were frustrated by the institutionalization of abstinence-based modalities and their resulting feelings of disempowerment. This sense of disempowerment paired with participants’ repeated treatment ‘failures’ precipitate an internalized sense of shame around drinking and homelessness that may erode self-efficacy for future recovery attempts.…”

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,…”