Resident and proprietor perspectives on a recovery orientation in community-based housing.

Abstract

Objective-Stable housing is a fundamental human right, and an important element for both mental health recovery and social inclusion among people with serious mental illness. This article reports findings from a study on the recovery orientation of structured congregate community housing services using the Recovery Self-Assessment Questionnaire (RSA) adapted for housing (O'Connell, Tondora, Croog, Evans, & Davidson, 2005).Methods-The RSA questionnaires were administered to 118 residents and housing providers from 112 congregate housing units located in Montreal, Canada.Results-Residents rated their homes as significantly less recovery-oriented than did proprietors, which is contrary to previous studies of clinical services or Assertive Community Treatment where RSA scores for service users were significantly higher than service provider scores. Findings for both groups suggest the need for improvement on 5 of 6 RSA factors. While proprietors favored recovery training and education, and valued resident opinion and experience, vestiges of a traditional medical model governing this housing emerged in other findings, as in agreement between the 2 groups that residents have little choice in case management, or in the belief among proprietors that residents are unable to manage their symptoms. Research on housing for people with SMI increasingly favors independent, supported, housing over traditional congregate models such as foster homes or group homes. While supported housing is considered a fundamental improvement in housing for this population (Nelson, 2010), no single, evidence-based model of housing has emerged to guide research and practice (Rog, 2004;Tabol, Drebing, & Rosenheck, 2010). Studies have revealed substantial differences in staffing, levels of support, and environmental characteristics among different housing types, as well as definitional confusion (Isaac, 2007;Priebe, Saidi, Want, Mangalore, & Knapp, 2009). One meta-analysis suggested the need to examine outcomes in terms of different population subgroups (Leff et al., 2009). Conclusions and Implications for Practice-ThisResearch on housing preferences consistently shows that people with SMI prefer independent housing with low restrictiveness and supports as needed (Fakhoury, Murray, Shepherd, & Priebe, 2002;Forchuk, Nelson, & Hall, 2006;. Living in one's preferred home predicts successful outcomes and is associated with perceived choice and control over the environment (Boydell, 2006;Nelson, Sylvestre, Aubry, George, & Trainor, 2007). By contrast, service providers tend to endorse structured settings such as group homes for their clients (Corrigan, Mueser, Bond, Drake, & Solomon, 2008;Tsai, Bond, Salyers, Godfrey, & Davis, 2010). Residents in congregate housing may also prefer that model for the security it provides, particularly when age and physical health concerns are taken into account (White, 2013;.Other research has identified key elements in recovery-oriented housing, beginning with the assumption that residents are full citizens wi...

The level of formal support received by people with severe mental illness living in supported accommodation and participation: A systematic review

“…There is no indication in the included studies if participation in daily living, social participation and personal empowerment were assessed prior to people living in SA to inform decisions about which type of SA an individual moved to. Previous studies have shown that healthcare professionals can overestimate the level of support people with SMI require, which often differs from what the individual identifies as needing (Afilalo et al, 2015;Lasalvia et al, 2012;Piat et al, 2015). There is limited reporting on how an individual's level of participation is considered when selecting SA, resulting in people with differing participation needs residing in the same types of SA.…”

A home but how to connect with others? A qualitative meta‐synthesis of experiences of people with mental illness living in supported housing

“…The majority of such studies focus on people who are homeless or at risk of becoming homeless, rather than those with persistent mental illness not identified as previously homeless (Kyle & Dunn, 2008). Other less consistent findings include decreased hospitalisation and improved quality of life, community functioning and satisfaction with housing (Killaspy et al, 2016;Kyle & Dunn, 2008;Leff et al, 2009;Townley & Kloos, 2011;Tsai et al, 2012).…”

Recovery-oriented Medical Training: An Informational Rapid Literature Review for the University of Recovery as a New Concept of Co-learning between Patients and (Future) Healthcare Providers

“…Training for staff is also addressed [43], including for psychiatric nurses [44] or staff in housing facilities [45]. Some are thus about changing already practicing professionals' attitudes or that of patients [46,47], while others target specific categories of patients like veterans [48,49] or youth [50].…”