Wohninterventionen für Menschen mit schweren psychischen Störungen – Internationale Evidenz aus RCTs

Abstract

Housing is important among psychosocial interventions for people with severe mental disorders. What do we know about the effectiveness of housing interventions? Systematic literature search for RCTs. Few RCTs, almost exclusively with homeless individuals were conducted. Housing stability is one of the most direct indicators of the effectiveness of housing interventions among homeless people. There are weaker or inhomogeneous findings in other outcome areas. There are no clear results yet regarding the effectiveness of different housing interventions compared with each other. The variability in routine interventions complicates their comparison. Future studies should address the housing needs of people who are at risk of getting homeless and of people living in inadequate housing. Methodological challenges are discussed.

Independent Housing and Support for non-homeless individuals with severe mental illness: randomised controlled trial vs. observational study – study protocol

“…Therefore, a historical justification of the non-inferiority margin δ and of an assay sensitivity as is usually recommended in noninferiority trials [72,73] was not applicable. Nevertheless, proposing a superiority hypothesis would not be appropriate for the present research because of the mixed results in comparative effectiveness research regarding residential rehabilitation in non-homeless people with SMI [16,[19][20][21][22]. Furthermore, the sample size calculation is based on the primary outcome measure, therefore, the present study has possibly not included enough participants to detect statistical significant differences in secondary outcomes tested on superiority of IHS.…”

“…Efficiency will be analysed based on the costs associated with the service utilization of the different housing settings. As the political goal is seen in allowing a freedom of choice in where to live and which support services to utilise [3] and because the differences in outcomes of previous studies between IHS and RCS for non-homeless populations were only small or inexistent [16,[19][20][21][22], we utilise a non-inferiority hypothesis in our study. We hypothesize that IHS yields no poorer social inclusion outcomes than traditional RCS/ TAU.…”

“…In contrast, evidence for residential rehabilitation approaches for non-homeless people is less clear [16,[19][20][21][22]. Unlike the supported housing models for the homeless, IHS for non-homeless people with SMI mainly focus on psychosocial outcome variables like reduction of rehospitalisation rates and improving social functioning [19].…”

Das Bundesteilhabegesetz als Chance für eine vernetzte gemeindepsychiatrische Versorgung

“…Bei der Kranken-und Rentenversicherung ist dies insbesondere die Anpassung von den Rehabilitationseinrichtungen für psychisch Kranke (RPK) auf ambulante Leistungen der medizinischen Rehabilitation gemäß § 43 SGB IX n. F. Hinsichtlich der beruflichen Rehabilitation ist vor allem die Leistung des Supported Employment entsprechend den evidenzbasierten Ansätzen zu erschließen [12,13]. Die Basis bleibt allerdings die selbstbestimmte Wohnform, in der die überwiegende Zahl der Menschen mit Behinderung leben will [14,15].…”

Evidenzbasierte Behandlung von schwer psychisch kranken Menschen mit psychosozialen Therapien – Erstes Update der DGPPN-S3-Leitlinie erscheint Ende 2018

“…Für Ansätze des unterstützten Wohnens liegen weit weniger Studien vor, dabei gehört das Wohnen aus Sicht der Nutzer zu den prioritären Themen [15]. In der Mehrheit wurden hier schwer psychisch kranke Menschen in Wohnungslosigkeit untersucht [16]. Wenngleich sich die Ergebnisse der internationalen Studien nicht unmittelbar auf die Verhältnisse hierzulande übertragen lassen (vgl.…”