Skip to main content
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 8/2013

01.08.2013 | Original Paper

Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia

verfasst von: Michelle Patterson, Akm Moniruzzaman, Anita Palepu, Denise Zabkiewicz, Charles J. Frankish, Michael Krausz, Julian M. Somers

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 8/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study used an experimental design to examine longitudinal changes in subjective quality of life (QoL) among homeless adults with mental illness after assignment to different types of supported housing or to treatment as usual (TAU, no housing or supports through the study). We hypothesized that subjective QoL would improve over time among participants assigned to supported housing as compared to TAU, regardless of the type of supported housing received or participants’ level of need.

Methods

Participants (n = 497) were stratified by level of need (“high” or “moderate”) and randomly assigned to Housing First (HF) in scattered-site apartments, HF in a congregate setting (high needs only), or TAU. Linear mixed-effects regression was used to model the association between study arm and self-reported QoL at baseline and at 6 and 12 months post-baseline by need level.

Results

Based on the adjusted overall score on the QoL measure, participants randomized to HF reported significantly greater overall QoL as compared to TAU, regardless of need level or type of supported housing at both 6 and 12 months post-baseline. Scores on the safety and living situation subscales were significantly greater for both high and moderate need participants assigned to supported housing regardless of type at both 6 and 12 months post-baseline as compared to TAU.

Conclusions

Despite multiple health and social challenges faced by homeless individuals with mental illness, HF in both scattered-site and congregate models results in significantly greater perceived QoL as compared to individuals who do not receive HF even after a relatively short period of time.
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
Support services were available to participants assigned to Housing First (ACT, CONG, and ICM) but were not mandatory. The only requirement for housing was compliance with the terms of the rental lease and weekly visits with a case manager to ensure safety and well-being [28].
 
2
The CONG residence was located in downtown Vancouver in a neighborhood consisting of primarily businesses, including an inner-city hospital and a number of affluent condominiums.
 
Literatur
1.
Zurück zum Zitat Sussman S (1998) The first asylums in Canada: a response to neglectful community care and current trends. Can J Psychiatr 43:260–264 Sussman S (1998) The first asylums in Canada: a response to neglectful community care and current trends. Can J Psychiatr 43:260–264
2.
Zurück zum Zitat Lamb H, Bachrach L (2001) Some perspectives on deinstitutionalization. Psychiatr Serv 52:1039–1045PubMedCrossRef Lamb H, Bachrach L (2001) Some perspectives on deinstitutionalization. Psychiatr Serv 52:1039–1045PubMedCrossRef
3.
Zurück zum Zitat Fulginiti D, Kriegel A, Brekke J (2012) Deinstitutionalization? Where have all the people gone? Curr Psychiatry Rep 14(3):259–269PubMedCrossRef Fulginiti D, Kriegel A, Brekke J (2012) Deinstitutionalization? Where have all the people gone? Curr Psychiatry Rep 14(3):259–269PubMedCrossRef
4.
Zurück zum Zitat Forchuk C, Russell G, Kingston-MacClure S et al (2006) From psychiatric ward to streets and shelters. J Psychiatr Ment Health Nurs 13:301–308PubMedCrossRef Forchuk C, Russell G, Kingston-MacClure S et al (2006) From psychiatric ward to streets and shelters. J Psychiatr Ment Health Nurs 13:301–308PubMedCrossRef
5.
Zurück zum Zitat Frankish C, Hwang S, Quantz D (2005) Homelessness and health in Canada: research lessons and priorities. Can J Pub Health 96:S23–S29 Frankish C, Hwang S, Quantz D (2005) Homelessness and health in Canada: research lessons and priorities. Can J Pub Health 96:S23–S29
6.
Zurück zum Zitat Schutt RK (2011) Homelessnes, housing, and mental illness. Harvard University Press, Cambridge Schutt RK (2011) Homelessnes, housing, and mental illness. Harvard University Press, Cambridge
7.
Zurück zum Zitat Gilmer T, Stefancic A, Ettner S, Manning W, Tsemberis S (2010) Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness. Arch Gen Psychiatry 67:645–652PubMedCrossRef Gilmer T, Stefancic A, Ettner S, Manning W, Tsemberis S (2010) Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness. Arch Gen Psychiatry 67:645–652PubMedCrossRef
8.
Zurück zum Zitat Ludwig J, Duncan G, Gennetian L, Katz L, Kessler R, Kling J, Sanbonmatsu L (2012) Neighbourhood effects on the long-term well-being of low-income adults. Science 337:1505–1510PubMedCrossRef Ludwig J, Duncan G, Gennetian L, Katz L, Kessler R, Kling J, Sanbonmatsu L (2012) Neighbourhood effects on the long-term well-being of low-income adults. Science 337:1505–1510PubMedCrossRef
9.
Zurück zum Zitat Tsemberis S, Eisenberg R (2000) Pathways to housing: supported housing for street dwelling homeless individuals with psychiatric disabilities. Psychiatr Serv 51:487–493PubMedCrossRef Tsemberis S, Eisenberg R (2000) Pathways to housing: supported housing for street dwelling homeless individuals with psychiatric disabilities. Psychiatr Serv 51:487–493PubMedCrossRef
10.
Zurück zum Zitat Gulcur L, Stefancic A, Shinn M et al (2003) Housing, hospitalization, and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes. J Comm Appl Soc Psychiatry 13:171–186CrossRef Gulcur L, Stefancic A, Shinn M et al (2003) Housing, hospitalization, and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes. J Comm Appl Soc Psychiatry 13:171–186CrossRef
11.
Zurück zum Zitat Yanos P, Felton B, Tsemberis S, Frye V (2007) Exploring the role of housing type, neighbourhood characteristics, and lifestyle factors in the community integration of formerly homeless persons diagnosed with mental illness. J Ment Health 16:703–717CrossRef Yanos P, Felton B, Tsemberis S, Frye V (2007) Exploring the role of housing type, neighbourhood characteristics, and lifestyle factors in the community integration of formerly homeless persons diagnosed with mental illness. J Ment Health 16:703–717CrossRef
12.
Zurück zum Zitat Field D (2011) Emotional refuge? Dynamics of place and belonging among formerly homeless individuals with mental illness. Emot Space Soc 4:258–267CrossRef Field D (2011) Emotional refuge? Dynamics of place and belonging among formerly homeless individuals with mental illness. Emot Space Soc 4:258–267CrossRef
13.
Zurück zum Zitat Siegel C, Samuels J, Tang D, Berg I, Jones K, Hoper K (2006) Tenant outcomes in supported housing and community residence in New York City. Psychiatr Serv 57(7):982–991PubMedCrossRef Siegel C, Samuels J, Tang D, Berg I, Jones K, Hoper K (2006) Tenant outcomes in supported housing and community residence in New York City. Psychiatr Serv 57(7):982–991PubMedCrossRef
14.
Zurück zum Zitat Hubley A, Russel L, Palepu A, Hwang S (2012) Subjective quality of life among individuals who are homeless: a review of current knowledge. Soc Indic Res doi:10.1007/s11205-012-9998-7 Hubley A, Russel L, Palepu A, Hwang S (2012) Subjective quality of life among individuals who are homeless: a review of current knowledge. Soc Indic Res doi:10.​1007/​s11205-012-9998-7
15.
Zurück zum Zitat Williams J (2000) Ready, set, stop: reflections on assessing quality of life and the WHOQOL-100 (US version). J Clin Epidemiol 53(1):13–17PubMedCrossRef Williams J (2000) Ready, set, stop: reflections on assessing quality of life and the WHOQOL-100 (US version). J Clin Epidemiol 53(1):13–17PubMedCrossRef
16.
Zurück zum Zitat Lehman A (1988) A quality of life interview for the chronically mentally ill. Eval Progr Plan 11:51–62CrossRef Lehman A (1988) A quality of life interview for the chronically mentally ill. Eval Progr Plan 11:51–62CrossRef
17.
Zurück zum Zitat Lehman A, Postrado L, Rachuba L (1993) Convergent validity of quality of life assessments for persons with mental illnesses. Qual Life Res 2:327–333PubMedCrossRef Lehman A, Postrado L, Rachuba L (1993) Convergent validity of quality of life assessments for persons with mental illnesses. Qual Life Res 2:327–333PubMedCrossRef
18.
Zurück zum Zitat Uttaro T, Lehman A (1999) Graded response modeling of the quality of life interview. Eval Progr Plan 22(1):41–52CrossRef Uttaro T, Lehman A (1999) Graded response modeling of the quality of life interview. Eval Progr Plan 22(1):41–52CrossRef
19.
Zurück zum Zitat Lehman A, Ward N, Linn L (1982) Chronic mental patients: the quality of life issue. Am J Psychiatry 139:1271–1276PubMed Lehman A, Ward N, Linn L (1982) Chronic mental patients: the quality of life issue. Am J Psychiatry 139:1271–1276PubMed
20.
Zurück zum Zitat Lehman A, Slaughter J, Myers C (1991) Quality of life in alternative residential settings. Psychiatr Q 62:35–49PubMedCrossRef Lehman A, Slaughter J, Myers C (1991) Quality of life in alternative residential settings. Psychiatr Q 62:35–49PubMedCrossRef
21.
Zurück zum Zitat Brunt D, Hansson L (2004) The quality of life of persons with severe mental illness across housing settings. Nord J Psychiatry 58:293–298PubMedCrossRef Brunt D, Hansson L (2004) The quality of life of persons with severe mental illness across housing settings. Nord J Psychiatry 58:293–298PubMedCrossRef
22.
Zurück zum Zitat Oliver JP, Mohamad H (1992) The quality of life of the chronically mentally ill: a comparison of public, private and voluntary residential provisions. Br J Soc Work 22:39–404 Oliver JP, Mohamad H (1992) The quality of life of the chronically mentally ill: a comparison of public, private and voluntary residential provisions. Br J Soc Work 22:39–404
23.
Zurück zum Zitat Schutt R, Goldfinger S, Penk W (1997) Satisfaction with residence and with life: when homeless mentally ill person are housed. Eval Progr Plan 20:185–194CrossRef Schutt R, Goldfinger S, Penk W (1997) Satisfaction with residence and with life: when homeless mentally ill person are housed. Eval Progr Plan 20:185–194CrossRef
24.
Zurück zum Zitat Goering PN, Streiner DL, Adair C, Aubry T, Barker J, Distasio J et al (2011) The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities. BMJ Open 1(2):e000323PubMedCrossRef Goering PN, Streiner DL, Adair C, Aubry T, Barker J, Distasio J et al (2011) The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities. BMJ Open 1(2):e000323PubMedCrossRef
25.
Zurück zum Zitat Zabkiewicz D, Patterson M, Frankish CJ, Somers J (2012) The Vancouver At Home Study: overview and methods of a Housing First trial among individuals who are homeless and living with mental illness. J Clin Trials. doi:10.4172/2167-0870.1000123 Zabkiewicz D, Patterson M, Frankish CJ, Somers J (2012) The Vancouver At Home Study: overview and methods of a Housing First trial among individuals who are homeless and living with mental illness. J Clin Trials. doi:10.​4172/​2167-0870.​1000123
26.
Zurück zum Zitat Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E et al (1998) The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59(Suppl 20):22–33PubMed Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E et al (1998) The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59(Suppl 20):22–33PubMed
27.
Zurück zum Zitat Barker S, Barron N, McFarland B et al (1994) Multnomah community ability scale. Network Behavioral Health and Multnomah County, Oregon Barker S, Barron N, McFarland B et al (1994) Multnomah community ability scale. Network Behavioral Health and Multnomah County, Oregon
28.
Zurück zum Zitat Stefancic A, Tsemberis S (2007) Housing First for long-term shelter dwellers with psychiatric disabilities in a suburban county: a 4-year study of housing access and retention. J Prim Prev 28:265–279PubMedCrossRef Stefancic A, Tsemberis S (2007) Housing First for long-term shelter dwellers with psychiatric disabilities in a suburban county: a 4-year study of housing access and retention. J Prim Prev 28:265–279PubMedCrossRef
30.
Zurück zum Zitat van Buuren S (2007) Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res 16(3):219–24230PubMedCrossRef van Buuren S (2007) Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res 16(3):219–24230PubMedCrossRef
31.
Zurück zum Zitat Norman G, Sloan J, Wyrwich K (2003) Interpretation of changes in health-related quality of life. Med Care 41(5):582–592PubMed Norman G, Sloan J, Wyrwich K (2003) Interpretation of changes in health-related quality of life. Med Care 41(5):582–592PubMed
32.
Zurück zum Zitat Revicki D, Cella D, Hays R et al (2006) Responsiveness and minimal important differences for patient reported outcomes. Health Qual Life Outcomes 4:70PubMedCrossRef Revicki D, Cella D, Hays R et al (2006) Responsiveness and minimal important differences for patient reported outcomes. Health Qual Life Outcomes 4:70PubMedCrossRef
33.
Zurück zum Zitat Cohen J (1988) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Erlbaum, Hillsdale Cohen J (1988) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Erlbaum, Hillsdale
34.
Zurück zum Zitat StataCorp (2011) Stata statistical software: release 12. StataCorp LP, College Station StataCorp (2011) Stata statistical software: release 12. StataCorp LP, College Station
35.
36.
Zurück zum Zitat Susser E, Valencia E, Conover S, Felix A, Tsai W, Wyatt R (1997) Preventing recurrent homelessness among mentally ill men: a “critical time” intervention after discharge from a shelter. Am J Pub Health 87(2):256–262CrossRef Susser E, Valencia E, Conover S, Felix A, Tsai W, Wyatt R (1997) Preventing recurrent homelessness among mentally ill men: a “critical time” intervention after discharge from a shelter. Am J Pub Health 87(2):256–262CrossRef
37.
Zurück zum Zitat LaGory M, Fitzpatrick K, Ritchey F (2001) Life chances and choices: assessing quality of life among the homeless. Soc Q 42(4):633–651CrossRef LaGory M, Fitzpatrick K, Ritchey F (2001) Life chances and choices: assessing quality of life among the homeless. Soc Q 42(4):633–651CrossRef
38.
Zurück zum Zitat Michalos AC (1985) Multiple Discrepancies Theory (MDT). Soc Indic Res 16:347–413CrossRef Michalos AC (1985) Multiple Discrepancies Theory (MDT). Soc Indic Res 16:347–413CrossRef
Metadaten
Titel
Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia
verfasst von
Michelle Patterson
Akm Moniruzzaman
Anita Palepu
Denise Zabkiewicz
Charles J. Frankish
Michael Krausz
Julian M. Somers
Publikationsdatum
01.08.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 8/2013
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-013-0719-6

Weitere Artikel der Ausgabe 8/2013

Social Psychiatry and Psychiatric Epidemiology 8/2013 Zur Ausgabe

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Typ-2-Diabetes und Depression folgen oft aufeinander

14.05.2024 Typ-2-Diabetes Nachrichten

Menschen mit Typ-2-Diabetes sind überdurchschnittlich gefährdet, in den nächsten Jahren auch noch eine Depression zu entwickeln – und umgekehrt. Besonders ausgeprägt ist die Wechselbeziehung laut GKV-Daten bei jüngeren Erwachsenen.

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.