Housing Satisfaction of Psychiatric Patients in Different Forms of Housing-A Cross-Sectional Study in Berlin, Germany.

Stefan Gutwinski,Meryam Schouler-Ocak,James K Moran,Ella Westerbarkey,Stefanie Schreiter

doi:10.3389/fpsyt.2021.652565

Abstract

The growing social problem of homelessness and precarious housing situations has negative effects on psychological outcomes and quality of life (QoL) for mentally ill people. Despite a large body of research on QoL among homeless mentally ill people, research on housing satisfaction as a specific QoL domain and important outcome variable for treatment interventions is scarce. The purpose of this cross-sectional study is to investigate housing satisfaction among psychiatric patients in various housing situations. Out of 1,251 patients that were treated in the targeted facilities during the admission period, 540 agreed to participate (43.2%). 123 participants were excluded from the analysis due to missing data, resulting in a sample of N = 417. Housing satisfaction data was assessed in a subjective screening and differences in satisfaction levels between housing status groups were analyzed. As hypothesized, more normative housing situations reported higher housing satisfaction. Homeless participants and those living in socio-therapeutic facilities were associated with more psychological and physical distress resulting from their housing situation than domiciled and flat-sharing participants. Problems of reducing homelessness and improving housing support are highlighted, as well as opportunities for improving support, particularly in therapeutic facilities.

Highlights

The deinstitutionalization and reformation of the psychiatric system in Germany in the 1970s aimed at improving the living conditions of people with mental illness by creating residential care facilities [1, 2]
A potential unintended consequence of this is that the deinstitutionalization of mental health care is nowadays associated with a growing number of people with mental illness living in precarious living conditions, as its association with a greater social, cultural, political and work-related exclusion is discussed [2, 4]
Several studies reported that higher Quality of life (QoL) in persons with mental illness is more generally associated with normative housing conditions

Summary

Introduction

The deinstitutionalization and reformation of the psychiatric system in Germany in the 1970s aimed at improving the living conditions of people with mental illness by creating residential care facilities [1, 2]. An increasing number of psychiatric patients live in community settings and housing facilities, and a great body of research has been conducted to evaluate those settings and conditions [1, 3]. Several studies reported that higher QoL in persons with mental illness is more generally associated with normative housing conditions. This encompasses community-based residences and family homes that foster independence, stability and commonness, as opposed to state hospitals [12,13,14]. Focusing mainly on clients in therapeutic psychiatric facilities, studies found that clients in assisted living accommodation reported lower levels of life satisfaction than the general population [15]. Increasing QoL was found to be interrelated to type of housing: whereas low QoL could be linked to large institutional settings, higher measures were associated with a “normalization” of the housing situation in sheltered accommodation [13]

Methods

Results

Conclusion