Abstract
BackgroundIndependent supported housing (ISH)—services to support independent housing are recommended by current guidelines. However, there is little evidence of ISH models for non-homeless people with severe mental illness (SMI). The aim of this study was to examine the effectiveness of ISH by comparing the clinical outcomes of a newly implemented ISH service with regular housing and support services.MethodsA total of 58 adults with a broad spectrum of mental disorders experiencing housing problems were randomly assigned to either the intervention group (IG) with the possibility to use the ISH service in Zurich providing targeted, individual and flexible support for housing problems or to the control group (CG) with regular housing and support services currently available (trial registration at ClinicalTrials.gov: NCT03815604).ResultsAfter 12 months, almost all participants of the IG were able to live independently and need for inpatient treatment could be significantly reduced. Service utilization varied between 2 and 79 h. In the CG, 70% of the participants wanted to join a waiting list for the ISH service. The results indicated that IHS was comparable to regular housing and support services in terms of social inclusion and other social and clinical outcomes such as quality of life, capabilities, needs, mental state and functioning (p's > 0.05). The costs of service utilization were on average 115 Swiss Francs (about 124 USD) per participant per month.ConclusionsISH is an effective service in housing rehabilitation in terms of social and clinical outcomes and costs. ISH is strongly preferred by service users. In line with the UN Convention on the Rights of Persons with Disabilities, access to ISH services for non-homeless people with SMI should be improved.Clinical Trial RegistrationClinicalTrials.gov, identifier: NCT03815604, December 04, 2019.
Highlights
Adequate and stable housing conditions are well-known key components for successful psychiatric rehabilitation [1] and have become an important target in mental healthcare
The results indicated that IHS was comparable to regular housing and support services in terms of social inclusion and other social and clinical outcomes such as quality of life, capabilities, needs, mental state and functioning (p’s > 0.05)
independent supported housing (ISH) is an effective service in housing rehabilitation in terms of social and clinical outcomes and costs
Summary
Adequate and stable housing conditions are well-known key components for successful psychiatric rehabilitation [1] and have become an important target in mental healthcare. There are three main types of support: residential care homes that provide intensive and longer-term support; supportive housing/sheltered housing with time-limited support; and independent supported housing (ISH) or floating outreach providing flexible and individual support in a permanent tenancy rented by the service users [3]. Based on the UN Convention on the Rights of Persons with Disabilities [8], service users should have the possibility to choose the type of accommodation and support In this sense, ISH aims to place individuals directly into an independent accommodation of the users’ choice, accompanied by flexible support provided by off-site professionals for an unlimited period of time [2]. The aim of this study was to examine the effectiveness of ISH by comparing the clinical outcomes of a newly implemented ISH service with regular housing and support services
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