Independent Supported Housing for Non-homeless People With Serious Mental Illness: A Pragmatic Randomized Controlled Trial.

BACKGROUND: Independent 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. METHODS: A 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). RESULTS: After 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. CONCLUSIONS: ISH 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 REGISTRATION: ClinicalTrials.gov, identifier: NCT03815604, December 04, 2019.

[Needs and self-reported quality of life of people with severe mental illness in sheltered housing facilities]. / Bedürfnisse und Lebenszufriedenheit von Menschen mit schweren psychischen Erkrankungen und Betreuungsbedarf beim Wohnen.

OBJECTIVE: This paper investigates the subjective needs of psychiatric patients in relation to the housing conditions with an additional focus on inclusion and participation. Furthermore, it examines differences in clinical and socio-demographic parameters, self-measured quality of life, stage of recovery. METHODS: In this quantitative cross-sectional study, we compared 50 patients in a psychiatric acute ward setting, who were looking for a residence in a sheltered housing facility with 50 patients in a sheltered housing facility using structured interviews. RESULTS: Patients living in a sheltered housing facility reported less unmet needs. However, no differences regarding inclusion and participation were found. More unmet needs were associated with poorer quality of life, and less social inclusion in both groups. CONCLUSIONS: Patients in sheltered housing facilities report less unmet needs. Nevertheless, more efforts are needed to regarding inclusion of these patients. A "supported inclusion"-approach should be considered.