Housing services for people with mental disorders in England: patient characteristics, care provision and costs.
ABSTRACT Since de-institutionalisation, housing services have taken a central role in the care of patients with severe mental illness. Yet, little is known about the characteristics of patients in different housing services, what care they receive, and what costs are generated. This study aimed to assess patient characteristics, care provision and costs in different types of housing services in England.
In 12 representative local areas in England, 250 housing services were randomly selected. Information on services, characteristics of randomly selected patients and care received were obtained from managers.
Data from 153 services (61% response rate) and 414 patients were analysed. Most patients receive support with activities of daily living and are involved in some sort of occupational activities. 52% have a care co-ordinator in a community mental health team. Care provision and costs differed significantly between care homes, supported housing services and floating support services.
Quality standards may have to be defined and applied to ensure that all patients in housing services receive appropriate care. More input of mental health services may be required for the rehabilitation and recovery of patients.
- SourceAvailable from: Tzipi Hornik-Lurie
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- "Whether the efforts to maintain these patients in the community are successful or not is crucially related to the nature and availability of accommodation (Moxham & Pegg 2000; Yamada & Korman 2000). Various types of accommodation have been developed, which reflect a continuum of support and staffing levels, from a relatively low level, such as supported group homes, to a high level of support and staff, such as 24-hour staffed facilities (hostels) (Fakhoury et al. 2002; Lamb 1998; Montgomery & Kirkpatrick 2002; Montgomery et al. 2008; O'Malley & Croucher 2005; Priebe et al. 2009; Santone et al. 2005). Similarly, graded stepwise vocational services were developed in the community for the mentally disabled (Cook & Razzano 2000) to enable them to acquire vocational skills and later the ability to work in protective workshops until they are eventually able to get paid employment in the open market (bond 2004; Watzke et al. 2009). "
ABSTRACT: In 2001 the Rehabilitation of the Mentally Disabled in the Community Law was implemented in Israel, defining a basket of rehabilitation services to which the mentally disabled are entitled. The objectives of the present study were to examine the effect of being placed in a rehabilitation program after discharge from a psychiatric hospitalization on the probability of rehospitalization and on the length of the following hospitalization if it occurred. Anonymized data were extracted from two registers of the Ministry of Health: the Rehabilitation Register and the Israeli Psychiatric Case Register, whose data were merged. The study population consisted of all the discharges from a psychiatric hospital during 2001-8. There were three study groups (those admitted to hostels, supportive housing, and vocational rehabilitation) and two control groups (those referred to rehabilitation and did not implement the referral and a matched control group of potential candidates for rehabilitation). Kaplan-Meyer survival and Cox analysis were performed on the data. The results showed that the probability to stay in the community after discharge was higher in all the study groups compared to those who were referred but did not reach the rehabilitation system and to the matched control group of potential candidates. Moreover, if the patients were rehospitalized, the probability of a short duration of the next inpatient episode was higher among all the study groups compared to the control groups. The results emphasize the beneficial effect on the pattern of psychiatric hospitalization of the legislation regarding national rehabilitation services for the mentally disabled.International Journal of Mental Health 10/2012; 2012 Vol 41( 3)45-59(3). DOI:10.2753/IMH0020-7411410303
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- "–, Data are not available in the reported studies a Data derived from Priebe et al. (2009), except for variables marked with b data derived from Slade et al. (2005) c From Priebe et al. (2009) "
ABSTRACT: Research into community housing programs for people with severe mental illness is underexposed. The Dutch UTOPIA study describes characteristics of their service users, which may predict their allocation to either supported housing or supported independent living programs. Additionally, a comparison is made with English studies. 119 Care coordinators of Dutch residential care institutes and 534 service users participated in a cross-sectional survey which includes socio-demographic data, clinical data, measures of functioning, needs for care and quality of life. Differences between Dutch residents and independent living service users were small, making predictions of care allocation difficult. This similarity suggests a possible lack of methodical assessment in the allocation procedure of people who are eligible for residential housing or independent living programs. This is largely comparable to the English situation. In comparison with their English counterparts, Dutch service users have more met needs and are more engaged in occupational activities.Community Mental Health Journal 06/2011; 48(3):321-7. DOI:10.1007/s10597-011-9381-1 · 1.03 Impact Factor
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ABSTRACT: The relative prevalence of common mental health problems among different ethnic groups in Britain is one of the least researched topics in health variations research. We calculate and compare income-related inequalities in common mental disorders among ethnic groups in Britain. Data from a nationally representative survey of ethnic minorities (the EMPIRIC survey) were used to calculate concentration index values to indicate the extent of income-related inequalities within and across ethnic groups. Looking at income-related inequalities in common mental disorders within each of the ethnic groups, it was found that the burden of these disorders were greater for the lower income groups among the Irish, White and African Caribbean communities. Within-group inequality was less clearly defined for each of the three Asian communities: Indian, Bangladeshi and Pakistani. However, when the data were pooled and individuals were assigned income ranks in the pooled set (not within their own ethnic group), the relative position of those in lower income groups among the different groups was striking. The poor among the Bangladeshi, Pakistani and the African Caribbean groups clearly suffered both from low income and a greater burden of mental health morbidity than the other three groups. The effect of lower income is thus worse for the mental health of populations if they are African Caribbean, Pakistani or Bangladeshi than if they are White, Irish or Indian. Inequality in mental health morbidity between and within ethnic groups is at least partly linked to income, and thus to employment and education. Tackling disadvantage and discrimination in these areas could help to tackle the challenge of mental ill-health.Social Psychiatry 02/2011; 47(3):351-9. DOI:10.1007/s00127-011-0345-0 · 2.58 Impact Factor