Housing First and Severe Mental Disorders: The Challenge of Exiting Homelessness

2021 ◽  
Vol 693 (1) ◽  
pp. 178-192
Author(s):  
James Lachaud ◽  
Cilia Mejia-Lancheros ◽  
Rosane Nisenbaum ◽  
Vicky Stergiopoulos ◽  
Patricia O’Campo ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Psychotic Disorders ◽  
Controlled Trial ◽  
Housing First ◽  
Severe Mental Disorders ◽  
Treatment As Usual ◽  
Personalized Care ◽  
Housing Subsidies ◽  
Psychotic Features

We examine the long-term housing trajectories of 543 program participants at the Toronto site of the At Home/Chez-Soi project, a randomized controlled trial of a Housing First (HF) intervention for adults with mental disorders. The average follow-up period for our study was 5.5 years. We find that the HF approach, which includes housing subsidies and support services, was strongly associated with rapid transitions to sustained housing (70.4 percent of HF participants vs. 27.9 percent of treatment as usual participants). Mood disorders with psychotic features and primary psychotic disorders were negatively associated with the rapid and sustained housing trajectory, and alcohol use disorders were positively associated with a rapid then declining housing trajectory. We argue that to understand the long-term impacts of housing programs, research needs to better explore comprehensive and personalized care to support individuals with severe mental disorders.

scholarly journals Evaluation of the Housing First program in patients with severe mental disorders in France: study protocol for a randomized controlled trial

Trials ◽  
2013 ◽  
Vol 14 (1) ◽  
pp. 309 ◽  
Author(s):  
Aurelie Tinland ◽  
Cecile Fortanier ◽  
Vincent Girard ◽  
Christian Laval ◽  
Benjamin Videau ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Mental Disorders ◽  
Study Protocol ◽  
Controlled Trial ◽  
Housing First ◽  
Severe Mental Disorders ◽  
Randomized Controlled

scholarly journals Housing First Reduces Re-offending among Formerly Homeless Adults with Mental Disorders: Results of a Randomized Controlled Trial

PLoS ONE ◽  
2013 ◽  
Vol 8 (9) ◽  
pp. e72946 ◽  
Author(s):  
Julian M. Somers ◽  
Stefanie N. Rezansoff ◽  
Akm Moniruzzaman ◽  
Anita Palepu ◽  
Michelle Patterson
Keyword(s):  
Randomized Controlled Trial ◽  
Mental Disorders ◽  
Controlled Trial ◽  
Housing First ◽  
Homeless Adults ◽  
Randomized Controlled ◽  
Formerly Homeless

Long-term mental health care for people with severe mental disorders – the importance of workplace rehabilitation

2013 ◽  
Vol 10 (02) ◽  
pp. 87-94
Author(s):  
J. Boardman
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Health Problems ◽  
Personal Recovery ◽  
Severe Mental Disorders ◽  
Individual Placement And Support ◽  
Meaningful Activity ◽  
Workplace Rehabilitation

SummaryWork and meaningful activity have historically played a key role in rehabilitation services for people with severe mental health problems and continues to do so today. People with long-term and severe mental disorders have low rates of employment. In the last 30 years the increasing emphasis on raising the sights of mental health services to focus on personal recovery and the importance given to social justice and to combating social exclusion has led to a focus on gaining open employment. Individual Placement and Support (IPS) has emerged as an important and evidence-based scheme for getting people with severe mental health problems into open employment. Despite the strong and consistent evidence for the effectiveness of IPS, these schemes are not widely implemented. This paper summarises the background to, and research on, IPS and possible barriers to its wider implementation.

scholarly journals Intractable schizo-affective disorder successfully treated with electroconvulsive treatment over six years

2012 ◽  
Vol 4 (2) ◽  
pp. 102-104 ◽  
Author(s):  
John E. Berg
Keyword(s):  
Mental Disorders ◽  
Affective Disorder ◽  
Electroconvulsive Therapy ◽  
Severe Mental Disorders ◽  
Electroconvulsive Treatment ◽  
Hospital Beds

Some patients with severe mental disorders are refractory to psychotherapeutic or psychopharmacological interventions. We describe a patient with severe symptoms from the age of 16 to 44. Her illness is best described as a schizo-affective disorder. Several series of electroconvulsive therapy (ECT) followed by maintenance once a week for more than six years has kept her out of hospital beds for three years. The patient demonstrates the feasibility of long term ECT and the absence of disturbing cognitive reductions.

scholarly journals Gender-informed psycho-educational programme to promote respectful relationships and reduce postpartum common mental disorders among primiparous women: long-term follow-up of participants in a community-based cluster randomised controlled trial

2018 ◽  
Vol 5 ◽  
Author(s):  
Jane Fisher ◽  
Thach Tran ◽  
Karen Wynter ◽  
Harriet Hiscock ◽  
Jordana Bayer ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Common Mental Disorders ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Print Materials ◽  
Randomised Controlled ◽  
Primiparous Women ◽  
Trained Nurse

BackgroundWhat Were We Thinking (WWWT) is a gender-informed, psychoeducational programme to promote respectful relationships and skilled management of unsettled infant behaviours and thereby reduce postpartum common mental disorders. It comprises a highly structured seminar for couples and babies, usual primary care from a WWWT-trained nurse and take-home print materials. The aim was to assess long-term outcomes after a cluster randomised controlled trial of WWWT.MethodTrial participants who consented completed a computer-assisted telephone interview 18 months postpartum. Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9) and anxiety symptoms with the Generalised Anxiety Disorder Scale (GAD-7). Impacts of baseline characteristics and trial arm on changes in scores from baseline to follow-up were calculated using Conditional Latent Growth Curve Models adjusting for prognostic indicators and controlling for clustering effects.ResultsOverall, 314/400 (78.5%) women contributed data at baseline (6 weeks postpartum), trial endline (26 weeks postpartum) and follow-up (12 months after trial endline). In intention-to-treat analyses, there was a significantly greater improvement in adjusted GAD-7 scores [regression coefficient (RC) −0.55; 95% confidence interval (CI) −0.94 to −0.17] and non-significant improvement (RC −0.27; 95% CI −0.63 to 0.08) in PHQ-9 scores from baseline to follow-up in the intervention than the control arm. In a per-protocol analysis, the proportion with GAD-7 scores ⩽4 (asymptomatic) improved 24.1% (55.7% baseline to 79.8% follow-up,p= 0.043) among women who received the full WWWT programme, which included the seminar, compared with 2.4% (77.1–79.5%,p= 0.706) among those who received the partial intervention (usual care from WWWT-trained nurse and print materials).ConclusionsThe WWWT programme has a significant sustained beneficial impact on postnatal generalised anxiety among primiparous women compared with usual care. The in-person seminar is the most influential component of the intervention. Psycho-educational programmes integrated into primary care appear promising as a strategy to reduce postpartum common mental disorders.

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