Helen Killaspy1, Stefan Priebe2, Peter McPherson3, Zohra Zenasni4, Lauren Greenberg4, Paul McCrone5, Sarah Dowling6, Isobel Harrison3, Joanna Krotofil3, Christian Dalton-Locke7, Rose McGranahan8, Maurice Arbuthnott9, Sarah Curtis10, Gerard Leavey11, Geoff Shepherd12, Sandra Eldridge13, Michael King14. 1. Professor of Rehabilitation Psychiatry, Division of Psychiatry, University College London, UK. 2. Professor of Social and Community Psychiatry, Unit for Social and Community Psychiatry, Queen Mary University of London, Newham Centre for Mental Health, UK. 3. Research Associate, Division of Psychiatry, University College London, UK. 4. Statistician, Pragmatic Clinical Trials Unit, Queen Mary University London, Blizard Institute, Barts and The London School of Medicine and Dentistry, UK. 5. Professor of Health Economics, King's Health Economics, King's College London, UK. 6. Project Manager, Division of Psychiatry, University College London, UK. 7. Research Assistant, Division of Psychiatry, University College London, UK. 8. Research Assistant, Unit for Social and Community Psychiatry, Queen Mary University of London, Newham Centre for Mental Health, UK. 9. Service User Representative, North London Service-User Research Forum, Division of Psychiatry, University College London, UK. 10. Professor Emerita, Department of Geography, Durham University, UK. 11. Director, Bamford Centre for Mental Health and Wellbeing, University of Ulster, Northern Ireland. 12. Senior Policy Adviser, Centre for Mental Health, UK. 13. Professor of Biostatistics, Pragmatic Clinical Trials Unit, Queen Mary University London, Blizard Institute, Barts and The London School of Medicine and Dentistry, UK. 14. Professorial Research Associate, Division of Psychiatry, University College London, UK.
Abstract
BACKGROUND: Around 60 000 people in England live in mental health supported accommodation. There are three main types: residential care, supported housing and floating outreach. Supported housing and floating outreach aim to support service users in moving on to more independent accommodation within 2 years, but there has been little research investigating their effectiveness. AIMS: A 30-month prospective cohort study investigating outcomes for users of mental health supported accommodation. METHOD: We used random sampling, accounting for relevant geographical variation factors, to recruit 87 services (22 residential care, 35 supported housing and 30 floating outreach) and 619 service users (residential care 159, supported housing 251, floating outreach 209) across England. We contacted services every 3 months to investigate the proportion of service users who successfully moved on to more independent accommodation. Multilevel modelling was used to estimate how much of the outcome and cost variations were due to service type and quality, after accounting for service-user characteristics. RESULTS: Overall 243/586 participants successfully moved on (residential care 15/146, supported housing 96/244, floating outreach 132/196). This was most likely for floating outreach service users (versus residential care: odds ratio 7.96, 95% CI 2.92-21.69, P < 0.001; versus supported housing: odds ratio 2.74, 95% CI 1.01-7.41, P < 0.001) and was associated with reduced costs of care and two aspects of service quality: promotion of human rights and recovery-based practice. CONCLUSIONS: Most people do not move on from supported accommodation within the expected time frame. Greater focus on human rights and recovery-based practice may increase service effectiveness.
BACKGROUND: Around 60 000 people in England live in mental health supported accommodation. There are three main types: residential care, supported housing and floating outreach. Supported housing and floating outreach aim to support service users in moving on to more independent accommodation within 2 years, but there has been little research investigating their effectiveness. AIMS: A 30-month prospective cohort study investigating outcomes for users of mental health supported accommodation. METHOD: We used random sampling, accounting for relevant geographical variation factors, to recruit 87 services (22 residential care, 35 supported housing and 30 floating outreach) and 619 service users (residential care 159, supported housing 251, floating outreach 209) across England. We contacted services every 3 months to investigate the proportion of service users who successfully moved on to more independent accommodation. Multilevel modelling was used to estimate how much of the outcome and cost variations were due to service type and quality, after accounting for service-user characteristics. RESULTS: Overall 243/586 participants successfully moved on (residential care 15/146, supported housing 96/244, floating outreach 132/196). This was most likely for floating outreach service users (versus residential care: odds ratio 7.96, 95% CI 2.92-21.69, P < 0.001; versus supported housing: odds ratio 2.74, 95% CI 1.01-7.41, P < 0.001) and was associated with reduced costs of care and two aspects of service quality: promotion of human rights and recovery-based practice. CONCLUSIONS: Most people do not move on from supported accommodation within the expected time frame. Greater focus on human rights and recovery-based practice may increase service effectiveness.
Authors: Helen Killaspy; Carol Harvey; Catherine Brasier; Lisa Brophy; Priscilla Ennals; Justine Fletcher; Bridget Hamilton Journal: World Psychiatry Date: 2022-02 Impact factor: 49.548
Authors: Justine Fletcher; Lisa Brophy; Helen Killaspy; Priscilla Ennals; Bridget Hamilton; Laura Collister; Teresa Hall; Carol Harvey Journal: Front Psychiatry Date: 2019-10-24 Impact factor: 4.157
Authors: Priscilla Paola Severo; Leonardo B Furstenau; Michele Kremer Sott; Danielli Cossul; Mariluza Sott Bender; Nicola Luigi Bragazzi Journal: Int J Environ Res Public Health Date: 2021-02-22 Impact factor: 3.390
Authors: Nerea Almeda; Carlos Ramón García-Alonso; Helen Killaspy; Mencía R Gutiérrez-Colosía; Luis Salvador-Carulla Journal: PLoS One Date: 2022-03-17 Impact factor: 3.240
Authors: Rudolf Slamanig; Andreas Reisegger; Hildegard Winkler; Giovanni de Girolamo; Giuseppe Carrà; Cristina Crocamo; Heiner Fangerau; Inga Markiewicz; Janusz Heitzman; Hans Joachim Salize; Marco Picchioni; Johannes Wancata Journal: Front Psychiatry Date: 2021-05-10 Impact factor: 4.157
Authors: Christian Dalton-Locke; Johan H Thygesen; Nomi Werbeloff; David Osborn; Helen Killaspy Journal: PLoS One Date: 2020-08-20 Impact factor: 3.240