Housing Choice and Control, Housing Quality, and Control over Professional Support as Contributors to the Subjective Quality of Life and Community Adaptation of People with Severe Mental Illness

  • Geoffrey Nelson
  • John Sylvestre
  • Tim Aubry
  • Lindsey George
  • John Trainor
ORIGINAL PAPER

Abstract

This research examined two premises of supported housing: (a) that consumer choice/control over housing and support and the quality of housing are important contributors to the subjective quality of life and adaptation to community living of people with mental illness, and (b) that apartments provide mental health consumers with more choice/control over housing and support than group living arrangements. To test these two hypotheses, we collected data from participants with mental illness housed through a government initiative in Ontario, Canada. A total of 130 participants completed a baseline interview, and 91 of those participants also completed a follow-up interview 9-months later. Support was found for both hypotheses. The results were discussed in terms of the paradigm of supported housing, previous research, and implications for housing policy and program development in the community mental health sector.

Keywords

Supported housing Choice Control Quality of life 

References

  1. Aubry, T., Flynn, R., Gerber, G., & Dostaler, T. (2005). Identifying the core competencies of case managers working in community mental health programs. Psychiatric Rehabilitation Journal, 28, 346–353.PubMedCrossRefGoogle Scholar
  2. Barker, S., Barron, N., McFarland, B.H., & Bigelow, D. (1994). A community ability scale for chronically mentally ill clients. Part I: Reliability and validity. Community Mental Health Journal, 30, 363–384.PubMedCrossRefGoogle Scholar
  3. Carling, P. J. (1995). Return to community: Building support systems for people with psychiatric disabilities. New York:Guilford Press.Google Scholar
  4. Evans, G. W., Wells, N. M., Chan, H.-Y. E., & Saltzman, H. (2000). Housing quality and mental health. Journal of Consulting and Clinical Psychology, 68, 526–530.CrossRefGoogle Scholar
  5. Evans, G. W., Wells, N. M., & Moch, A. (2003). Housing and mental health: A review of the evidence and a methodological and conceptual critique. Journal of Social Issues, 59, 475–500.CrossRefGoogle Scholar
  6. Greenwood, R. M., Schaefer-McDonald, N. J., Winkel, G., & Tsemberis, S. (2005). Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. American Journal of Community Psychology, 36, 223–238.CrossRefGoogle Scholar
  7. Lehman, A. F., Kernan, E., & Postrado, L. (1997). Toolkit: Evaluating quality of life for persons with severe mental illness. Prepared for the Evaluation Center at HSRI.Google Scholar
  8. Lipton, F. R., Siegel, C., Hannigan, A., Samuels, J., & Baker, S. (2000). Tenure in supportive housing for homeless persons with severe mental illness. Psychiatric Services, 51, 479–486.PubMedCrossRefGoogle Scholar
  9. Lord, J., Ochocka, J., Czarny, W., & MacGillivary, H. (1998). Analysis of change within a mental health organization: A participatory process. Psychiatric Rehabilitation Journal, 21, 327– 339.Google Scholar
  10. Nelson, G., Hall, G. B., & Forchuk, C. (2003). Current and preferred housing of psychiatric consumer/survivors. Canadian Journal of Community Mental Health, 22(1), 5–19.PubMedGoogle Scholar
  11. Nelson, G., Hall, G. B., & Walsh-Bowers, R. (1998). The relationship between housing characteristics, emotional well-being, and the personal empowerment of psychiatric consumer/survivors. Community Mental Health Journal, 34, 57–69.PubMedCrossRefGoogle Scholar
  12. Nelson, G., Hall, G. B., & Walsh-Bowers, R. (1999). Predictors of the adaptation of people with psychiatric disabilities residing in group homes, supportive apartments, and board-and-care homes. Psychiatric Rehabilitation Journal, 22, 381–389.Google Scholar
  13. Nelson, G., Lord, J., & Ochocka, J. (2001). Empowerment and mental health in community: Narratives of psychiatric consumer/survivors. Journal of Community and Applied Social Psychology, 11, 125–142.CrossRefGoogle Scholar
  14. Nelson, G., Wiltshire, C., Hall, G. B., Peirson, L., & Walsh-Bowers, R. (1995). Psychiatric consumer/survivors’ quality of life: Quantitative and qualitative perspectives. Journal of Community Psychology, 23, 216–233.CrossRefGoogle Scholar
  15. Newman, S. J. (2001). Housing attributes and serious mental illness: Implications for research and practice. Psychiatric Services, 52, 1309–1317.PubMedCrossRefGoogle Scholar
  16. Parkinson, S., Nelson, G., & Horgan, S. (1999). From housing to homes: A review of the literature on housing approaches for psychiatric consumer/survivors. Canadian Journal of Community Mental Health, 18, 145–164.PubMedGoogle Scholar
  17. Priebe, S., & Gruyters, T. (1993). The role of the helping alliance in psychiatric community care. The Journal of Nervous and Mental Disease, 181(9), 552–557.PubMedCrossRefGoogle Scholar
  18. Pyke, S., & Lowe, J. (1996). Supporting people, not structures: Changes in the provision of housing support. Psychiatric Rehabilitation Journal, 19, 6–12.Google Scholar
  19. Rosenheck, R., Kasprow, W., Frisman, L., & Liu-Mares, W. (2003). Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry, 60, 940–951.PubMedCrossRefGoogle Scholar
  20. Srebnik, D., Livingston, J., Gordon, L., & King, D. (1995). Housing choice and community success for individuals with serious and persistent mental illness. Community Mental Health Journal, 31, 139–152.PubMedCrossRefGoogle Scholar
  21. Sylvestre, J., Nelson, G., Durbin, J., George, L., Aubry, T., & Ollenberg, M. (2005). Housing for people with serious mental illness: Challenges for system-level development. Manuscript submitted for publication.Google Scholar
  22. Tanzman, B. H. (1993). Researching the preferences for housing and supports: An overview of consumer preference surveys. Hospital and Community Psychiatry, 44, 450–455.PubMedGoogle Scholar
  23. Toro, P. A., Rabideau, J. M., Bellavia, C. W., Daeschler, C. V., Wall, D. D., & Smith, S. J. (1997). Evaluating an intervention for homeless persons: Results of a field experiment. Journal of Consulting and Clinical Psychology, 65, 476–484.PubMedCrossRefGoogle Scholar
  24. Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94, 651–656.PubMedCrossRefGoogle Scholar
  25. Tsemberis, S., Rogers, E. S., Rodis, E., Dushuttle, P., & Shryka, V. (2003). Housing satisfaction for persons with psychiatric disabilities. Journal of Community Psychology, 31, 581–590.CrossRefGoogle Scholar
  26. Yanos, P. T., Barrow, S. M., & Tsemberis, S. (2004). Community integration in the early phase of housing among homeless persons diagnosed with severe mental illness: Successes and challenges. Community Mental Health Journal, 40, 133–150.PubMedCrossRefGoogle Scholar
  27. Zimmerman, M. A. (1995). Psychological empowerment: Issues and illustrations. American Journal of Community Psychology, 23, 581–599.PubMedCrossRefGoogle Scholar
  28. Zimmerman, M. A. (2000). Empowerment theory: Psychological, organizational, and community levels of analysis. In J. Rappaport & E. Seidman (Eds.), Handbook of community psychology (pp. 43–63). New York: Kluwer Academic/Plenum.Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Geoffrey Nelson
    • 1
  • John Sylvestre
    • 2
  • Tim Aubry
    • 2
  • Lindsey George
    • 3
  • John Trainor
    • 4
  1. 1.Department of PsychologyWilfrid Laurier UniversityWaterlooCanada
  2. 2.University of OttawaOttawaCanada
  3. 3.St. Joseph’s HospitalHamiltonCanada
  4. 4.Centre for Addiction and Mental HealthTorontoCanada

Personalised recommendations