Supported housing in the community for persons with severe mental illness. Psychosocial environment, needs, quality of life and social network

Abstract: This study investigated psychosocial environment, needs, quality of life and social network for persons with severe mental illness in supported housing in the community. Eighty-three persons with severe mental illness living in three different types of housing setting accepted to participate in the interviews, which took place between December 1997 and April 2000. These settings were: inpatient settings (psychiatric rehabilitation units), small congregate residences and independent living with support from social services personnel. A majority of the subjects had a diagnosis of schizophrenia, were unmarried and unemployed. In the interviews the residents emphasized the importance of social interaction, Autonomy, Support and personal security as major constituents of the psychosocial environment of small congregate community residences. In a comparison of the psychosocial environment between psychiatric inpatient settings and congregate community residences both the residents and staff of the latter setting rated higher levels of Autonomy and lower levels of Practical Orientation, Anger and Aggression, and Order and Organization than their counterparts in from the former setting. In the study of quality of life greater satisfaction in four life domains, living situation, social relations, leisure activities and work as well as two global measures of quality of life was registered by individuals living in the two community settings as compared to those in inpatient settings. No differences in social network were found between those in inpatient settings and those in community settings. A greater number of total and met needs for care was associated with living in community settings in comparison to inpatient settings. This association was still valid after controlling for the influence of factors known to affect the level of needs, duration of illness and psychopathology. A greater proportion of the residents in supported community settings reported a need in the areas of psychotic symptoms, accommodation, food, daytime activities, asexual expression, and looking after the home than their counterparts in inpatient settings. No differences were found for quality of life, social network, and needs for care between the two community settings, congregate residences and independent living with support.