Supported accommodation for people with schizophrenia

Nord J Psychiatry. 2019 May-Jul;73(4-5):211-218. doi: 10.1080/08039488.2019.1606938. Epub 2019 May 9.

Abstract

Background: As a result of deinstitutionalization of psychiatric treatment and care, many people with severe mental illness have been offered supported accommodation. However, research on this costly intervention in Norway has been scarce. Aims: The aim of this study was to prospectively investigate the clinical and demographic factors associated with allocation to supported accommodation for people with schizophrenia. Methods: The study was a prospective cohort study of 334 people with schizophrenia acutely admitted to Haukeland University Hospital between 2005 and 2010. Information concerning allocation to supported accommodation in their residential municipalities was collected retrospectively. Univariate and multivariate statistical methods were used to assess the association of clinical and demographical variables with allocation to supported accommodation. Results: Supported accommodation was allocated to 29.6% of the participants during the study period. Age, gender, implementation of compulsory mental health care, substance abuse, symptom burden and suicidality were not associated with allocation to supported accommodation. Functional impairment, especially difficulties with activities of daily living, experiencing exacerbation in the course of chronic disease, being medicated and of Norwegian origin, favoured supported accommodation. Conclusions: Our results supported the hypothesis that people with severe mental illness presenting the greatest need for supported accommodation, based on functional difficulties and exacerbation of chronic disease were allocated supported accommodation. Symptom burden was not associated with allocation. Clinical implications: Further research is needed to examine the impact of supported accommodation on the outcomes for people with schizophrenia.

Keywords: Schizophrenia; allocation; compulsory mental healthcare; disability; supported accommodation.

MeSH terms

  • Activities of Daily Living / psychology*
  • Adult
  • Cohort Studies
  • Deinstitutionalization / methods
  • Female
  • Housing
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Prospective Studies
  • Retrospective Studies
  • Schizophrenia / epidemiology
  • Schizophrenia / therapy*
  • Schizophrenic Psychology*
  • Social Support*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy