A non-randomised controlled trial of a community-based accommodation and psychosocial support programme for adults experiencing mental illness and homelessness.

IF 4 2区 医学 Q1 PSYCHIATRY Australian and New Zealand Journal of Psychiatry Pub Date : 2024-12-01 Epub Date: 2024-08-16 DOI:10.1177/00048674241270996
Melissa Savaglio, Ash Vincent, Nicholas Merklin, Helen Skouteris
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Abstract

Background: The transition out of inpatient mental health is a crucial time for adults experiencing concurrent mental illness and homelessness, yet evidence regarding effective support options is mixed. Choices is an intensive 3-month psychosocial outreach and crisis accommodation support programme for adults experiencing mental illness and homelessness, delivered by Baptcare in Tasmania, Australia. This study examined the effect of Choices on adults' psychosocial functioning, clinical symptomology and psychiatric readmissions in comparison to standard care only.

Method: Participants were adults aged 18-64 years experiencing mental illness and homelessness, recruited upon discharge from a psychiatric admission. Intervention participants (n = 124) received the Choices programme. Control participants (n = 122) received standard care, clinical assessment and treatment from hospital-based Mental Health Services. Outcomes were psychosocial functioning (primary), clinical symptomology, hospital readmission rate and readmission length of stay. Outcomes were assessed at programme commencement and closure (3 months) and 3 months post-closure (intervention group only). Analysis of covariance was used to analyse differences between groups at closure, while controlling for baseline differences.

Results: Intervention participants had significantly improved social functioning (encompassing living conditions, social relationships, self-esteem/confidence), overall psychosocial functioning, symptoms of depression and anxiety and shorter hospital readmission length of stay in comparison to the control group. Intervention participants experienced further improvements in social and overall psychosocial functioning 3 months post-closure.

Conclusion: The Choices programme is effective in enhancing the psychosocial functioning of adults experiencing concurrent mental illness and homelessness. These findings support the ongoing delivery of this combined accommodation and wrap-around psychosocial model of intensive support.

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一项针对患有精神疾病且无家可归的成年人的社区住宿和社会心理支持计划的非随机对照试验。
背景:对于同时患有精神疾病和无家可归的成年人来说,从精神疾病住院治疗过渡到出院是一个关键时期,然而有关有效支持方案的证据却不尽相同。选择"(Choices)是一项为期 3 个月的强化社会心理外展和危机住宿支持计划,由澳大利亚塔斯马尼亚州的浸信会护理中心(Baptcare)负责实施,主要针对患有精神疾病且无家可归的成年人。这项研究考察了 "选择 "项目对成年人社会心理功能、临床症状和精神病再入院率的影响,并与标准护理项目进行了比较:研究对象为 18-64 岁患有精神疾病且无家可归的成年人,他们都是在精神病院出院时被招募的。干预参与者(n = 124)接受了选择方案。对照组参与者(122 人)接受标准护理、临床评估以及医院精神卫生服务机构的治疗。结果包括社会心理功能(主要)、临床症状、再入院率和再入院住院时间。结果在计划开始和结束时(3 个月)以及结束后 3 个月(仅干预组)进行评估。在控制基线差异的情况下,采用协方差分析法对结束时各组之间的差异进行分析:结果:与对照组相比,干预参与者的社会功能(包括生活条件、社会关系、自尊/自信)、整体社会心理功能、抑郁和焦虑症状均有明显改善,再次入院的住院时间也有所缩短。干预参与者在结业后 3 个月的社交和整体社会心理功能得到了进一步改善:选择 "项目能有效提高同时患有精神疾病和无家可归的成年人的社会心理功能。这些研究结果支持继续实施这种住宿与社会心理服务相结合的强化支持模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.00
自引率
2.20%
发文量
149
审稿时长
6-12 weeks
期刊介绍: Australian & New Zealand Journal of Psychiatry is the official Journal of The Royal Australian and New Zealand College of Psychiatrists (RANZCP). The Australian & New Zealand Journal of Psychiatry is a monthly journal publishing original articles which describe research or report opinions of interest to psychiatrists. These contributions may be presented as original research, reviews, perspectives, commentaries and letters to the editor. The Australian & New Zealand Journal of Psychiatry is the leading psychiatry journal of the Asia-Pacific region.
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