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Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review

Permanent supportive housing is an effective intervention for stably housing most people experiencing homelessness and mental illness who have complex support needs. However, high-risk behaviours and challenges are prevalent among this population and have the potential to seriously harm health and t...

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Autores principales: Kerman, Nick, Kidd, Sean A., Mutschler, Christina, Sylvestre, John, Henwood, Benjamin F., Oudshoorn, Abe, Marshall, Carrie Anne, Aubry, Tim, Stergiopoulos, Vicky
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542260/
https://www.ncbi.nlm.nih.gov/pubmed/37775776
http://dx.doi.org/10.1186/s12954-023-00873-z
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author Kerman, Nick
Kidd, Sean A.
Mutschler, Christina
Sylvestre, John
Henwood, Benjamin F.
Oudshoorn, Abe
Marshall, Carrie Anne
Aubry, Tim
Stergiopoulos, Vicky
author_facet Kerman, Nick
Kidd, Sean A.
Mutschler, Christina
Sylvestre, John
Henwood, Benjamin F.
Oudshoorn, Abe
Marshall, Carrie Anne
Aubry, Tim
Stergiopoulos, Vicky
author_sort Kerman, Nick
collection PubMed
description Permanent supportive housing is an effective intervention for stably housing most people experiencing homelessness and mental illness who have complex support needs. However, high-risk behaviours and challenges are prevalent among this population and have the potential to seriously harm health and threaten housing tenures. Yet, the research on the relationship between high-risk issues and housing stability in permanent supportive housing has not been previously synthesized. This rapid review aimed to identify the housing-related outcomes of high-risk behaviours and challenges in permanent supportive housing settings, as well as the approaches used by agencies and residents to address them. A range of high-risk behaviours and challenges were examined, including risks to self (overdose, suicide/suicide attempts, non-suicidal self-injury, falls/fall-related injuries), and risks to multiple parties and/or building (fire-setting/arson, hoarding, apartment takeovers, physical/sexual violence, property damage, drug selling, sex trafficking). The search strategy included four components to identify relevant academic and grey literature: (1) searches of MEDLINE, APA PsycINFO, and CINAHL Plus; (2) hand searches of three journals with aims specific to housing and homelessness; (3) website browsing/searching of seven homelessness, supportive housing, and mental health agencies and networks; and (4) Advanced Google searches. A total of 32 articles were eligible and included in the review. Six studies examined the impacts of high-risk behaviours and challenges on housing tenancies, with overdose being identified as a notable cause of death. Twenty-six studies examined approaches and barriers to managing high-risk behaviours and challenges in PSH programs. These were categorized into eight types of approaches: (1) clinical, (2) relational/educational, (3) surveillant, (4) restrictive, (5) strategic, (6) design-based, (7) legal, and (8) self-defence. Consistent across all approaches was a lack of rigorous examination of their effectiveness. Further, some approaches that are legal, restrictive, surveillant, or strategic in nature may be used to promote safety, but may conflict with other program objectives, including housing stability, or resident empowerment and choice. Research priorities were identified to address the key evidence gaps and move toward best practices for preventing and managing high-risk behaviours and challenges in permanent supportive housing.
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spelling pubmed-105422602023-10-03 Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review Kerman, Nick Kidd, Sean A. Mutschler, Christina Sylvestre, John Henwood, Benjamin F. Oudshoorn, Abe Marshall, Carrie Anne Aubry, Tim Stergiopoulos, Vicky Harm Reduct J Review Permanent supportive housing is an effective intervention for stably housing most people experiencing homelessness and mental illness who have complex support needs. However, high-risk behaviours and challenges are prevalent among this population and have the potential to seriously harm health and threaten housing tenures. Yet, the research on the relationship between high-risk issues and housing stability in permanent supportive housing has not been previously synthesized. This rapid review aimed to identify the housing-related outcomes of high-risk behaviours and challenges in permanent supportive housing settings, as well as the approaches used by agencies and residents to address them. A range of high-risk behaviours and challenges were examined, including risks to self (overdose, suicide/suicide attempts, non-suicidal self-injury, falls/fall-related injuries), and risks to multiple parties and/or building (fire-setting/arson, hoarding, apartment takeovers, physical/sexual violence, property damage, drug selling, sex trafficking). The search strategy included four components to identify relevant academic and grey literature: (1) searches of MEDLINE, APA PsycINFO, and CINAHL Plus; (2) hand searches of three journals with aims specific to housing and homelessness; (3) website browsing/searching of seven homelessness, supportive housing, and mental health agencies and networks; and (4) Advanced Google searches. A total of 32 articles were eligible and included in the review. Six studies examined the impacts of high-risk behaviours and challenges on housing tenancies, with overdose being identified as a notable cause of death. Twenty-six studies examined approaches and barriers to managing high-risk behaviours and challenges in PSH programs. These were categorized into eight types of approaches: (1) clinical, (2) relational/educational, (3) surveillant, (4) restrictive, (5) strategic, (6) design-based, (7) legal, and (8) self-defence. Consistent across all approaches was a lack of rigorous examination of their effectiveness. Further, some approaches that are legal, restrictive, surveillant, or strategic in nature may be used to promote safety, but may conflict with other program objectives, including housing stability, or resident empowerment and choice. Research priorities were identified to address the key evidence gaps and move toward best practices for preventing and managing high-risk behaviours and challenges in permanent supportive housing. BioMed Central 2023-09-29 /pmc/articles/PMC10542260/ /pubmed/37775776 http://dx.doi.org/10.1186/s12954-023-00873-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Kerman, Nick
Kidd, Sean A.
Mutschler, Christina
Sylvestre, John
Henwood, Benjamin F.
Oudshoorn, Abe
Marshall, Carrie Anne
Aubry, Tim
Stergiopoulos, Vicky
Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review
title Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review
title_full Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review
title_fullStr Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review
title_full_unstemmed Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review
title_short Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review
title_sort managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542260/
https://www.ncbi.nlm.nih.gov/pubmed/37775776
http://dx.doi.org/10.1186/s12954-023-00873-z
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