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Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes

BACKGROUND: Post-deinstitutionalisation, mental health supported accommodation services have been implemented widely. The available research evidence is heterogeneous in nature and resistant to synthesis attempts, leaving researchers and policy makers with no clear summary what works and for whom. I...

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Autores principales: McPherson, Peter, Krotofil, Joanna, Killaspy, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952646/
https://www.ncbi.nlm.nih.gov/pubmed/29764420
http://dx.doi.org/10.1186/s12888-018-1725-8
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author McPherson, Peter
Krotofil, Joanna
Killaspy, Helen
author_facet McPherson, Peter
Krotofil, Joanna
Killaspy, Helen
author_sort McPherson, Peter
collection PubMed
description BACKGROUND: Post-deinstitutionalisation, mental health supported accommodation services have been implemented widely. The available research evidence is heterogeneous in nature and resistant to synthesis attempts, leaving researchers and policy makers with no clear summary what works and for whom. In this context, we undertook a comprehensive systematic review of quantitative studies in order to synthesise the current evidence on mental health and psychosocial outcomes for individuals residing in mental health supported accommodation services. METHODS: Using a combination of electronic database searches, hand searches, forward-backward snowballing and article recommendations from an expert panel, 115 papers were identified for review. Data extraction and quality assessments were conducted, and 33 articles were excluded due to low quality, leaving 82 papers in the final review. Variation in terminology and service characteristics made the comparison of service models unfeasible. As such, findings were presented according to the following sub-groups: ‘Homeless’, ‘Deinstitutionalisation’ and ‘General Severe Mental Illness (SMI)’. RESULTS: Results were mixed, reflecting the heterogeneity of the supported accommodation literature, in terms of research quality, experimental design, population, service types and outcomes assessed. There is some evidence that supported accommodation is effective across a range of psychosocial outcomes. The most robust evidence supports the effectiveness of the permanent supported accommodation model for homeless SMI in generating improvements in housing retention and stability, and appropriate use of clinical services over time, and for other forms of supported accommodation for deinstitutionalised populations in reducing hospitalisation rates and improving appropriate service use. The evidence base for general SMI populations is less developed, and requires further research. CONCLUSIONS: A lack of high-quality experimental studies, definitional inconsistency and poor reporting continue to stymie our ability to identify effective supported accommodation models and practices. The authors recommend improved reporting standards and the prioritisation of experimental studies that compare outcomes across different service models. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12888-018-1725-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-59526462018-05-21 Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes McPherson, Peter Krotofil, Joanna Killaspy, Helen BMC Psychiatry Research Article BACKGROUND: Post-deinstitutionalisation, mental health supported accommodation services have been implemented widely. The available research evidence is heterogeneous in nature and resistant to synthesis attempts, leaving researchers and policy makers with no clear summary what works and for whom. In this context, we undertook a comprehensive systematic review of quantitative studies in order to synthesise the current evidence on mental health and psychosocial outcomes for individuals residing in mental health supported accommodation services. METHODS: Using a combination of electronic database searches, hand searches, forward-backward snowballing and article recommendations from an expert panel, 115 papers were identified for review. Data extraction and quality assessments were conducted, and 33 articles were excluded due to low quality, leaving 82 papers in the final review. Variation in terminology and service characteristics made the comparison of service models unfeasible. As such, findings were presented according to the following sub-groups: ‘Homeless’, ‘Deinstitutionalisation’ and ‘General Severe Mental Illness (SMI)’. RESULTS: Results were mixed, reflecting the heterogeneity of the supported accommodation literature, in terms of research quality, experimental design, population, service types and outcomes assessed. There is some evidence that supported accommodation is effective across a range of psychosocial outcomes. The most robust evidence supports the effectiveness of the permanent supported accommodation model for homeless SMI in generating improvements in housing retention and stability, and appropriate use of clinical services over time, and for other forms of supported accommodation for deinstitutionalised populations in reducing hospitalisation rates and improving appropriate service use. The evidence base for general SMI populations is less developed, and requires further research. CONCLUSIONS: A lack of high-quality experimental studies, definitional inconsistency and poor reporting continue to stymie our ability to identify effective supported accommodation models and practices. The authors recommend improved reporting standards and the prioritisation of experimental studies that compare outcomes across different service models. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12888-018-1725-8) contains supplementary material, which is available to authorized users. BioMed Central 2018-05-15 /pmc/articles/PMC5952646/ /pubmed/29764420 http://dx.doi.org/10.1186/s12888-018-1725-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
McPherson, Peter
Krotofil, Joanna
Killaspy, Helen
Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes
title Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes
title_full Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes
title_fullStr Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes
title_full_unstemmed Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes
title_short Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes
title_sort mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952646/
https://www.ncbi.nlm.nih.gov/pubmed/29764420
http://dx.doi.org/10.1186/s12888-018-1725-8
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