Search results for ‘Subject term:"mental health problems"’ Sort:
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Community integration of adults with psychiatric disabilities and histories of homelessness
- Authors:
- GULCUR Leyla, et al
- Journal article citation:
- Community Mental Health Journal, 43(3), June 2007, pp.211-228.
- Publisher:
- Springer
This study tests components of Wong and Solomon’s (2002, Mental Health Services Research, 4(2), 13–28) model of community integration, identifying both the dimensions and predictors of integration. It evaluates community integration among adults with psychiatric disabilities assigned randomly to receive either independent scatter-site apartments with the Housing First approach (experimental) or services as usual (control). Factor analysis supported a definition of community integration that includes psychological, physical, and social domains, but also suggested the existence of another factor, independence/self-actualization. Regression analysis suggested that choice and independent scatter-site housing were predictors of psychological and social integration respectively. Psychiatric hospitalization, symptomatology and participation in substance use treatment were also found to influence aspects of integration. The authors discuss several issues that future studies should explore including the possibility that the same factor can differentially influence discrete aspects of integration, the role of person-environment fit, integration that is not based in the neighbourhood, and, finally, conceptions of community integration from the perspective of consumers themselves.
A theory of mental health and optimal service delivery for homeless children
- Author:
- MARCAL Katherine E.
- Journal article citation:
- Child and Adolescent Social Work Journal, 34(4), 2017, pp.349-359.
- Publisher:
- Springer
Homeless children are a vulnerable group with high risk for developing mental health disorders. The environments of homeless children are uniquely chaotic, marked by frequent moves, family structure changes, household and neighbourhood disorder, parenting distress, and lack of continuous services. Despite high rates of service use, mental health outcomes remain poor. This paper reviews the literature on homeless children’s mental health, as well as prior theoretical explorations. Finally, the paper proposes a theoretical model that explains elevated rates of mental health problems among homeless children as consequences of harmful stress reactions triggered by chronic household instability along with repeated service disruptions. This model draws upon existing conceptual frameworks of child development, family poverty, health services utilisation, and the biology of stress to clarify the role of environmental chaos in the development of child emotional and behavioural problems. Potential strategies to mitigate the risk for mental health disorders among homeless children and future research directions are discussed. (Edited publisher abstract)
Taking it to the street: a psychiatric outreach service in Canada
- Authors:
- FARRELL Susan J, et al
- Journal article citation:
- Community Mental Health Journal, 41(6), December 2005, pp.737-746.
- Publisher:
- Springer
This paper describes a model of flexible psychiatric outreach service in Canada designed to meet the needs of persons who are homeless or marginally housed and have mental illness. The activities of the Psychiatric Outreach Team of the Royal Ottawa Hospital for individual clients and the community agencies who serve them are profiled, followed by a demographic and mental and physical health profile of the clients seen in the past year. The differences from other models of service and the benefits and limitations of this unique multidisciplinary team are discussed, with implications for future service development for this vulnerable population.
Meeting mental health needs of ethnic minority groups
- Authors:
- GAUNTLETT Nick, et al
- Journal article citation:
- Nursing Times, 18.10.95, 1995, pp.36-37.
- Publisher:
- Nursing Times
The TULIP Outreach Service uses a team approach model to provide community support to people with long-term mental health problems. It was primarily set up to reach people falling through the net of mainstream services, that is, homeless or potentially homeless people and those from minority ethnic groups. Describes how the team approach works in practice. It also gives the preliminary results of an evaluation showing the team's success in targeting and supporting these clients.
Harm reduction in a Norwegian housing first project: a qualitative study of the treatment providers’ practice
- Authors:
- ANDVIG Ellen Sofie, SAELOR Knut Tore, OGUNDIPE Esther
- Journal article citation:
- Advances in Dual Diagnosis, 11(1), 2018, pp.4-15.
- Publisher:
- Emerald
Purpose: Little is known about how harm reduction is practiced in Norwegian housing first (HF) projects. The purpose of this paper is to explore, describe, and interpret how providers apply a harm reduction approach within a housing project focused on individuals who are homeless with co-morbid substance use and mental health problems. Design/methodology/approach: This qualitative study was part of a larger evaluation study of a three-year HF project in a Norwegian municipality. Data were collected using four multi-stage focus groups with five providers working in the HF project. Focus group interviews were transcribed verbatim and analysed using thematic analysis. Findings: Analysis resulted in three main themes: “Letting the service user sit in the driver’s seat,” “We don’t follow service provision contracts, we do everything,” and “Collaborating with the local community.” Research limitations/implications: There is a need to develop increased knowledge about service users’ experiences within the harm reduction approach. Practical implications: To practice effective harm reduction, treatment providers must have open authorisations and the opportunity to exercise professional judgement. Harm reduction practice must also focus on social, political, and economic factors influencing users’ everyday lives. Originality/value: The paper contributes to the knowledge base on harm reduction within HF practice that differs from a traditional model wherein clients are expected to abstain from substance use. It highlights important preconditions for challenges practitioners might encounter at both individual and service system levels. (Publisher abstract)
Psychologically informed environments for homeless people: resident and staff experiences
- Authors:
- PHIPPS Catriona, et al
- Journal article citation:
- Housing Care and Support, 20(1), 2017, pp.29-42.
- Publisher:
- Emerald
Purpose: Many homeless people have significant levels of early adverse experiences and consequent mental health difficulties. This study examines the experiences of residents and staff living and working in a Psychologically Informed Environment (PIE), a new model of hostel for homeless people which aims to update and make more flexible the principles of the therapeutic community, thereby meeting the psychological and emotional needs of residents. Design/methodology/approach: Semi-structured interviews were carried out with nine residents, ten staff and five psychotherapists at two PIE hostels in London. The data were analysed using thematic analysis with a phenomenological epistemological approach. Findings: Analysis generated 18 themes for residents and staff combined, organised into five domains: what makes a home, resident needs, managing relationships, reflective practice and theory vs practice of PIEs. The study suggests that PIEs broadly meet their aim in providing a different type of environment from standard hostels. Efforts to build relationships with residents are particularly prioritised. This work can be challenging for staff and reflective practice groups provide a supportive forum. There are limits to the extent to which the theoretical PIE can be put into practice in the current political and economic climate. Originality/value: Originality/Value: This is one of the first qualitative studies of PIEs. It provides perspectives on their theoretical background as well as how they operate and are experienced in practice. It may be informative to services intending to establish a PIE and to commissioners in assessing appropriate resources. (Publisher abstract)
The Dartmouth Assertive community treatment Scale (DACTS): a generalizability study
- Authors:
- WINTER Joel P., CALSYN Robert J.
- Journal article citation:
- Evaluation Review, 24(3), June 2000, pp.319-338.
- Publisher:
- Sage
This article uses generalisability theory to assess the reliability of Dartmouth Assertive Community Treatment Scale (DACTS), which was developed to assess treatment reliability to assertive community treatment (ACT). The total scale scores for the DACTS demonstrated acceptable internal consistency and interrogator reliability. The generalisability analyses provide additional detail on the effects of site, occasion, and site by occasion interactions on the reliability of the DACTS.
Outreach to homeless mentally ill people: conceptual and clinical considerations
- Authors:
- MORSE Gary A., et al
- Journal article citation:
- Community Mental Health Journal, 32(3), June 1996, pp.261-274.
- Publisher:
- Springer
Describes a model of outreach predicated on developing a trusting, meaningful relationship between the outreach worker and the homeless person with mental illness. Describes five common tasks inherent in this model of outreach (establishing contact and credibility, identifying people with mental illness, engaging clients, conducting assessment and treatment planning, and providing ongoing service). Other issues discussed include: (a) responding to dependency needs and promoting autonomy; (b) setting limits while maintaining flexibility; (c)resistance to mental health treatment and follow-up service options.
Blackpool Fulfilling Lives. Year two evaluation report: value for money analysis
- Author:
- CORDIS BRIGHT
- Publisher:
- Cordis Bright
- Publication year:
- 2017
- Pagination:
- 48
- Place of publication:
- London
An evaluation of the second year of the Blackpool Fulfilling Lives (BFL) project, covering the period from 1 October 2015 to 30 September 2016. BFL is a Big Lottery funded project which supports people with complex needs, focusing on experiencing at least two of the following issues: homelessness, reoffending, problematic substance misuse, or mental ill health. The BFL service model includes the role of navigator, which has evolved from someone who would help service users to ‘navigate’ other services, to the point where therapeutic engagement, advice, advocacy and support have become part of the role. This second year evaluation explores why the navigator service model works and what benefits is has for individuals and the wider system. It includes a theory of change model, which explains how the changes BFL aims to help service users make lead to outcomes which results in reductions in the cost of homelessness, crime and poor physical and mental health. The methodology included a desktop review, interviews with service users and staff, and analysis of project data. The results of the evaluation show that the project is having a positive impact for service users; both staff and service users believe that the navigator model works well; and the involvement of people with lived experience as navigators helps people to engage and begin to trust workers. It finds that the BFL service plays a key role in reducing the costs of service use for the most complex people, who would otherwise continue to be heavy users of the criminal justice and health system. It estimates the service has the potential to save around £133,000 per person over a lifetime. (Edited publisher abstract)
Comprehensive services for complex needs: a summary of the evidence
- Authors:
- REVOLVING DOORS AGENCY, CENTRE FOR MENTAL HEALTH
- Publisher:
- Revolving Doors Agency
- Publication year:
- 2015
- Pagination:
- 11
- Place of publication:
- London
Summarises evidence for three ways of working with people with multiple and complex needs: Multisystemic Therapy; wraparound; and the link worker model. The needs of this group often includes mental health problems, offending, homelessness and substance misuse. These models seek to address repeated failures to help people facing multiple needs and address interrelated outcomes such as reducing reoffending, improving mental health and preventing further exclusion. Section one introduces the models and highlights common features developed for work with people with multiple and complex needs. Section two summarises the evidence for all three models, focusing on outcomes relevant to commissioners' responsibilities. Section three outlines the financial case for the models, which focus on preventing costly outcomes such as offending and homelessness. Section four raises some key considerations and recommendations for commissioners and for further research. (Edited publisher abstract)