Community Mental Health Journal, 53(3), 2017, pp.340-343.
Publisher:
Springer
Women engaging in substance use who have been justice-involved are systemically isolated from the legal economy and are therefore underresourced. Utilising a conservation of resources framework of stress, this study examined housing as a resource in 200 women exiting the criminal justice system who reported having a history of substance use. A general linear model was run to examine the relationship between the setting where participants spent the most time and CORE Loss scores. Women who had spent the majority of their time in independent house settings had significantly higher CORE-L scores compared to those who spent the majority of their time in precarious settings. This study highlights the importance of understanding housing within the context of working with underresourced populations, and the continued support necessary as women transition out of institutions and into the community.
(Publisher abstract)
Women engaging in substance use who have been justice-involved are systemically isolated from the legal economy and are therefore underresourced. Utilising a conservation of resources framework of stress, this study examined housing as a resource in 200 women exiting the criminal justice system who reported having a history of substance use. A general linear model was run to examine the relationship between the setting where participants spent the most time and CORE Loss scores. Women who had spent the majority of their time in independent house settings had significantly higher CORE-L scores compared to those who spent the majority of their time in precarious settings. This study highlights the importance of understanding housing within the context of working with underresourced populations, and the continued support necessary as women transition out of institutions and into the community.
(Publisher abstract)
Journal of Dual Diagnosis, 12(2), 2016, pp.153-162.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
Housing options for people exiting homelessness and seeking recovery from substance use disorders in the USA are limited. Policies tend to favour low-demand models such as Housing First and permanent supportive housing that do not require abstinence, but offer immediate housing placement based on consumer choice and separate housing from clinical services. While these models have proven effective in promoting housing retention, especially among individuals with a primary diagnosis of mental illness, evidence to support positive outcomes related to people with a primary or co-occurring substance use disorder are mixed. Recovery housing models provide abstinence-focused environments and integrated peer support embedded within a recovery framework. Various models exist along a continuum from fully peer-run to clinically staffed residences. However, this continuum is typically separate from the homeless services system, and many barriers to integration persist. This perspective paper argues that recovery housing is essential for supporting some homeless individuals and families. Within a comprehensive continuum based on choice, both recovery housing and low-demand models can support housing retention, reduce homelessness, promote recovery, and foster self-determination.
(Edited publisher abstract)
Housing options for people exiting homelessness and seeking recovery from substance use disorders in the USA are limited. Policies tend to favour low-demand models such as Housing First and permanent supportive housing that do not require abstinence, but offer immediate housing placement based on consumer choice and separate housing from clinical services. While these models have proven effective in promoting housing retention, especially among individuals with a primary diagnosis of mental illness, evidence to support positive outcomes related to people with a primary or co-occurring substance use disorder are mixed. Recovery housing models provide abstinence-focused environments and integrated peer support embedded within a recovery framework. Various models exist along a continuum from fully peer-run to clinically staffed residences. However, this continuum is typically separate from the homeless services system, and many barriers to integration persist. This perspective paper argues that recovery housing is essential for supporting some homeless individuals and families. Within a comprehensive continuum based on choice, both recovery housing and low-demand models can support housing retention, reduce homelessness, promote recovery, and foster self-determination.
(Edited publisher abstract)
Health and Social Care in the Community, 27(6), 2019, pp.1375-1387.
Publisher:
Wiley
Poor recovery among older adults with hip fractures can occur despite successful surgical repair and rehabilitation, suggesting other factors might play a role in recovery, such as social factors. The aim of this scoping review was to provide an overview of the literature on the role of social factors in older adult's recovery after hip fracture. This review followed the York Framework and its modifications and recent reporting guidelines. Two independent researchers searched main medical databases (CINAHL, EMBASE, Medline, PsycINFO and the Cochrane libraries) from inception to June 2017, for studies investigating social factors and recovery post hip fracture. Studies were excluded if they were qualitative, perspective papers or if participants were < 65 years or they were not living in the community. This study screened 2,503 unique abstracts in total and 19 studies fulfilled the inclusion criteria. Social factors investigated in the included studies were social support, socioeconomic factors and living arrangement. This study classified outcomes in the studies into three subgroups: physical functional recovery, mortality and other outcomes (pain, hospital length of stay and quality of life). This study found evidence that social support and socioeconomic factors (e.g. socioeconomic status) were significantly associated with an increase in functional recovery, a decrease in mortality and other outcomes, but conflicting evidence was found for the effect of one's living arrangement. Only two included studies were randomised controlled trials. To conclude, social factors, such as social support and socioeconomic status, affect physical functional recovery and mortality in older adults with hip fractures. However, this is an under researched area that lacks rigorously designed studies and would benefit from more studies with rigorous designs.
(Edited publisher abstract)
Poor recovery among older adults with hip fractures can occur despite successful surgical repair and rehabilitation, suggesting other factors might play a role in recovery, such as social factors. The aim of this scoping review was to provide an overview of the literature on the role of social factors in older adult's recovery after hip fracture. This review followed the York Framework and its modifications and recent reporting guidelines. Two independent researchers searched main medical databases (CINAHL, EMBASE, Medline, PsycINFO and the Cochrane libraries) from inception to June 2017, for studies investigating social factors and recovery post hip fracture. Studies were excluded if they were qualitative, perspective papers or if participants were < 65 years or they were not living in the community. This study screened 2,503 unique abstracts in total and 19 studies fulfilled the inclusion criteria. Social factors investigated in the included studies were social support, socioeconomic factors and living arrangement. This study classified outcomes in the studies into three subgroups: physical functional recovery, mortality and other outcomes (pain, hospital length of stay and quality of life). This study found evidence that social support and socioeconomic factors (e.g. socioeconomic status) were significantly associated with an increase in functional recovery, a decrease in mortality and other outcomes, but conflicting evidence was found for the effect of one's living arrangement. Only two included studies were randomised controlled trials. To conclude, social factors, such as social support and socioeconomic status, affect physical functional recovery and mortality in older adults with hip fractures. However, this is an under researched area that lacks rigorously designed studies and would benefit from more studies with rigorous designs.
(Edited publisher abstract)
Subject terms:
literature reviews, health, injuries, falls, recovery, older people, social care, socioeconomic groups, housing, standard of living;
Therapeutic Communities: the International Journal of Therapeutic Communities, 40(1), 2019, pp.51-65.
Publisher:
Emerald
... or parole to understand their experiences living in the houses, aspects of the houses that facilitated recovery, ways residence in an SLH affected compliance with probation and parole, and ways the houses addressed HIV risk, a widespread problem among this population. Interviews were audiotaped and coded for dominant themes. Findings: Study participants identified housing as a critically important need research. Originality/value: This paper is the first to document the views and experiences of persons on probation or parole who reside in sober living recovery houses. These data can be used by SLH operators to develop houses that are responsive to factors experienced as helpful and counterproductive. The significance of this paper is evident in the trend toward decreasing incarceration in the USA
(Edited publisher abstract)
Purpose: Persons in the USA who are incarcerated for drug offenses are increasingly being released into the community as a way to decrease prison and jail overcrowding. One challenge is finding housing that supports compliance with probation and parole requirements, which often includes abstinence from drugs and alcohol. Sober living houses (SLHs) are alcohol- and drug-free living environments that are increasingly being used as housing options for probationers and parolees. Although a few studies have reported favorable outcomes for residents of SLHs, little is known about resident experiences or the factors that are experienced as helpful or counterproductive. The paper aims to discuss this issue. Design/methodology/approach: This study conducted qualitative interviews with 28 SLH residents on probation or parole to understand their experiences living in the houses, aspects of the houses that facilitated recovery, ways residence in an SLH affected compliance with probation and parole, and ways the houses addressed HIV risk, a widespread problem among this population. Interviews were audiotaped and coded for dominant themes. Findings: Study participants identified housing as a critically important need after incarceration. For residents nearing the end of their stay in the SLHs, there was significant concern about where they might live after they left. Residents emphasized that shared experiences and goals, consistent enforcement of rules (especially the requirement of abstinence) and encouragement from probation and parole officers as particularly helpful. There was very little focus in HIV issues, even though risk behaviors were fairly common. For some residents, inconsistent enforcement of house rules was experienced as highly problematic. Research is needed to identify the organizational and operational procedures that enhance factors experienced as helpful. Research limitations/implications: Data for this study are self-reported views and experiences. Therefore, the study may not tap into a variety of reasons for resident experiences. In addition, the data set was small (n=28) and limited to one city in the USA (Los Angeles), so generalization of results might be limited. However, SLHs represent an important housing option for criminal justice involved persons and knowledge about resident experiences can help guide organization and operation of houses and identify areas for further research. Originality/value: This paper is the first to document the views and experiences of persons on probation or parole who reside in sober living recovery houses. These data can be used by SLH operators to develop houses that are responsive to factors experienced as helpful and counterproductive. The significance of this paper is evident in the trend toward decreasing incarceration in the USA of persons convicted of drug offenses and the need for alcohol- and drug-free alternative living environments.
(Edited publisher abstract)
Subject terms:
criminal justice, probation, licence, offenders, recovery, user views, qualitative research, housing, access to services;
Community Mental Health Journal, 55(2), 2019, pp.331-335.
Publisher:
Springer
Housing is an important factor for individuals addressing substance use disorders (SUD). This work compared aims and outcomes for new housing services and made suggestions for improvement. 16 new services were assessed over 6 months activity against factors identified as important. Services defined expected standards including (1) engagement with treatment for SUD, (2) restrictions on continuing substance use by tenants. After 6 months, 9 (56%) housing projects did not achieve planned standards and lowered criteria for inclusion. When setting up housing for people with SUD it is important to define clearly the nature of the intended service. Different types of housing programs in a network are needed to meet the evolving behaviour of tenants. One size does not fit all. Stable housing is important for people addressing SUD and these suggestions may increase the chance of providing a suitable foundation for people in need.
(Edited publisher abstract)
Housing is an important factor for individuals addressing substance use disorders (SUD). This work compared aims and outcomes for new housing services and made suggestions for improvement. 16 new services were assessed over 6 months activity against factors identified as important. Services defined expected standards including (1) engagement with treatment for SUD, (2) restrictions on continuing substance use by tenants. After 6 months, 9 (56%) housing projects did not achieve planned standards and lowered criteria for inclusion. When setting up housing for people with SUD it is important to define clearly the nature of the intended service. Different types of housing programs in a network are needed to meet the evolving behaviour of tenants. One size does not fit all. Stable housing is important for people addressing SUD and these suggestions may increase the chance of providing a suitable foundation for people in need.
(Edited publisher abstract)
Subject terms:
housing, substance misuse, recovery, alcohol misuse, drug misuse, rented accommodation, service provision, user views, placement disruption;
Mental Health and Social Inclusion, 21(5), 2017, pp.271-279.
Publisher:
Emerald
Purpose: The purpose of this paper is to understand how daily life reflects the recovery journeys of individuals with serious mental illness (SMI) living independently in the community.
Design/methodology/approach: The go-along technique, which blends participant observation and interviewing, was used to gather data from 19 individuals with SMI living in supported housing. Data were analysed through the CHIME framework of personal recovery, which includes social connectedness, hope and optimism, identity, meaning in life, and empowerment.
Findings: Applying the CHIME framework to qualitative data reveals the multiple ways in which everyday experiences, within and beyond formal mental healthcare environments, shapes personal recovery processes.
Research limitations/implications: Combining novel methods and conceptual frameworks to lived experiences sharpens extant knowledge of the active and non-linear aspects to personal recovery. The role of the researcher must be critically considered when using go-along methods.
Practical implications: Practitioners working with this population should account for the role of socially supportive and financially accessible spaces and activities that support the daily work of recovery beyond the context of formal care and services.
Originality/value: This study utilises an innovative method to illustrate the crucial role of daily and seemingly banal experiences in fostering or hindering personal recovery processes. It is also the one of the first studies to comprehensively apply the CHIME framework to qualitative data in order to understand the recovery journeys of individuals with SMI living in supported housing.
(Publisher abstract)
Purpose: The purpose of this paper is to understand how daily life reflects the recovery journeys of individuals with serious mental illness (SMI) living independently in the community.
Design/methodology/approach: The go-along technique, which blends participant observation and interviewing, was used to gather data from 19 individuals with SMI living in supported housing. Data were analysed through the CHIME framework of personal recovery, which includes social connectedness, hope and optimism, identity, meaning in life, and empowerment.
Findings: Applying the CHIME framework to qualitative data reveals the multiple ways in which everyday experiences, within and beyond formal mental healthcare environments, shapes personal recovery processes.
Research limitations/implications: Combining novel methods and conceptual frameworks to lived experiences sharpens extant knowledge of the active and non-linear aspects to personal recovery. The role of the researcher must be critically considered when using go-along methods.
Practical implications: Practitioners working with this population should account for the role of socially supportive and financially accessible spaces and activities that support the daily work of recovery beyond the context of formal care and services.
Originality/value: This study utilises an innovative method to illustrate the crucial role of daily and seemingly banal experiences in fostering or hindering personal recovery processes. It is also the one of the first studies to comprehensively apply the CHIME framework to qualitative data in order to understand the recovery journeys of individuals with SMI living in supported housing.
(Publisher abstract)
Subject terms:
severe mental health problems, mental health problems, mental health, recovery, recovery approach, supported housing, independent living, housing;
... (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasise a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidised or free housing and optional professional
(Edited publisher abstract)
Design/methodology/approach: In this paper the authors examine the literature on housing models for homeless persons with alcohol/other drug AOD problems in the USA and critically analysed how service settings and operations aligned with service goals.
Findings: The authors found two predominant housing models that reflect different service goals: sober living houses (SLHs) and housing first (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasise a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidised or free housing and optional professional services for substance abuse, psychiatric disorders, and other problems.
Research limitations/implications: If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of “recovery,” roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing.
(Edited publisher abstract)
Subject terms:
homeless people, alcohol misuse, drug misuse, substance misuse, housing, models, peer support, recovery, literature reviews;
Purpose: The purpose of this paper is to investigate how service professionals involved in the provision of services to clientele who use solvents and are often without stable housing understand the process of healing and recovery in their work.
Design/methodology/approach: Using a narrative methodology, semi-structured interviews were conducted with 12 human service professionals (i.e. social workers, case managers, etc.) employed in providing recovery-based services to individuals who use volatile solvents.
Findings: Despite the dominant cultural story about “street addicts” and solvent users’ limited possibilities for recovery, professionals indicate that they view their clients as “just like everyone else.” The dominant storyline was that of advocating for the capability of the client This study highlights how human service professionals make sense of their role in their work and how they maintain hope for themselves and for the recovery of the clientele they work alongside.
Purpose: The purpose of this paper is to investigate how service professionals involved in the provision of services to clientele who use solvents and are often without stable housing understand the process of healing and recovery in their work.
Design/methodology/approach: Using a narrative methodology, semi-structured interviews were conducted with 12 human service professionals (i.e. social workers, case managers, etc.) employed in providing recovery-based services to individuals who use volatile solvents.
Findings: Despite the dominant cultural story about “street addicts” and solvent users’ limited possibilities for recovery, professionals indicate that they view their clients as “just like everyone else.” The dominant storyline was that of advocating for the capability of the client group. These stories are discussed in relation to hope for professionals who provide health and housing services to clientele with complex and multi-systemic needs.
Originality/value: The findings have implications for how human service providers maintain hope and purpose in their work with stigmatized populations (e.g. homeless individuals, those with alcohol or other drug-related problems). This study highlights how human service professionals make sense of their role in their work and how they maintain hope for themselves and for the recovery of the clientele they work alongside.
Subject terms:
health professionals, attitudes, homelessness, solvent misuse, housing, service provision, recovery, social workers, substance misuse, complex needs;
Leaflet from a group of housing associations which highlights different approaches to tackling mental health issues in the West Midland. It provides brief descriptions of Midland Heart's Mental Health Step Down Service for people discharged from an acute mental health setting, Walsall Housing Group's Young persons housing project, which supports vulnerable young people maintain their independence; Nehemiah UCHA Retirement Living Service which supports black and minority ethnic older people, including those with dementia, to live independently; and the Fry Housing Trust's Support and resettlement service, which provides supported housing to vulnerable homeless adults who have multiple and complex needs. The examples emphasise the positive value of health and housing partnerships, and the savings and successful outcomes they bring for individuals.
(Edited publisher abstract)
Leaflet from a group of housing associations which highlights different approaches to tackling mental health issues in the West Midland. It provides brief descriptions of Midland Heart's Mental Health Step Down Service for people discharged from an acute mental health setting, Walsall Housing Group's Young persons housing project, which supports vulnerable young people maintain their independence; Nehemiah UCHA Retirement Living Service which supports black and minority ethnic older people, including those with dementia, to live independently; and the Fry Housing Trust's Support and resettlement service, which provides supported housing to vulnerable homeless adults who have multiple and complex needs. The examples emphasise the positive value of health and housing partnerships, and the savings and successful outcomes they bring for individuals.
(Edited publisher abstract)
Subject terms:
housing, dementia, mental health problems, supported housing, case studies, prevention, recovery, mental health services;
Purpose: The purpose of this paper is to describe a high-profile social enterprise in Blackpool, England, called Jobs, Friends and Houses (JFH) that has created a visible social identity of recovery and meaningful activity, to assess how stigma is challenged through active and visible community engagement.
Design/methodology/approach: Case study based on in-depth individual interview and focus been central to challenging stereotypes and discriminating attitudes and suggests that a social identity approach may be central to generating and sustaining a recovery community and to confronting and reversing long-held stigmatised attitudes.
Originality/value: The paper is important as it discusses the impact of recovery through engagement in meaningful activities that challenge stigma and exclusion through work. The paper is framed in terms of a social identity model of recovery.
(Publisher abstract)
Purpose: The purpose of this paper is to describe a high-profile social enterprise in Blackpool, England, called Jobs, Friends and Houses (JFH) that has created a visible social identity of recovery and meaningful activity, to assess how stigma is challenged through active and visible community engagement.
Design/methodology/approach: Case study based on in-depth individual interview and focus group, supplemented by participant in-depth interviews.
Findings: The paper describes one particular incident in which a worker at JFH intervened in a violent attack, possibly saving a woman’s life. The paper describes the experiences of internalised stigma and external exclusion being challenged by the development of a positive social identity and a pro-social community role that has high visibility. Data are presented showing the strong social identity experienced by participants and recognised by external stakeholders.
Research limitations/implications: This is a pilot study which uses an opportunistic design and much stronger longitudinal designs will be needed to address the issues raised in the paper.
Social implications: The paper argues that the visibility of the pro-social identity has been central to challenging stereotypes and discriminating attitudes and suggests that a social identity approach may be central to generating and sustaining a recovery community and to confronting and reversing long-held stigmatised attitudes.
Originality/value: The paper is important as it discusses the impact of recovery through engagement in meaningful activities that challenge stigma and exclusion through work. The paper is framed in terms of a social identity model of recovery.
(Publisher abstract)